Italy: 878 pneumonia cases in Brescia province, legionella bacterium in the cooling towers

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?Pneumonia, the epidemic continues to scare. "The number of new accesses is stable", explains Regional Health Councilor Giulio Gallera, commenting on the update of the situation in the municipalities of Brescia and Mantua where there have been numerous cases of pneumonia since 2 September.?



?But the numbers seem to say more: Sunday there are 33 people who came to the emergency room with the symptoms of pneumonia. One third more on Saturday, when there were 22, and even three times more than on Friday, when around ten. "Once the peak phase is over - Gallera commented - we are entering a phase in which the number of accesses to the emergency room is now constant".

?Of the 33 accesses in the emergency room, there are a total of 21 hospitalizations, of which 12 in Ats Brescia and 9 in Ats Valpadana. Among these, the most serious is a 30-year-old boy from Calcinato, hospitalized in Montichiari for a suspected legionella. There are 40 people today who are positive to the legionella, with a new confirmed case.


?In addition to deaths, many patients are hospitalized in serious conditions. Two are from Remedello: a 43-year-old hospitalized at the San Gerardo hospital in Monza and a 56-year-old hospitalized in Pavia. Also in Monza also the 29 year old Ro? Volciano but originally from Lake Garda. In Milan instead the 57 year old Carpenedolo who was among the first to contract the legionella.


?To date, there are 191 people in the hospital. There are eight Brescian municipalities in which the epidemic would have been concentrated: Acquafredda, Calvisano, Carpenedolo, Ghedi, Isorella, Montichiari, Remedello and Visano. For all the other municipalities, the Council of Representatives of the mayors of Ats had written, "no extraordinary precautions are required to be observed, and it is not necessary to take precautions for attendance in schools and other centers of aggregation".?


http://www.bresciatoday.it/cronaca/p...ornamenti.html

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Epidemic of pneumonia in Lombardy: the current situation and ongoing investigations

Maria Cristina Rota¹, Maria Luisa Ricci¹, Maria Scaturro¹, Maria Gramegna², Antonio Piro³, Danilo Cereda⁴, Giovanni Rezza^1
1Dipartimento Malattie infettive, Istituto superiore di sanit?
²DG Welfare ? UO Prevenzione, Regione Lombardia
³Ats Brescia
⁴Ats Valpadana


September 13, 2018 - In relation to the pneumonia cases recorded in numerous municipalities of the Provinces of Brescia and Mantua starting from the beginning of September 2018, the Higher Institute of Health (ISS) emphasizes that the epidemiological and microbiological investigation of all cases is still ongoing and is aimed at finding an eventual common exposure such as: frequentation of environments, whether working or leisure or commercial activities, participation in public events or other. Specific actions are also under way to identify the source and methods of transmission of the bacterium. The data available at September 10 show: 235 accesses to the emergency room (the largest number registered on 6 and 7 September) 196 currently hospitalized people 12 people who refused hospitalization 2 deaths (including 1 with a confirmed diagnosis of legionellosis) 12 cases of legionellosis confirmed 9 cases hospitalized in intensive care units 9 Municipalities most affected, with at least 5 cases each.
The subjects involved are mainly males (about 70%), mainly elderly or people with immunosuppression conditions and / or with risk factors (such as smoking habits). Since the diagnosis of legionellosis was confirmed mainly on the day of 10 September (until the morning the confirmed cases were only 2), the epidemiological survey is now oriented towards a cluster of legionellosis. At the moment, clinical research continues on individual cases to confirm the etiologic agent of pneumonia in hospitalized patients. All cases of pneumonia will be tested for Legionella with more than one diagnostic method, since initially all cases were negative to the urinary antigen. Both the First Aid and General Practitioners (Mmg) and Care Continuity were alerted.

