Legionnaires' contributes to a third death

Man had been treated at Harford Memorial Hospital in June

Nurses contacting patients

Number of cases at 5

initial tests show tank was source in 3 of them

July 12, 1999|By Dan Thanh Dang | Dan Thanh Dang,SUN STAFF

A third person has died in an outbreak of Legionnaires' disease at Harford Memorial Hospital, raising to five the number of patients confirmed to have been infected with the bacteria, hospital officials said yesterday.

An elderly man who had been treated at the Havre de Grace facility last month was readmitted Friday with pneumonia-like symptoms and died there that evening, hospital officials acknowledged. On Saturday, test results showed that the man -- who was in the hospital from June 18 to June 28 for an unrelated illness -- had contracted the disease, they said.

"It is possible that we will identify more cases," said Dr. Peggy Vaughan, Harford Memorial's medical director. "We certainly hope not, but it can happen. There are still people out there who were exposed."

A team of six nurses worked yesterday to contact more than 400 patients who were treated at the hospital and possibly exposed to the disease during a two-month period before July 3, the day after hospital officials diagnosed a third and fourth case. That is also the date that the hospital super-heated its water system to eradicate the Legionella bacteria.

The state health department's preliminary tests confirmed last week that the hospital's hot water tank was the source for the bacteria in three of four cases at the hospital. Two of those people died there -- an unidentified patient June 26 and Elizabeth M. Cox, 79, on Tuesday.

Tests are continuing to determine whether the fourth patient, an elderly woman from a Havre de Grace nursing home who remains hospitalized, contracted it at Harford Memorial.

State health officials said yesterday that they strongly believe that the elderly man who died Friday contracted the disease at the hospital.

Hospital officials have refused to identify any of the patients because of state patient confidentiality laws. But hospital officials did confirm yesterday that all five of the patients with the disease were elderly.

"I think it would be fair to call this an outbreak now," said Tori Leonard, a spokeswoman for the Maryland Department of Health and Mental Hygiene.

Legionellosis is a bacterial infection that can cause a very mild respiratory illness or severe pneumonia that can lead to death. Symptoms include a dry cough, high fever, chills, muscle aches, diarrhea, fatigue, headache and abdominal pain. The disease is spread by water droplets in the air and the bacteria can develop in air conditioners, whirlpools, spas and showers.

Hospital officials are urging anyone who received treatment at Harford Memorial before July 3 and might be experiencing symptoms of Legionnaires' disease to contact a physician or go to the hospital for testing. It can take up to 10 days after exposure for symptoms to surface, doctors say.

The first case at Harford Memorial involved a patient who had been treated for an undisclosed illness and released. That patient was readmitted four days later, June 4, with pneumonia. When the patient did not respond well to antibiotics, the attending physician conducted a series of tests, including one for the Legionella bacterium. Those tests led to a diagnosis of Legionnaires' disease June 8.

Harford health officials were notified of the diagnosis, and the patient was treated and released.

On June 25, a second case was diagnosed. That patient, who had also been treated at the hospital earlier for an unrelated illness and released, died June 26, a day after being readmitted.

State health officials said that because the two patients had been discharged earlier, the hospital had no reason to suspect that the facility was the source of the infection -- until Cox and a fourth patient were diagnosed there with the disease July 2.

The fifth patient, who died Friday, was "very seriously ill with other medical conditions and Legionella contributed to, but was not the sole cause of, the death," hospital authorities said in a prepared statement released in response to media queries.

"This case shouldn't panic people," said Dr. Diane Dwyer, the state health department's chief epidemiologist.

Dwyer said the elderly man who died Friday contracted the disease before the hospital cleansed its water system July 3.

"If we had a case after July 3, that would indicate we have ongoing exposures even after the water treatment," she said. "In this case, it is unfortunate to have another case, but it's consistent with the time frame."

As of last night, Harford Memorial was not aware of any other patients with Legionnaires' cases, said Robert Netherland, the hospital spokesman.

"Almost everyone the nurses have called has been receptive. They are cooperating with us," Netherland said. "If they have any symptoms, we're asking them to call their personal physician, who would know their medical history, or to get testing if they need it. We are also telling them there will be no out-of-pocket charge for testing at our facility."

That news brought little comfort to Cox's family yesterday.

"My condolences go out to the family," said Ralph Cox, referring to the most recent patient who died of the disease. Cox buried his mother Friday at Rock Run Cemetery in Havre de Grace.

"It's devastating," Cox said. "You basically feel like you've been betrayed. Why weren't we told not to come there? It's deceitful. The hospital is supposed to be the pillar of this community. You're supposed to go there to get better, not to get infected and die."

Harford Memorial patients or their families can call the hospital's hot line with questions daily from 8 a.m. to 7 p.m. at 800-515- 0044.

Pub Date: 7/12/99

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