EAST HILLS, N.Y. -- Recognition that Legionella bacteria are transmitted to humans through contaminated water systems is increasing worldwide as the number of outbreaks of Legionnaires disease, a potentially fatal pneumonia, continues to rise.
The problem is at its most critical in hospitals due to the large concentration of people with compromised immune systems. They are at high risk of contracting Legionnaires disease, and are also at greater risk of dying from it. To help control the problem in medical settings, Pall Corporation is introducing for the European market its newest Pall-Aquasafe Water Filter (AQL3), a disposable point-of-use, clip-on showerhead, validated to remove Legionella for up to one month. The new water filter is being launched today throughout Europe at the 19th annual meeting of the European Working Group for Legionella Infections (EWGLI) in Chamonix Mont-blanc, France.
The latest epidemiological evidence points out that the prevalence of waterborne pathogens is considerably underestimated. According to EWGLI, more than 700 cases of Legionnaires disease were reported in Europe in 2002, tripling the number of reported cases over the past decade. In the United Kingdom (UK), approximately 300 cases of Legionella infections are diagnosed each year, of which approximately 15 percent are hospital-acquired. However, leading UK experts report that approximately 95 percent of cases are misdiagnosed or unreported. Legionella contaminates about 70 percent of hospitals there, thriving in their complex and often aging water systems. The problem of Legionella contaminated water systems has also been pervasive in some hospitals in France. To combat the problem, the French Ministry of Health issued a guideline that all hospitals install a 0.2 micron filter in water units where immune compromised patients are treated to protect against the spread of Legionella pneumophilia.
"Legionella contaminated water can be found in a wide variety of places throughout the hospital, from patient rooms to intensive care units," says Dr. Karen Wilkins, director of scientific and laboratory services at Pall Medical. "As it is frequently difficult to control its growth by using conventional methods of treatment and disinfection including high-temperature water pasteurization, ultra-violet radiation, chlorination and other anti-bacterial agents, this new water filter should have a major impact on the efficacy of infection control procedures based on the laboratory study."
The Pall-AquaSafe Water Filter is a CE marked medical device incorporating a 0.2 micron membrane validated to remove Legionella. Its effectiveness has been demonstrated in the clinical setting in French, Italian, German and British hospitals. The disposable showerhead is easy to clip on for protection. It withstands even high water temperatures and requires only a simple change every thirty days.
"The newest Pall-Aquasafe Water Filter enables the delivery of high volumes of water over an extended period of time for a cost-effective way to ensure protection against Legionella bacteria within the hospital water supply," says Roberto Perez, president of Pall Medical.
Legionella bacteria occur naturally in water sources in the environment such as lakes, rivers and reservoirs. Once the bacteria get into the water systems in buildings, such as hospitals, it can have serious consequences especially for people whose immune systems are compromised due to their disease and/or treatment of their disease such as cancer, transplants, HIV, burns and surgery, as well as for the elderly and newborns. Death occurs in anywhere from 5 to 15 percent of people who contract the infection and can be as high as 40 percent for the immune compromised.
People become infected when they breathe in the air that contains tiny invisible droplets of water, known as aerosols, which contain the Legionella bacteria. Aerosols can be formed wherever there is a buildup of biofilm on the surface of a faucet, showerhead, water pipe or storage tank. Biofilms are colonies of microorganisms, which can form on any surface exposed to water and bacteria. A patient taking a shower would inhale the bacteria in the aerosols when the water hits the hard surfaces of the shower unit.
A growing number of hospitals throughout Europe are using Pall-Aquasafe Water Filters as part of their routine standard for infection control wherever immune compromised patents are. Most recently, in Germany there was an official recommendation in the "Bundesgesundheitsblatt" for point-of-use filtration especially in areas with immune compromised patients in order to protect them from Legionella and Pseudomonas infections. Since the introduction of the first Pall-Aquasafe Water Filter, unit sales in Europe have grown on average 150 percent annually.
The AQL3 filter is the latest addition to the family of Pall-Aquasafe Water Filters that provide an effective barrier against contaminants in hospital water systems. The Company offers a variety of versions for the European market so that healthcare institutions can tailor infection control procedures to their specific needs and to the specific health guidelines of their nation. Pall provides a 7-day, 0.2 micron sterilizing grade filter for use on both taps and showerheads that is validated to remove a host of waterborne pathogens associated with hospital-acquired infections including the bacterium Pseudomonas and fungi in addition to Legionella. It also provides a 14-day, 0.2 micron sterilizing grade filter for use on showerheads and taps that is validated to remove Legionella. (The product information contained herein applies only to the European market.)
What The Experts Say About Legionella And Pall-Aquasafe Water Filters:
"Extrapolation of the data from a prospective study on community acquired cases of pneumonia has indicated that approximately 95% of cases of Legionnaires' disease are misdiagnosed or go unreported, partly because the symptoms of this atypical form of pneumonia are diverse and may not assist in the diagnosis of pneumonia. This would tend to suggest that the current level of reported cases of hospital-acquired or nosocomial Legionnaires' disease, at approximately 15 per annum, is also a far from accurate indication of how many patients acquire legionella infection while in hospital. Whilst hospital doctors are perhaps more likely to spot the symptoms and make a correct diagnosis more rapidly than GP's, due, in part, to easier access to diagnostic facilities, this needs to be balanced against the fact that hospital in-patients normally represent a far more susceptible population. Mortality rates from nosocomial Legionnaires' disease in this group are in excess of 30 percent (i.e., around three times higher than that for community and travel associated Legionnaires' disease). We don't know how many hospital-acquired cases of Legionnaires' disease are missed, but it is most likely to be considerably more than we are detecting, perhaps by a factor of 10 or more, as in community acquired Legionnaires' disease. What is beyond question is that the number of reported nosocomial cases of Legionnaires' disease is increasing, and this is borne out by recent cases in hospitals in Bath, Basildon, Liverpool and Birmingham."
-- Dr. Tom Makin, Directorate Manager, Department of Medical Microbiology, The Royal Liverpool and Broadgreen University Hospitals
"Legionella is a ubiquitous microorganism that is commonly found in municipal water systems, and up to 70 percent of UK hospitals have this bacterium in their water supplies. In recent years there have been an increased number of reports of hospital acquired infections throughout the country. We feel that hospital acquired waterborne disease is often overlooked, and poses a serious problem, particularly to high risk patients such as those undergoing transplantation, major surgery or who have long stays in intensive care. Leading experts will be discussing this issue at the Medical and Life Sciences Filtration Meeting to be held at the Hammersmith Hospital July 10, 2004, which this year focuses on `Nosocomial Waterborne Diseases.' Pall Medical's new shower head filter for removal of Legionella is a welcome addition to the technology available to clinicians to protect vulnerable patients from Legionella infection during their stay in hospital."
-- Professor Terry Gourlay, Department of Cardiothoracic Surgery, Imperial College London; Strathclyde University
"We have undertaken test work on behalf of Pall Medical to evaluate their new shower head filter for the removal of Legionella spp. from the water supply. The test protocol involved challenging the filter with high levels of Legionella pneumophila (approximately 1010 CFU) during simulated clinical use. The results demonstrated that the filters completely retained this organism for the period of time under test and would therefore provide an effective barrier to the waterborne transmission of this bacterium."
-- David Lamph, Laboratory Manager, Wessex Environmental Microbiology Services; Part of the Local and Regional Services Division of the Health Protection Agency
Source: Pall Corporation