Environmental investigation After checking the drinking water distribution network, the possibility of possible connections between the various municipalities involved was excluded. However, sampling was carried out on the water network (more than 50 points sampled) and at the homes of those diagnosed with legionellosis. Sampling for the research of the Legionella pneumophila bacterium is now focusing on the cooling towers of the industrial settlements in the area. All the interested Municipalities are located near the river Chiese.
Regarding the communication aspects towards the population, the involved Auditors (immediately called by the local health authority of Brescia) received support and guidelines for communicating the risk to the population, underlining that currently there are no reasons to limit the use of the 'water. The Ats (Health Protection Agencies) concerned informed the population also through their institutional sites. The Ats and the Asst (Local Healthcare Organizations) concerned are still actively engaged in the investigations, in close connection with the DG Welfare - Prevention OU, the Higher Institute of Health and the Ministry of Health.

http://www.epicentro.iss.it/temi/infettive/EpidemiaPolmoniti2018.asp

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Pneumonia, Gallera: "42 cases of legionella pneumonia"


Alarm pneumonia. the regional councilor Giulio Gallera in a press conference in Brescia. Cases established "To date, 400 cases of pneumonia were detected, of which 42 were positive for the legionella bacteria. In total, the number of inmates is still at 200, including new admissions and resignations ". And the river Chiese? According to Gallera, among the large excluded, there is the river Chiese, which today would not seem to be the transmission vector, but in the
evaporative cooling tower there are the cooling towers of many industrial activities that rise right near the waterway.

https://bresciasettegiorni.it/cronac...da-legionella/

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Legionella is in cooling towers

MILAN, 17 SEP - "The results of the sampling carried out by ATS Brescia allow us to definitively establish that the cause is not found in the water of the aqueducts, but in the cooling towers of the companies. I calm down all citizens that they can continue to drink and use the water in the water supply in all tranquility ", said the Lombardy Region Welfare Councilor, Giulio Gallera after nine cooling towers in the Brescia area, nine they were positive for the legionella bacteria.

http://www.ansa.it/sito/notizie/topnews/2018/09/17/legionella-e-in-torri-raffreddamento_2c19df3b-70a8-4928-bd63-d7c0a28d3e2d.html

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Gallera: legionella in cooling towers, immediate sanification

The results of the sampling carried out by ATS Brescia have definitively established that the cause is not found in the water of the aqueducts, but in the cooling towers of the companies. This is a summary of what was declared by Giulio Gallera, Welfare Councilor of the Lombardy Region on the cases of pneumonia and the samplings carried out by ATS Brescia on the territories of the lower Brescia region and in the upper Mantua area. "I calm down all the citizens that they can continue to drink and use water from the water supply in complete tranquility". "To date - Gallera explained - the analysis of data allows us to concentrate all the efforts made by ATS in the cooling towers of companies. The results of the sampling carried out in the most affected municipalities are positive for Legionella. Of the 10 samples analyzed to date on the cooling towers of 3 companies in the Municipalities of Montichiari, Carpenedolo and Calvisano, 9 were positive for Legionella ".

Following the first results, the ATS Brescia convened the mayors of the three municipalities to provide the first appropriate information. Then they were sent a formal note requesting the issuance of contingency and urgent order to have the sanitation of some companies in their territory. It will also be assessed whether they have carried out biological risk assessments and self-checks. "We will extend the sampling work - the councilor pointed out - to a larger area and we will involve the mayors of the territory concerned so that all the companies can sanitize their cooling towers. By the end of the year, we would approve in the Regional Council a measure to record all the cooling towers in Lombardy, specific rules for their periodic sanification and checks and sanctions by ATS in case of failure to comply ". "Even in the river Chiese - has concluded Gallera - have been found of the positivity, but the reduced number makes us believe that it is not the river water the cause of the cases of pneumonia found in the last two weeks. It is hypothesized that legionella was present in stagnant pools, but we believe that there are no conditions because from there it spread in the environment, we remember that legionella spreads only through nebulized water ".

