Poland - Legionnaires' outbreak in the city of Rzeszow kills 24

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Legionnaires' outbreak in southern Polish city kills five

Reuters
August 24, 20237:01 AM CSTUpdated an hour ago

WARSAW, Aug 24 (Reuters) - An outbreak of Legionnaires' disease in the southern Polish city of Rzeszow has killed five people so far, a doctor said on Thursday, as authorities scrambled to find the source of the bacterial infection, which they believed was in the water supply.

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https://www.reuters.com/business/he...k-southern-polish-city-kills-five-2023-08-24/

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Translation Google

A fifth person with Legionella has died, and the number of infected is rising. There is an appeal to the people

TVN24 | Cracow

August 24, 2023, 8:44
Author: ms/current
Source: PAP, tvn24.pl
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A 79-year-old patient died at night in the City Hospital in Rzeszów. She was infected with the Legionella pneumophila bacteria, Grzegorz Materna, director of the City Hospital at ul. Rycerska. This is the fifth person to die from Legionella infection.

The 79-year-old lived in Rzeszów. She was hospitalized a few days ago. "She was a patient with multiple diseases, including cancer. She was in the anesthesiology and intensive care ward. Tests confirmed the presence of bacteria" - said Grzegorz Materna. A 70-year-old man died in the same facility a day earlier.

Three other people died in the University Clinical Hospital at ul. Szopena and in the Podkarpackie Center for Lung Diseases at ul. Rycerska.

In the hospital at ul. Rycerska, there are currently 15 people with confirmed legionella. Two patients are in critical condition in the intensive care unit. Eleven patients are in the hospital at ul. Chopin, and nine - in the Podkarpackie Center for Lung Diseases at ul. Rycerska. "Three people are in a serious condition in the ICU" - said Andrzej Sroka, spokesman for the USK.

Legionella in Rzeszów. The president appeals to the people

On Thursday, a press conference was held at the Rzeszów town hall, during which the situation related to legionella infections was discussed.

According to Jaromir Ślączka, director of the Poviat Sanitary and Epidemiological Station in Rzeszów, the first confirmed notification about a person infected with legionella was received by the health department on Thursday, August 17. The infection was found in one of the patients of the University Clinical Hospital in Rzeszów.

- To date, the infection has already been confirmed in 76 people - he said. Most of them are elderly people. Patients are staying in hospitals in Rzeszów and in the Rzeszów poviat.

He added that an epidemiological investigation is underway to determine the source of infection. Samples have been taken, the results are expected on Monday, August 28. The source of the infection has not yet been located.

When asked by journalists, he said that in recent years no legionella infections have been found in Rzeszów and the Rzeszów district.

The Mayor of Rzeszów, Konrad Fijołek, assured that the city has been monitoring the situation from the beginning. - We ordered the involvement of city services to look for potential sources of bacteria in the city and the surrounding area - he said. He added that samples for testing were taken from the municipal network and water intakes on the same day.

He reminded that the next weekend (August 26-27) the water supply system will be disinfected. He stressed that these are preventive measures. - A dose of chlorine will be introduced into the network on Saturday, it should spread throughout the network on Sunday and decontaminate it - said Konrad Fijołek.

- When, especially on Sunday, we fill the tank with water, be it a kettle or a jug, it is worth draining the water a little earlier, and if we notice a larger amount of chlorine, we need to let the water cool down a bit and boil it best - he appealed.

The number of infected people is growing, the health department has already detected legionella in 76 people
Jaromir Ślączka, head of the Rzeszów Sanitary Inspectorate, announced on Thursday morning that legionella had already been confirmed in 76 patients hospitalized in Rzeszów, in the Rzeszów poviat, Dębica and Przemyśl. "Five new confirmed test results for Legionella pneumophila concern patients hospitalized in hospitals in Rzeszów and the Rzeszów district" - said Jaromir Ślączka.

The largest number of people with confirmed legionella causing legionellosis, i.e. acute pneumonia, are residents of Rzeszów - 54, Rzeszów poviat - 15, Dębica poviat - 3 and one case each from the following poviats: Ropczycko-Sędziszów, Nizański, Stalowowolski and Przemyśl.

