Phigenics - Water Management Company

Questions and Answers
What is Legionnaires' disease?
	Legionnaires' disease is a type of pneumonia that is caused by Legionella, a bacterium found primarily in warm water environments. Both the disease and the bacterium were discovered following an outbreak traced to a 1976 American Legion convention in Philadelphia. Pontiac fever, a flu-like illness, is also caused by Legionella organisms (legionellae), but is not as serious as Legionnaires' disease. Most people who get Pontiac fever recover within five days, without having to be hospitalized.
How do people get legionellosis?
	People get legionellosis when they inhale aerosols (water mist) that carry Legionella bacteria. People can be exposed to aerosols from mist-producing devices (especially water heaters and air-conditioning systems) in their homes and in workplaces, hospitals, or other public places.
What are the symptoms of Legionnaires' disease?
	Legionnaires' disease develops within 2 to 10 days after exposure to legionellae. Initial symptoms may include loss of energy, headache, nausea, aching muscles, high fever (often exceeding 104°F), and chest pains. Later, many bodily systems as well as the mind may be affected. The disease eventually will cause death if the body’s high fever and antibodies cannot defeat it. Victims who survive may suffer permanent physical or mental impairment.
How is Legionnaires' disease treated?
	Erythromycin and Azithromycin, antibiotics, have been effective, especially when cases are detected early.
Who is at risk of contracting Legionnaires disease?
	The risk of infection is based on two key factors: the number of legionellae reaching the body and the resistance of the individual. Young and healthy people can get Legionnaires’ disease, but persons who are immunocompromised either because of illness (e.g., cancer) or medical treatment (e.g., chemotherapy) are at a much higher risk because they can be infected by relatively low legionellae counts. HIV-infected patients, for example, have a 40-fold increased risk; organ transplant recipients have a 200-fold increased risk. Smokers, persons over 65 years of age, and heavy drinkers have a moderately higher risk. Children have contracted Legionnaires' disease. Most cases have occurred in immunosuppressed children, but a number of immunocompetent children, particularly newborns, have acquired the disease, most often after surgeries, or through the use of legionellae-contaminated ventilators.
*Is Legionella* Prevalent in Health Care Facilities?**
	Phigenics has developed the Phigenics Water Management Subscription in response to the increasing incidence of disease resulting from water contaminated with waterborne pathogens in healthcare facilities. The Phigenics Water Management Subscription is designed to help healthcare executives and administrators prevent and respond to waterborne pathogen disease resulting from contaminated water in their facilities.
What is the death rate?
	Underlying disease and advanced age not only increase the risk of contracting Legionnaires’ disease but also the risk of dying from it, so it is not surprising that a CDC study of reported cases indicated a death rate of 40 percent for cases acquired during a hospital stay (nosocomial cases), but a death rate of 20 percent for community-acquired cases. Some outbreaks have claimed more than 50 percent.
What is PVT?
	The Phigenics Validation Test (PVT) is a new field method for the quantitative determination of viable Legionella and total heterotrophic aerobic bacteria. The method has been proven reliable for determining viable cell concentrations of Legionella pneumophila, Legionella species and total heterotrophic aerobic bacteria. In comparison to standard methods, the new protocol has been shown to be more accurate, faster and more convenient. The Issue Currently, measurement of viable Legionella and other bacteria using standard culture methods require shipment of water samples to an analytical laboratory. The results typically take 12-14 days which can leave facilities in a holding pattern. The shipment of water samples can cause unpredictable changes: In some water samples, viable bacteria increase during transit and in other samples they decrease. When the facility receives their Legionella results, these challenges can make interpretation and decision-making difficult. The Solution The patents pending Phigenics Validation Test (PVT) completely eliminates the need to ship water samples, thereby giving more reliable data about the water system. The PVT is a field sampling protocol to obtain viable cell counts (CFU/ml) for the following: - Total heterotrophic aerobic bacteria - Legionella pneumophila (serogroup 1 and serogroups 2-14) - All non-pneumophila Legionella species Data is obtained for the exact moment when the PVT field sampler contacts the water sample. Shipment of water samples to laboratory is not required. Time required to obtain results is reduced 75-80% compared to the Standard Method for Legionella. Test results including quantitative viable cell counts, digital photographs of the field samplers and authenticity labels are emailed to the facility, typically within 2-3 days of receipt of the sample in the lab. The PVT validates under