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

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[h=1]Pneumonia epidemic in the Brescia area. Over 600 registered cases and at least 2 deaths in the last 4 weeks[/h]
An epidemic of pneumonia occurred in Bresciano with over 600 cases and over 450 hospital admissions and at least two deaths in the last four weeks. The incidence of pneumonia in the period grew by more than nine times in eight municipalities in the Lower Bresciana Orientale, with peaks of 2,661% in Remedello, from where one of the two reported deaths, of 4,510% to Acquafredda, of 2,950% in Visano. The epidemic has however spread to the whole of Brescia and also to several municipalities of Mantua, affecting males twice in three and people aged less than 60 in 39% of cases, with ages between 60 and 75 in 24.5 % of cases and with age greater than 75 years in the remaining 36.5%. The average age of the sick is 64 and a half years.

The ATS of Brescia is engaged in the determination of the etiology, ie in the identification of pathogens responsible for this scourge and the modality of transmission of the disease. The ordinary instruments of forensic medicine, anamnesis and laboratory diagnostics available to the Brescia hospital clinic may not be sufficient. At present 48 cases of legionella have been recognized. Epidemic pneumonia is even more worrying today because it is flanked by the legionella epidemic which has caused 43 cases and 5 deaths in Bresso.

https://www.agenpress.it/notizie/20...ti-e-almeno-2-morti-nelle-ultime-4-settimane/

 

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[h=1]Epidemic pneumonia, after the black September remain many doubts[/h] Over 550 cases of pneumonia, about fifty caused by legionella and, for now, a certain death due to the bacterium. All this, in a well-circumscribed area of ​​Lower Brescia and the Upper Mantua, with seven municipalities in our province especially.

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As has not been confirmed for the towers of the fourth company analyzed and we are waiting for the results of the sampling of the fourteen towers of Visano. The framework, at least in the search for the causes of atypical pneumonia, is complicated. "The towers are one of the causes, but not the only one. For this reason, we do not leave any stone unturned, but it will take time to be sure that the strain of the bacteria in the towers is the same as that found in people who are positive for Legionella. The analyzes are entrusted to the Istituto Superiore di Sanit?, "said Carmelo Scarcella, the Director General of the Ats, who on Saturday, together with the health director Fabrizio Speziani, participated in the municipal council of Calvisano. The summits of Ats will also be present at the next councils of the most affected municipalities, in a framework full of shadows, but comforted by the ?slow, but gradual regression of the epidemic?.

https://www.giornaledibrescia.it/ba...-settembre-nero-restano-molti-dubbi-1.3304619

 

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[h=1]Legionella pneumonia, another suspicious death[/h]
Acquafredda cried a suspicious death, so that the Ats, in recent days, has reached the family of the deceased to ask questions about his habits and places frequented by man before falling ill. It was Saturday, September 8 when the 76 year-old Francesco Cropano died at the hospital in Montichiari, where he was hospitalized for pneumonia. A death remained quiet because, then, the emergency was only at the beginning. Suffice it to think of the fact that the first Ats sampling of the affected countries dates back to that Saturday, as well as the first convocation of mayors by the health authorities. We want to clarify the causes of death - says the Cropano family -. If necessary, an autopsy should also be performed, since it was not arranged immediately after death ".

https://www.giornaledibrescia.it/st...-legionella-un-altra-morte-sospetta-1.3305025

 

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Pneumonia, a legionella positive in the tower of a company in Visano

The Ats of Brescia informs with a note that the results of the analysis for the verification of presence of legionella made by the Brescia Public Health Laboratory on the fifth company, based in Visano, have shown that a cooling tower contained the bacterium, possible due to a part of the pneumonia. The Ats of Brescia has therefore ordered that the mayor of the municipality proceed to issue an urgent and contingent order for reasons of public health, imposing the sanification of the tower turned out positive. To date, there are 54 cases of legionella positivity in the critical area. But the data on new admissions for pneumonia in Bresciano are not available and it is therefore not possible to determine whether the phenomenon is growing or decreasing. Overall, according to some estimates, the number of infected persons is higher than 600 (with two confirmed deaths and one suspect): legionella, therefore, would be responsible only for one in ten cases.

http://www.bsnews.it/2018/10/04/polm...nda-di-visano/

 

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[h=1]Legionella, hunting for bacterial strains Comparison between the bacteria of 13 patients with that found at Ofar[/h]
From the cooling towers to the faucets at home, Ats continues to find out where the epidemic of pneumonia that hit the Lower Brescia region originated. That something exceptional is what the numbers say: from 2 to 26 September the first aid in the province of Brescia and Mantua managed 602 pneumonia, while in the same period of 2017 the number of cases was 258, or less than half. The sick so far "positive" results to the legionella are 54.
Attention, however: as confirmed by the infectious diseases, the clinical tests performed on patients admitted for pneumonia are not able to immediately highlight the presence of all legionella strains. For the most common strain (?1?), the urinary antigen is sufficient. Which has very short reaction times. While for other strains - for example the ?2-14? found in the cooling tower of the Ofar of Visano - it could take several weeks before the clinical outcome, for example with the examination of the patient's antibodies or with that of the research of DNA. Positives are therefore destined to rise. So far, the "positive" cases are 54.