Sanepid also informed that so far 56 water samples have been collected for testing from installations in Rzeszów, Rzeszów and Ropczyce-Sędziszów poviats.

The crisis team meets in the town hall

The meeting of the crisis staff was attended by Mayor Konrad Fijołek, Jaromir Ślączka, director of the Poviat Sanitary and Epidemiological Station, Zbigniew Sowa, director of the municipal crisis management department and directors of municipal and environmental companies.

Bartosz Gubernat from the Chancellery of the President of Rzeszów told PAP that "the situation related to legionella infections will be discussed at the meeting"

As PAP learned, Deputy Minister of Health Waldemar Kraska , head of the Minister's Crisis Management Team, is to come to Rzeszów on Thursday.

The Minister of Health at a meeting at the Voivodship Office in Rzeszów

On the night from Wednesday to Thursday, the crisis team convened urgently was convened at the Podkarpackie Voivodship Office. The meeting was attended by the Minister of Health Katarzyna Sójka and the Deputy Minister of Health Marcin Martyniak, Ewa Leniart, the Podkarpackie Voivode, and Krzysztof Saczka, the head of GIS.

After the meeting, the Ministry of Health announced on social media that "the variant regarding the municipal water supply network as a source of infection is being verified. A strategy for further actions to extinguish the outbreak, necessary for immediate action by the competent authorities, has been established."

On Wednesday, the head of the Rzeszów Sanepid, Jaromir Ślączka, announced that the number of hospitalized people in the Podkarpackie Voivodeship with confirmed Legionella pneumophila infection had increased to 71. Four people died.

An epidemiological investigation is underway

An epidemiological investigation is underway to determine the source of infection, as well as other anti-epidemic measures, including inspections and water collection for laboratory tests. The first test results from the samples taken from the hot water installation from the municipal water supply points will be known on Monday. The waiting time for the results of Legionella pneumophila tests after sampling is up to 10 days.

First, samples were taken at water intake points in the city, and then samples were taken from the homes of infected people.

The city temporarily shut down all fountains, water curtains and drinking fountains.

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https://tvn24.pl/krakow/rzeszow-pon...iec-zmarlo-zebral-sie-sztab-kryzysowy-7305208

 

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Translation Google

Seven people are dead, the number of infected with Legionella has exceeded 100

TVN24 | Rzeszow

August 25, 2023, 7:55 am
Author:
ms,pp,bp/current

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113 people infected with legionella in Rzeszów, 7 victims. More and more cases

The seventh person infected with legionella is dead, Chief Sanitary Inspector Krzysztof Saczka said on Friday morning. On Thursday, a meeting of the municipal crisis staff took place in the town hall in Rzeszów. According to the latest announcement of the health department, 113 people have already been infected with the dangerous bacteria - all of them have been hospitalized. Due to the growing number of infections, the provincial sanitary inspectorate has appointed an expert team.

On Friday morning, the Podkarpackie sanepid announced that so far seven deaths of people infected with legionella "and burdened with comorbidities" have been confirmed in the province. The number of infections with this bacterium has increased to 113.

"37 new confirmed test results for Legionella pneumophila concern patients who have been hospitalized so far in hospitals in the Podkarpackie Voivodeship" - we read in the Friday release of the Sanepid. In total, 76 patients with legionella come from Rzeszów alone, 23 are from the Rzeszów poviat. In other poviats of Podkarpacie, these are isolated cases.

Legionella in Rzeszów. Sanepid appoints an expert team

According to the Government Center for Security, the threats related to legionella infections in Podkarpacie are discussed on Friday by the Government Crisis Management Team.

In connection with Legionella infections in the city of Rzeszów and the Rzeszów poviat, the Podkarpackie State Provincial Sanitary Inspector appointed an expert team. It is primarily intended to support anti-epidemic activities and exchange experiences in combating outbreaks of infectious diseases.