operating conditions in the field that bacterial hazards in water have been eliminated, reduced or prevented from harming people (Principle 7 in Hazard Analysis and Control) The Benefits Compared to the Standard Methods for total bacteria and Legionella, the PVT is: * More accurate, because water samples are not compromised during shipment to the laboratory. * Faster, because transit time is not wasted and microcolonies are enumerated directly on the PVT field samplers. * More convenient, because results for total bacteria AND Legionella bacteria are obtained and archived by the Phigenics Analytical Services Laboratory in a standardized protocol for future reference. If you are interested in how the PVT can address the safety of water systems in your facility, please contact Phigenics at 630-717-7546 for more information.
What is a Water Management Plan?
	A comprehensive water management plan helps kickstart a successful water management program. This plan includes clear information about how a facility uses its water, from the time it is piped onto the facility through disposal. Knowledge of current water consumption and its costs is essential for making the most appropriate water management decisions. What is in a Water Management Plan? Water Treatment Strategy * Chemical, Mechanical and Operational Solutions * Focused to Minimize Cost and Maximize Reliability Control and Monitoring * Based upon Critical Control Points in the Water Process * Establish Critical Limits that Maximize System Performance Corrective Actions * Procedures to Address Test Results Outside Critical Training * Decision Trees Provide Systematic Troubleshooting for Facility Staff Validation and Verification * Independent Quantitative Data Generated under operating conditions that hazards have been removed from the system * Evidence that the Plan is being followed Record Keeping * Documentation of Decision Making Process * Periodic Validation Reports and Business Reviews
What is HACCP?
	Hazard Analysis and Critical Control Point (HACCP) is a systematic approach to identifying and controlling hazards (microbiological, chemical or physical) that pose a danger to the preparation of safe food. HACCP seeks to control the safety of ingredients and supplies coming into a food business and what is done with them thereafter. The implementation of HACCP is a legal requirement for many American and most European food. The 7 Principles of HACCP: 1. Systematically analyze hazards using process flow diagrams 2. Identify critical control points (CCPs) 3. Establish critical limits for each CCP 4. Establish control and monitoring procedures 5. Establish corrective action procedures 6. Establish record keeping plan, a crisis response plan and assign responsibilities 7. Regularly validate and verify that the HACCP plan is being effectively implemented Phigenics 5 Preliminary Steps: 1. Assemble a Phigenics-facilitated HACCP team of facility personnel 2. Identify the end users water especially to determine at-risk consumers 3. Identify all uses for water at the facility 4. Develop process flow diagrams to describe how water is processed in the facility 5. Verify that process flow diagrams are accurate by on-site confirmation
What is the size of Legionella organisms?
	The average Legionella cell is 0.5-1.0 micrometer wide and 1.0-3.0 micrometers long (Barbaree, J. M. "Controlling Legionella in Cooling Towers," ASHRAE Journal, June 1991; 38-42).
What are the long term side effects of Legionnaires disease? I heard asthma is one side effect.
	As with any acute illness, patients who recover from Legionnaires' disease can suffer long term side effects. The most common are fatigue and lack of energy for several months. However, asthma of new onset is uncommon, although I know of a few cases who have persistent chest x-ray abnormalities with sustained wheezing. It is unclear as to whether this can be blamed solely on Legionnaires' disease; asthma may be due to a number of stresses besides Legionnaires' disease. Answer provided by Victor L. Yu, MD, Professor of Medicine, Unviersity of Pittsburgh; Chief, Infectious Disease Section, VA Medical Center, Pittsburgh, PA, USA.
What can I do to make my home less conducive to Legionella contamination?
	A. The plumbing system (via showers and faucets), whirlpool spas and bathtubs, and humidifiers present a potential risk of legionellae exposure in homes. A number of measures can be taken to minimize legionellae growth. The long list of risk reduction options for homes cannot be covered in this brief FAQ.
Are certain types of buildings more prone than others to have problems with legionellae?
	Cases of Legionnaires' disease have been linked to many types of equipment that contain water, but plumbing systems and air conditioning systems are most often blamed. Although it is possible to contract the illness from legionellae growing in home plumbing systems, most cases have been traced to large buildings. This may be because larger piping networks are generally more conducive to legionellae growth. Also, the air conditioning systems for large buildings often include cooling towers, which contain a pool of warm water in which legionellae can flourish.

Legionella FAQ

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