https://www.milanopost.info/2018/09/18/gallera-legionella-nelle-torri-di-raffreddamento-immediata-sanificazione/

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Falling pneumonia but hospital departments are full

Mantua Cases are falling say a little 'everyone and everywhere talking about the epidemic of pneumonia that hit in particular the provinces of Mantua and Brescia. All the doctors in Poma say so, where patients with pneumonia continue to arrive, and they are hospitalized all over the place, but especially in the Departments of Medicine, Emergency Medicine and Infectious Diseases. Twenty new hospitalizations during the past weekend compared to as many cases a day last week; in short, this epidemic will also be declining, but given the numbers, one should think that it is falling from figures much higher than the official ones. A "falling spike" of cases of pneumonia that in the last weekend also involved Bresciano, where on the day before yesterday, on Sunday, 33 new accesses were registered.

http://www.vocedimantova.it/articoli/6465794/Polmoniti-in-calo-ma-reparti-pieni-

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Legionella in Bresciano, reclamation started in the three companies suspected of the epidemic

Brescia, 19 September 2018 - Work in progress to sanitize the cooling towers of the three companies from which the abnormal wave of pneumonia and legionella in the lower Brescia region would have started. The paper mill of the Churches of Montichiari, the Acciaierie di Calvisano and the Gkn Wheels of Carpenedolo were reached, already on Monday evening, by the ordinances signed by the mayors of their respective municipalities, with the obligation to clear the towers within 72 hours to neutralize the health risks. The ordinances were drafted immediately after the results of the first analyzes of Ats Brescia had detected the presence of legionella in 9 samples out of 10 taken from the three subsidiaries. According to the director general of Ats Brescia, Carmelo Scarcella, the situation in Brescia is a case that "has no evidence in the international scientific literature, new in terms of size and mode of development".

Scarcella specifies that that of the towers for now is only a working hypothesis and that therefore there is no certainty that "they are responsible for the incident. It 'possible that they are - he explained - but we still have to analyze the weather data that allow us to understand if the emissions have moved in time in the direction of those municipalities that have been particularly affected by the episodes of pneumonia. It is not excluded that other cooling towers of neighboring municipalities may have made their contribution, so that Ats has extended the sampling to those known (there is, in fact, a monitoring). A series of concomitant factors such as high temperatures and a period of stoppage of plants, may have caused the water in the tanks to stagnate, creating a favorable situation for the reproduction of bacteria. The presence of legionella bacterium, alone, however, would not be enough to determine a contagion of such dimensions. An answer will come from the analysis of the winds. Among the hypotheses, there is also that the contagion could have started from a tower, and that from there, always the winds, may have spread the bacterium to the others, lighting more foci.

https://www.ilgiorno.it/brescia/cronaca/legionella-polmonite-1.4191758

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Pneumonia, ATS data: 43 people positive for legionella, almost 200 patients

It seems to be decreasing, at the level of cases, the epidemic of pneumonia that for a couple of weeks has been affecting the Bassa Bresciana and the Alto Mantovano. On Monday 17 September, with the results of the sampling carried out by the ATS, it was established that the epidemic is due to the cooling towers of some companies - positive for Legionella - in the Municipalities of Montichiari, Carpenedolo and Calvisano. So you get rid of the waters of the aqueducts that, right up to the other side, had come under the magnifying glass. The same ATS of Brescia then, after having definitively clarified the causes, continues with the daily collection and analysis of reports of cases of pneumonia, provided by public and private hospitals in the territories of ATS Brescia and ATS Valpadana. The data of last night, Tuesday, September 18, said this: 43 people positive to the legionella, 22 new accesses to the Emergency Room (including 5 at the ATS Valpadana), 14 admissions (including 4 at the ATS Valpadana) and 198 patients.

http://www.bsnews.it/2018/09/19/polmonite-dati-ats-legionella-positive-degenti/

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Contagion from Legionella, new suspected cases