As reported on Friday by the Podkarpackie sanitary inspector Dr. Adam Sidor, the first meeting of the team, which took place online on Thursday, was attended by representatives of the Chief Sanitary Inspectorate, the director of the National Institute of Hygiene and the Office of the World Health Organization (WHO) in Poland and the National Consultant in the field of epidemiology , and the director of the Social Policy Department of the Podkarpackie Voivodeship Office.

The leading task of the team is to support the anti-epidemic activities of the State Poviat Sanitary Inspector in Rzeszów, the Mayor of the City of Rzeszów and entities responsible for individual elements of municipal infrastructure in the City of Rzeszów, as well as the exchange of experience in combating outbreaks of infectious diseases .

The team will meet periodically.

What is known about the dead?

The Chief Sanitary Inspector added that all the people who died were "people heavily burdened with a health situation, with chronic diseases - especially oncology - with reduced immunity". Six of the deceased patients came from Rzeszów, one person - from the Rzeszów poviat.

- These are people aged 63 to 95. Four men and three women, emphasized Saczka.

A 79-year-old patient died in the night from Wednesday to Thursday in the City Hospital in Rzeszów. The woman lived in Rzeszów. She was hospitalized a few days ago. "She was a patient with multiple diseases, including cancer. She was in the anesthesiology and intensive care ward. Tests confirmed the presence of bacteria" - the hospital said. A 70-year-old man died in the same facility a day earlier.

Three other people died in the University Clinical Hospital at ul. Szopena and in the Podkarpackie Center for Lung Diseases at ul. Rycerska.

Patients are hospitalized in Rzeszów and the Rzeszów poviat, but also in Dębica, Przemyśl, Kolbuszowa, Łańcut and Sędziszów Małopolski.

Legionella in Rzeszów. The president appeals to the people

On Thursday, a press conference was held at the Rzeszów town hall, during which the situation related to legionella infections was discussed.

According to Jaromir Ślączka, director of the Poviat Sanitary and Epidemiological Station in Rzeszów, the first confirmed notification about a person infected with legionella was received by the health department on Thursday, August 17. The infection was found in one of the patients of the University Clinical Hospital in Rzeszów.

- To date, the infection has already been confirmed in 76 people - he said. Most of them are elderly people. Patients are staying in hospitals in Rzeszów and in the Rzeszów poviat.

He added that an epidemiological investigation is underway to determine the source of infection. Samples have been taken, the results are expected on Monday, August 28. The source of the infection has not yet been located.

He reported that in recent years, no legionella infections have been found in Rzeszów and the Rzeszów poviat.
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The Mayor of Rzeszów, Konrad Fijołek, assured that the city has been monitoring the situation from the beginning. - We ordered the involvement of city services to look for potential sources of bacteria in the city and the surrounding area - he said. He added that samples for testing were taken from the municipal network and water intakes on the same day.

He reminded that the next weekend (August 26-27) the water supply system will be disinfected. He stressed that these are preventive measures. - A dose of chlorine will be introduced into the network on Saturday, it should spread throughout the network on Sunday and decontaminate it - said Konrad Fijołek.

- When, especially on Sunday, we fill the tank with water, be it a kettle or a jug, it is worth draining the water a little earlier, and if we notice a larger amount of chlorine, we need to let the water cool down a bit and boil it best - he appealed.

As the sanitary inspectorate informed on Thursday, so far 56 water samples have been collected for testing from installations in Rzeszów, the Rzeszów and Ropczyce-Sędziszów poviats.

The first patient cured of legionellosis left the hospital

Spokesman for the University Clinical Hospital (USK), Andrzej Sroka, announced on Thursday that a 70-year-old man, infected with the Legionella pneumophila bacteria, left the USK on Thursday at ul. Chopin in Rzeszów. This is the first patient cured of legionellosis at the facility, PAP reported.

"The patient was in a gastroenterology clinic, where he reported symptoms of legionellosis. Today he left the hospital in good condition. He had no comorbidities" - Sroka told PAP.

He added that the second patient cured of legionellosis, who has been in the urology clinic for several days, will probably leave the hospital on Friday.