And the choice of the Agency for the protection of health of Brescia was to take samples of water in the homes "of all the people who were positive for Legionella". It was then proceeded to check faucets, shower heads, sinks, pipes. Overall, since the beginning of the survey - and until September 28 - Ats technicians have carried out 244 samples, but each house has been the subject of more than one withdrawal of water. Of the 230 samples of water already tested, 26 were positive for Legionella.
In the meantime, antibiotic therapy has allowed almost all patients to heal. But it remains the node of the origin of the bacterium: the boiler of the house? The well of the first water table for irrigation purposes? The Churches? The cooling towers? Certainly, at the moment, the cooling machinery track remains in the spotlight.
Yesterday, the mayor of Visano issued a contingent and urgent ordinance to have the tower number 16 made sanitized positive for legionella culture. The Ofar of Visano still has 48 hours to clean up the plant, thus interrupting the airborne contamination. If ever there has been. One more proof will perhaps be from the laboratory tests of the citizens of Visano: if even the 13 people suffering from pneumonia will have traces of legionella "serotype 2-14" in the body then the experts of the Higher Institute of Health will have to tell us if there is a direct connection with the legionella found in the cooling tower of Visano. Conclusions to be put in black and white by experts, who still await many clinical and laboratory data. For now, in fact, several hypotheses remain open.

https://brescia.corriere.it/notizie...4b-11e8-9bde-b14535fa581c.shtml?refresh_ce-cp

 

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[h=1]Legionella pneumonia: new case recorded in the Brescia area[/h]
There is a new case of legionella pneumonia recorded in recent hours in the Brescia area. The epidemic, which has been affecting the provinces of Brescia and Mantova for over a month now, has struck again. In fact, in the past few hours - as reported by various sources - a man was admitted to the Ospedale Civile di Brescia because infected by the bacterium, which is attributed only ten percent of the total cases. The patient's condition does not seem to be serious as it is not in danger of life, but it has already been ascertained that this case is part of the number of the infected. The alert remains high.

http://www.bsnews.it/2018/10/10/polmonite-legionella-nuovo-caso-bresciano/?refresh_ce

 

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Pneumonia: in the Brescia area an average of 16 cases a day
Seven hundred and fifty cases diagnosed, an average of 16 per day between August 25 and October 10 last. The report of the Higher Institute of Health certifies that the epidemic of bacterial pneumonia registered in the Lower East is an "unprecedented phenomenon at national and probably continental" level. It is not so much the absolute number of infections that make the infectious wave anomalous, as the ratio between the average of expected and recorded cases, the limited size of the outbreak, the aggressiveness of the bacterium that has overlapped with that of legionella. In the "red" zone, the most affected area, which includes Carpenedolo, Montichiari, Calvisano, Visano, Remedello, Isorella and Acquafredda, in September the bacterial pneumonia was 200% higher than expected. During the peak the average of 24 infections per day was exceeded. No deviations from expectations, however, for Legionella, which also resulted in at least two confirmed deaths: the 56 cases diagnosed are in line with those expected by epidemiologists.


Per approfondire http://www.meteoweb.eu/2018/10/polmo...U36IoO3pwfg.99

 

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[h=1]A 56-year-old died, suspected legionella[/h]
The epidemic of bacterial pneumonia continues to reap its victims. On 15 October a 56-year-old died at the Brescia Civil Hospital and was hospitalized following a pulmonary infection. An autopsy was arranged to ascertain the causes

http://gazzettadimantova.gelocal.it...orto-un-56enne-sospetta-legionella-1.17362936

 

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Pneumonia: ?Epidemic run out ?. However, the analysis do not stop


The epidemic has run out. And the cases of pneumonia that are now found in the emergency room or in the studies of general practitioners are part of an epidemiological picture of normality. There is no doubt that the director general of ATC of Brescia, Carmelo Scarcella, reassures the population of the Municipalities of the Bassa. What is certain is that we are approaching the flu season and that pneumonia is one of the complications that can arise, especially in elderly patients or those suffering from chronic diseases. In the meantime, the investigation of the causes of the epidemic continues, which have not yet been fully ascertained. The Higher Institute of Health is responsible for this case. It has received both the environmental samples collected by Ats and those of patients tested positive for Legionella. A complex investigation therefore that will still require weeks of work.