The investigations are still ongoing to clarify the causes of the epidemic of pneumonia that is affecting the territory of Brescia. In these days access to the emergency rooms of the hospitals of Brescia and Mantua have decreased, but yesterday there have been more than 15 registered, with 12 new admissions. The cases of contagion from Legionella instead amounted to 43, with four people who had been hospitalized in serious conditions but which are now being improved. In the list of cases still to be clarified are added three friends who a few weeks ago went fishing in an artificial lake at Acquafredda. Under observation in a hospital in Mantua there is a 60-year-old woman from Asola: her case is suspect. The last established, however, is that of a 30 year old from Calcinato who works in a supermarket in Montichiari.

http://www.bsnews.it/2018/09/20/contagio-legionella-nuovi-casi-sospetti/

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Pneumonia, another dead: he was 57 years old and lived between Brescia and Mantua

Pavia, September 21, 2018 - Another died of pneumonia. He is a 57-year-old from Remedello, in the province of Brescia, admitted to San Matteo di Pavia. Even if only the results of the analysis can ascertain whether it is the fault of the legionella bacteria, which since the beginning of September has caused a peak of infections, even fatal, in the eastern Lower Brescia and in the Alto Mantovano. The country of residence of the victim is one of the municipalities affected by the epidemic of bacterial pneumonia. The patient arrived at the hospital in Pavia fifteen days ago, after being admitted to Mantua, due to the aggravation of the conditions, so much so that the use of the ECM for extra-body breathing was essential. But the man died at dawn yesterday. On Wednesday, however, a 90-year-old resident in the province of Brescia died in the Mantua area. To date, in the area between the Bassa Bresciana and Mantovano, there are 450 accesses for pneumonia occurred in the emergency room and 45 confirmed cases of legionella with two deaths due to the bacterium.

https://www.ilgiorno.it/brescia/cronaca/polmonite-legionella-morto-1.4194980

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Remedello cries two deaths killed by pneumonia

it raises to to 5 the number of victims caused by the epidemic of pneumonia who does not want to learn to loosen the grip on the Bassa. To the sad and disturbing list (the first to die was an 85 year old from Carpenedolo for bacterial pneumonia, then a 69 year old from the village of Mezzane di Calvisano for legionella and finally a 68 year old from Roe Volciano for suspected legionella) two inhabitants of Remedello were added. Gianfranco Bignozzi, 57, was hospitalized in serious condition on September 3 at the Carlo Poma hospital in Mantua due to bacterial pneumonia. Subsequently, due to the worsening of health conditions, he had been transferred urgently to the hospital of Pavia. Here, on the night between Wednesday and Thursday, he died in the intensive care unit. BIGNOZZI, well-known and known to Remedello with affectionate fondness as "Bengio" or "Benjamin", already had some health problems and bacterial pneumonia compromised his clinical picture.

http://www.bresciaoggi.it/territori/bassa/remedello-piange-due-morti-uccisi-dalla-polmonite-1.6769493

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Pneumonia, the epidemic continues: another nine cases in the province of Brescia

The Brescia Healthcare Agency continues with the daily collection and analysis of reports of pneumonia cases, provided by public and private hospitals in the territories of ATS Brescia and ATS Valpadana. To date, 20 September, there are 45 people with a positive legionella. There were nine new emergency room accesses and in six cases it was necessary to admit the seriousness of the health conditions. Currently, in Brescia, there are 151 people admitted to hospitals with pneumonia. Furthermore, in the last days there has been a case of suspected death due to the disease.

http://www.bsnews.it/2018/09/20/polmonite-lepidemia-continua-altri-nove-casi-in-provincia-di-brescia/?refresh_ce

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Pneumonia, two more victims. Towers in companies sanified

If it were legionella, it would be the youngest victim in Bresciano: 57 years. But there is no evidence to say that the man from Remedello, who died yesterday at the Pavia hospital, died of legionella infection. Certainly the death is related to severe pneumonia: as reported by the health authorities, until yesterday the 57 year old was not on the list of 45 patients suffering from pneumonia and at the same time positive results in the legionella test.

