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Allegheny County Health Department updates guidelines for controlling Legionella

Allegheny County Health Department updates guidelines for controlling Legionella

The Allegheny County Health Department on Thursday put out its first update in 17 years of its internationally known guidelines for Legionella control.

Spurred by the outbreak of Legionnaires’ disease in 2011 and 2012 at the Veterans Affairs Pittsburgh Health System that killed six veterans and sickened 22, the new guidelines are vastly different from the two predecessors that were widely adopted around the country and the world after the first version came out in 1993.

Not only is the new document longer — 70 pages versus 23 in the second, 1997 edition — it has a different objective than providing basic recommendations for how to prevent, detect and treat patients, as the previous guidelines did, said Melinda Moore, a senior national scientist at Rand Corp., which researched and authored the new guidelines for the county.

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“I think the intention was to provide an update of the state-of-the-art and best practices,” Dr. Moore said.

Rand was paid $60,000 by the Jewish Healthcare Foundation to put the guidelines together. The foundation was asked in early 2013 by both the Centers for Disease Control and Prevention and the VA to oversee the effort.

The foundation was approached because in the midst of the controversy over the Legionnaires’ outbreak, the federal agencies believed the foundation was “credible and neutral,” said Karen Wolf Feinstein, foundation president and CEO.

But the foundation’s health research arm, the Pittsburgh Regional Health Initiative, believed it didn’t have “the muscle” to get such an undertaking done on its own and to get it done quickly, said Keith Kanel, the health initiative’s chief medical officer, and it decided to hire Rand.

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Sharon Silvestri, who is chief of the infectious disease program for the county and was consulted on the new guidelines, said they come at a different time than the previous guidelines.

Many facilities that worry about Legionnaires’ in their water, particularly hospitals, already have protocols in place.

“The document is more of an overall guideline to let facilities know that there are steps you can take to reduce Legionella in your facility,” she said.

First Published: October 24, 2014, 4:00 a.m.

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