The crisis staff met in the town hall

The Thursday meeting of the crisis staff was attended by Mayor Konrad Fijołek, Jaromir Ślączka, director of the Poviat Sanitary and Epidemiological Station, Zbigniew Sowa, director of the municipal crisis management department, and directors of municipal and environmental companies.

Bartosz Gubernat from the Chancellery of the President of Rzeszów told PAP that "the situation related to legionella infections will be discussed at the meeting"


On the night from Wednesday to Thursday, the crisis team convened urgently was convened at the Podkarpackie Voivodship Office. The meeting was attended by the Minister of Health Katarzyna Sójka and the Deputy Minister of Health Marcin Martyniak, Ewa Leniart, the Podkarpackie Voivode, and Krzysztof Saczka, the head of GIS.

After the meeting, the Ministry of Health announced on social media that "the variant regarding the municipal water supply network as a source of infection is being verified. A strategy for further actions to extinguish the outbreak, necessary for immediate action by the competent authorities, has been established."

An epidemiological investigation is underway

An epidemiological investigation is underway to determine the source of infection, as well as other anti-epidemic measures, including inspections and water collection for laboratory tests. The first test results from the samples taken from the hot water installation from the municipal water supply points will be known on Monday. The waiting time for the results of Legionella pneumophila tests after sampling is up to 10 days.

First, samples were taken at water intake points in the city, and then samples were taken from the homes of infected people.

The city temporarily shut down all fountains, water curtains and drinking fountains.


https://tvn24.pl/rzeszow/rzeszow-po...arlo-sanepid-powolal-specjalny-zespol-7305208

 

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Legionella is spreading. The mayor of Rzeszów on the situation in the city

TVN24 | Poland
August 26, 2023, 20:57
Author: acre/tr
Source: TVN24

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The Mayor of Rzeszów, Konrad Fijołek, and Dr. Paweł Grzesiowski, an expert of the Supreme Medical Council for epidemic threats, spoke in "Fakty po Faktach" on TVN24 about legionella infections, which are registered in large numbers mainly in Rzeszów and the vicinity of the city. A total of 127 people have been infected, eight of whom have died.

- The situation in Rzeszów and its vicinity is very serious. The scale of the spread of bacteria and diseases is quite large, as for the historical cases that have happened so far. The cases are actually quite numerous, admitted Fijołek. "Unfortunately, I also have to say that several people are still in quite a difficult condition and unfortunately it may turn out that this is not the last victim we talked about today," he added.

He also said he had "good news". - The number of these hospitalizations in our hospitals is not increasing in a significant way. Therefore, it seems that the largest number of hospitalizations of people reporting to the hospital is behind us - he said.

"This epidemic has an unprecedented character in Rzeszów"

The local government official informed that "so far in the epidemiological proceedings conducted by the health department, which we are trying to support, we have not been able to find a common denominator" for the diseases.

- And this epidemic in Rzeszów has an unprecedented (...) character. So far (...) these legionella attacks have happened somewhere in the spot. And this in a hospital, and this in a hotel, and this in one place. And there was one reason, he explained. Meanwhile, at present, he said, there are "many people from different places who are sick" in the city.

He emphasized that there are still unknown answers to the questions, "Is this one point that spreads bacteria?" and "what is it related to?". He estimated that next week could bring answers.

Mayor of the city on chlorination of the water supply network and drinking tap water

The Mayor of Rzeszów was also asked whether residents can use water without fear. "I would like to assure you 100 percent that residents can safely use water," he said. - Water in Rzeszów has always been of good quality. We have one of the best water purification systems. And using water, drinking cold water, the water from the water supply, is always safe, he added.

The TVN24 guest said that the process of chlorination of the water supply network has now begun. "We're doing it just in case, as a precaution," he said. He assessed that "this process is known to the residents, because usually (...) once a year, depending on the needs, the network is disinfected". “Residents know what it means. There is a little more chlorine in our taps, a little more in our water tanks. And we are used to it. It does not require any extraordinary behavior.