https://www.giornaledibrescia.it/bas...lisi-1.3310027

 

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[h=1]Epidemic of pneumonia, the anger of the sick: united to claim compensation[/h]
The epidemic of pneumonia has stopped, but on the legionella front a new chapter could now open. That of compensation. Already fifteen people have turned to the lawyer Donatella Mento, asking them to represent them in civil. Waiting for the truth to emerge on the epidemiological front, there are those who make claims for compensation. This is, for example, a 29-year-old who was among the first to fall ill: pneumonia created serious problems with mobility, so today the young man - forced to a complex rehabilitation, still underway - would like to get compensation.


Yes, but to whom would the claim for compensation be debited? To the Health Protection Agency? Or to companies whose cooling towers were positive for legionella contamination? A very complex issue, given that at the epidemiological level it is not yet established who is at the origin of the infection. If the hypothesis of the companies, which had to sanitize their towers, was confirmed, it remains to be seen whether the companies will be considered responsible for the bacterial transmission or "victims" of the whole affair, as claimed by some entrepreneurs."Before advancing any hypothesis - explains the lawyer Mento - we must have all the material in hand, including the medical records that I am collecting. We are at an early stage. But we also await the results of the analyzes that will emerge from the studies of Ats and the Higher Institute of Health ?


It is clear that not all patients have had the same outcomes: some have had to deal with aggressive bronchopneumonia, those who have sustained long-term or permanent physical injuries. And then there are almost ten deaths from pneumonia: one case is established, it is legionella; three were negative for the bacterium; then the publication of the results of the autopsy of two deceased is awaited. In all, we speak of 878 people who have had to deal with pneumonia from early September until October 18 this year. A phenomenon repeatedly described as exceptional, but that threatens to leave people with a bitter taste: little news and the gattopardiana impression that now nothing will change.


https://brescia.corriere.it/notizie...8a-11e8-b2ec-2281f86eb2f8.shtml?refresh_ce-cp

 

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„The epidemic that continues to scare: more than 900 cases and already 10 deaths“


„The emergency seems outdated, but the alert remains high: this confirms the death of the 51-year-old Provaglio d'Iseo, who died on Sunday at the Civile probably due to legionella, on which the prosecution has already opened an investigation ( parallel to the investigations of a culpable epidemic that have been going on for a few weeks now).

„Alert high, and dutiful, also because of the numbers of the epidemic of pneumonia that has plagued the Lower Brescia, and not only: there are 868 confirmed cases, people who have turned to the emergency room. Of these, over 75% are those who were actually admitted to hospital, in all 654 patients. But there would also be another fifty list of subjects who took care of themselves at home, anyway reached by Ats. Out of the total number of patients suffering from bacterial pneumonia, less than 10% are those with a positive legionella

„A total of 54 cases: among the most affected countries, certainly Montichiari (with 8 cases of legionella), then Carpenedolo and Remedello (4 cases), Acquafredda (3 cases) and then with only one case Calvisano, Isorella and Visano. But it is Calvisano that for now there has been the only confirmed death due to legionella: the death of 69 year-old Guglielmina Castelletti, who lived in Mezzane.

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„Then there are eight more deaths, nine considering also the 51-year-old woman from Provaglio d'Iseo: three residents in Carpenedolo, two in Remedello and two others in Calvisano, one in Ro? Volciano. Just as a result of the violence of the epidemic in the Bassa was born a Committee of citizens (based in Montichiari, and captained by Carmine Piccolo) that has already announced battle: the next step is the implementation of a real class-action , to get compensation.“


https://www.bresciatoday.it/cronaca/...ella-dati.html

 

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Legionella pneumonia: ?Two years for answers?


'To date we do not have sufficient elements to create a correlation between what happened in the environment for the cooling towers of companies and the spread of legionella in humans'. This was stated by the director of AST of Brescia Carmelo Scarcella talking about the epidemic that caused 880 cases of pneumonia between late August and early September, of which 70 per legionella, in the Lower Brescia and the Mantovano. Not even the Istituto Superiore di Sanit? was able to give definite answers on the causes of what happened. ?It will take two years of analysis to have perhaps a definitive answer? added Scarcella. In the meantime, the investigation by the Complaints Agency for culpable epidemics remains open without any suspects.

https://www.giornaledibrescia.it/bassa/polmoniti-da-legionella-due-anni-per-le-risposte-1.3323280