In the meantime, in the meantime, the 72 hours granted to the companies of Calvisano, Carpenedolo and Montichiari have expired to sanitize the cooling towers that were positive for Legionella bacteria. We do not know the bacterial concentration found by the technicians who performed the samples, but the health authorities trust that in this way we can stop the airborne contamination: the bacterium, in fact, can infect humans only by air, not drinking infected water .

As is well known, in fact, the Ats of Brescia has also found positive results in the taps of 17 homes, but in these cases the low boiler temperature or the negligence of the pipes could play a role. At the water network - wells and aqueducts - all the analyzes conducted so far were negative. The technicians and sanitary workers continue to work, without excluding the hypothesis of expanding the number of sanitation towers.

Since the beginning of the pneumonia epidemic, the number of pneumonia sufferers between Brescia and Mantova has exceeded four hundred. Several were treated at home, with antibiotics. Five deaths for pneumonia are five: a 69-year-old woman from Mezzane di Calvisano (positive to the bacterium), a 68-year-old who died at the Gavardo hospital, a 84-year-old woman from Carpenedolo and then the last two victims - the 90-year-old died in Mantua and the 57-year-old died in Pavia - both excluded from the list of patients with positive legionella tests. The prognosis for the 29-year-old Ro? Volciano admitted to the hospital in Monza or for a 43-year-old from Remedello in Monza, whose mother is admitted to Desenzano, has not been resolved.

https://brescia.corriere.it/notizie/cronaca/18_settembre_21/polmonite-altre-due-vittime-sanificate-torri-aziende-52dfd4c4-bd7d-11e8-92b2-6ab34b2db80e.shtml

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Pneumonia in Brescia: 13 in the emergency room, 8 hospitalized in the last hours


There were 13 people arrived in the emergency room today, and 8 new admissions for pneumonia in Bresciano. This was announced by the Health Protection Agency of Brescia, which continues with the daily collection and analysis of reports of cases of pneumonia, provided by public and private hospitals in the areas of Ats Brescia and Ats Valpadana. To date there are no new cases of positivity to Legionella, according to the Ats reporting also that "today have been carried out new sampling of water". On the killer pneumonia the Brescia prosecutor's office has long opened an investigation, while the Welfare Minister Gallera last week indicated in the cooling towers of some companies the cause of the legionella.

https://milano.repubblica.it/cronaca...eri-207184285/

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The epidemic of pneumonia is close to 500 cases: Legionella may not be the only cause

The reassurance of recent days collide with the reality of the facts. The epidemic of pneumonia that hit the provinces of Brescia and Mantua in Lombardy in particular since the beginning of September shows no sign of abating: the cases have reached a peak of 500. And they bring with them the uncertainty about the causes of contagion. Legionella, the bacterium considered the only one responsible, has so far been ascertained only in 45 of the 485 people affected by bacterial pneumonia.
In addition, more detailed investigations have "cleared" the paper mill of Lake Garda in Montichiari, Brescia, in whose cooling tower in recent days the Health Protection Agency had said it had traces of bacteria. And so, as written by the mayor of Montichiari Mario Fraccaro in a post, we came back in a certain sense to the starting point: "The Ats Brescia has just announced that the insights on the cooling tower West of the paper mill of Chiese have yielded negative and therefore ordered that the undersigned revokes the contingency and urgent sanitation recently issued against the company - wrote the first citizen in a post two days ago - We note this decision, but 14 days after the outbreak of the 'epidemic we are back to the starting point: therefore we are waiting for the solutions that Ats Brescia will want to provide as soon as possible about the pneumonia emergency to reassure our populations.

continua su: https://milano.fanpage.it/epidemia-d...la-sola-causa/

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