Fijołek said that the whole process started on Saturday at 2 pm. - It will intensify at night. During the night, we hope that this additional, increased dose of chlorine will reach the entire network. Tomorrow morning, residents will see a little more chlorine in our network. For 24 hours from tomorrow morning, we recommend using water traditionally, but still boiling it for consumption, he said.

Grzesiowski: The greatest risk in the shower. I would recommend removing the strainers and washing yourself with a stream of water

Doctor Grzesiowski concluded that "if there is no common denominator for patients who reported to hospitals, i.e. there was no one event, no single place where they were exposed, the hypothesis remains that they could have been infected at home." - And in our houses we have tap water, there is no other - he stressed.

According to him, "the greatest risk is in the shower, in the shower." - Because that's when the most aerosol is produced. So, as a doctor, I would recommend - especially to those who are in risk groups, i.e. the elderly, the sick - to remove the screens from the shower for the time of uncertainty and simply wash with a stream of water - he said. As he said, "this is the basic activity that we do when we have a problem in a building, for example a hospital or nursing home".

Grzesiowski pointed out that "legionella occurs in pipes". "It's not a new bacterium or anything out of the ordinary. After all, we have regulations that say how many cells of this bacteria can be in 100 milliliters of water, and this is strictly tested and observed. So something extraordinary must have happened.

The expert said he was looking for information on what might have happened. - I found information that the network in Rzeszów is being expanded, repairs are being carried out all the time, new sections are being opened. Recently, there was a cleaning of the sewage network. This is connected with the shutdown of large sections of water supply. So maybe something happened during the renovation work that caused the bacteria to multiply. We have high temperatures, and that's also good. Hot weather is conducive to the growth of this bacteria in natural conditions - added Grzesiowski.


https://tvn24.pl/polska/legionella-...gowej-dr-pawel-grzesiowski-o-bakterii-7309098

 

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11 people with legionella are dead, infections in another region. Bacteria were detected in four samples

TVN24 | Rzeszow

August 28, 2023, 9:17 am
Author: bp/current
Source: PAP, TVN24, tvn24.pl

The Poviat Sanitary and Epidemiological Station in Rzeszów informed on Monday about three more deaths of people infected with legionella. In total, 11 people who have been diagnosed with this bacterium have died.

As Andrzej Sroka, the spokesman for the University Clinical Hospital, informed earlier on Monday, a 91-year-old patient infected with legionella, burdened with multiple diseases, died in the Podkarpackie Center for Lung Diseases in the last 24 hours.

The number of people infected with legionella who stay at the Podkarpackie Center for Lung Diseases also increased by one person. On Monday, it's 19 people. Another 10 people are staying at the University Clinical Hospital. Three people are in the intensive care unit, the spokesman said. The others are in a stable condition.

Results of water tests in Rzeszów

Sanepid employees carried out water tests in the Rzeszów water supply system, water intakes, as well as in the homes of people infected with legionella. The director of the Podkarpackie Sanitary Inspectorate, Adam Sidor, announced the first results of these tests on Monday.

In Rzeszów, on August 18, 105 water samples were taken from the installation, and eight in the neighboring poviats. On August 17, the health department had information about 11 confirmed cases of legionella infections in Rzeszów and four in the Rzeszów poviat.

So far, the health department has the results of testing nine samples. Eight of them come from the municipal water supply, the ninth - from the place of residence of the person who was confirmed to be infected.

- Of these eight samples, four were contaminated, two of which were considered high. This is a level where there is a risk of infection by using the shower - emphasized the director of the Podkarpackie Sanepid. The presence of legionella was not confirmed in a water sample collected in the patient's apartment.

The next few days will be decisive. At the moment and after these few reports, this does not give us grounds (...) that hot or cold water installations are a source of infection. Only the following days, reports and information from epidemiological interviews will give us grounds to determine the potential source of infection. We'll have more evidence. At the moment, we do not have such evidence yet - said director Adam Sidor at a press conference.

