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Patients' DNA tested to ID source of 8 Legionnaires' disease cases, including a death

LOCKPORT - DNA testing and surveys of cooling towers within a two-mile radius of Eastern Niagara Hospital are part of the investigation of the source of the bacteria that caused eight known cases of Legionnaires' disease in Lockport late this summer, including at least one death.

The probe began after a state-mandated test in September showed a high level of Legionella, the bacteria that causes the disease, in a rooftop cooling tower that's part of the air conditioning system at the Lockport hospital. The eight cases all were reported in residents who live near Eastern Niagara Hospital.

At least one of the Lockport cases was a fatality. Richard A. Jepson, 68, of Beverly Avenue, died July 22 in Buffalo General Hospital after being transferred there from Eastern Niagara Hospital two days earlier. His granddaughter, Sarah Davey, told The Buffalo News that Legionnaires' disease is listed as the cause of death on Jepson's death certificate.

The Niagara County Health Department won't discuss individual cases and wouldn't comment on whether there had been any deaths.

Niagara County Public Health Director Daniel J. Stapleton said Monday that the DNA of the bacteria found in the cooling tower is being compared to DNA collected from two of the eight Lockport residents. The testing is being done at the state's Wadsworth Laboratory in Albany.

Legionnaires' disease can result from a person breathing in the bacteria, which travels in "aerosolized water" - water vapor - floating through the air or emitted by an infected cooling tower, such as the one at the hospital.

But Stapleton said,  "There's been no evidence found to connect the Legionella in the tower to the Legionella in the patients' sputum."

The state lab is trying to grow the bacteria in the samples for comparison purposes, but so far without success. "There's 45 different strains of Legionella. That's why it's so complicated," Stapleton said.

That's also why it could be possible to zero in on the source of an outbreak through DNA comparisons and testing at various sites.

Ronald Gwozdek, county public health engineer, said samples were taken looking for the bacteria in cooling towers at Milward Alloys on Mill Street, VanDeMark Chemical on North Transit Street, ATI Specialty Materials on Ohio Street and Wyndham Lawn Home for Children on Lake Avenue.

Stapleton said all the tests showed very low levels of Legionella, although one sample from Wyndham Lawn isn't back yet.

The mere presence of Legionella does not mean a person will contract the disease. "Legionella needs to be a high number, and the people around there would have to be severely compromised in their health," Stapleton said. Smokers and people with depressed immune systems are most vulnerable to the pneumonia-like disease.

The U.S. Centers for Disease Control and Prevention says about 10 percent of reported Legionnaires' cases turn out to be fatal.

CDC spokeswoman Kristen Nordlund said, "Weather patterns and other factors can make a difference in how far cooling tower drift can travel. Most of the drift falls near the cooling tower, and most transmission of Legionella bacteria tends to occur within a quarter-mile of the cooling tower. However, transmission has occurred up to a mile or two away in several outbreaks, and as far as seven and a half miles away in one outbreak in New Zealand."

If the bacteria happens to fall on food, such as the plants in a vegetable garden, that doesn't make the food dangerous, Nordlund said. That's because the infection results from breathing in the bacteria, not swallowing it, although a person who got water in their lungs from having a drink go "down the wrong pipe" could contract the disease.

Legionella is found in the natural environment and likes to live in moist areas, such as air handling equipment. Gwozdek said drinking water supplies that undergo mandatory testing are not tested specifically for Legionella, but there is a "plate test" for all kinds of bacteria.

Gwozdek said a bacteria reading of more than 100 colony forming units per milliliter "would raise a red flag." The Eastern Niagara Hospital cooling tower scored more than 1,000 on that test, which the state has required since last year at all cooling towers every 90 days. The owners of the towers are required to log into a page at the State Health Department website to post their latest results, Gwozdek said.

After the high reading, the hospital sanitized its cooling tower with a special solution provided by one of its suppliers, Stapleton said. Results in a retest "were very good," he said.

Hospital spokeswoman Carolyn Moore said the hospital followed state guidelines in sanitizing the tower. "The hospital is confident that the cooling tower is functioning well," Moore said.

The hospital chlorinated its drinking water for a few days in August 2014 after Legionella was found in the pipes.


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