Over the weekend, employees of the Municipal Water and Sewage Company in Rzeszów carried out flushing of the water supply system. As the bacteria lives, among others, in such installations, MPWiK introduced a preventive dose of chlorine 20 times higher than usual into the network. After disinfection, which began on Saturday, on Sunday, waterworks employees flushed the installation so that the water parameters returned to normal.

Legionella infections in Małopolska

Representatives of the health department announced on Monday that since the beginning of this year, 11 cases of legionella infection have been recorded in the Lesser Poland Voivodeship, including six in August.

- There is no outbreak of legionellosis in Małopolska, we have recorded individual cases. I can certainly say that we are safe - informed the voivode Łukasz Kmita at a press briefing.

In Krakow itself, two people became infected in August, one has already left the hospital, the other is still hospitalized. The source of infection in one of them was an aerosol from a garden hose that had been left in the sun for a long time. The source of infection of the second person in Krakow was air conditioning.

On Sunday, a senior from a retirement home from the Brzesko district went to a hospital in Brzesko. Tests confirmed that she was infected with legionella. - Her general condition at the moment is satisfactory. However, she is a patient with heavy loads, multi-morbidity - said Norbert Kopeć, the deputy director for treatment at the Brzesko hospital on Monday.

Also two other charges of this house were hospitalized with suspected legionellosis. – Today, infection in these people has been ruled out – said the governor of Lesser Poland and emphasized that this means there is no legionella outbreak in Lesser Poland.

Also, the deputy of the Małopolska state provincial sanitary inspector, Maciej Klima, reassured that the cases in Małopolska are scattered. He also informed that in the last decade, two deaths of people who were infected with the Legionella bacteria were recorded in the province - in 2013 and 2017.
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Legionella infections in Wielkopolska

In turn, in the hospital in Ostrów Wielkopolski (Wielkopolskie Voivodeship), two cases of legionella infection were detected. It's a married couple, a 53-year-old man and a 54-year-old woman.

As Dr. Adam Stangret from the local hospital informed us, the course of infection in infected people was not severe. - These people were admitted a few days ago with high fever, musculoskeletal pains and headaches. The tests confirmed high inflammatory parameters, features of pneumonia, urine tests also showed the presence of legionella bacteria. As a result of the implemented treatment, the condition of the patients has improved a lot, they will undergo check-ups today - Doctor Stangret told us.

Soon the couple will probably be sent home - they are residents of the Ostrów district.

The doctor added that the interview with the patients did not indicate that they had recently been to Podkarpacie. He reminded that the source of legionella infection very often occurs through contaminated, neglected air-conditioning installations.

It is not yet known how the people hospitalized in Ostrów hospital became infected. The health department is investigating the infection.

Legionella. Tarnobrzeg turns off the fountains and heats the water

In the message sent to our editorial office, the authorities of Tarnobrzeg (Podkarpackie Voivodeship) informed about taking preventive measures in connection with the increasing number of legionella infections.

- Fountains can be a threat in public space, which is why I asked the Waterworks to turn off the fountain on A. Surowiecki Square and the fountain on B. Głowacki Square - says the mayor of Tarnobrzeg, Dariusz Bożek, quoted in the press release.

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Legionella. The number of infections is increasing

The first notification of legionella infection was received by the Rzeszów health department on Thursday, August 17. So far, the presence of the bacteria has already been confirmed in 144 people (data from Sunday). The largest number of people infected with the bacterium live in Rzeszów - 96 patients - and in the Rzeszów district - 31. In addition, four infections were revealed in the inhabitants of the Dębica district, three in the Ropczycko-Sędziszów district, two in Łańcut and one in the following districts: Jasielski, Przeworski, Przemyśl, Kolbuszów, Niżański, Stalowa Wola. One of the patients is a resident of the Lubelskie Voivodeship, who was previously supposed to stay in Podkarpacie.

People infected with legionella are hospitalized in Rzeszów, in the Rzeszów poviat, Dębica, Przemyśl, Kolbuszowa, Łańcut, Sędziszów Małopolski, Jasło and Lublin. On Monday, the authorities of the hospital in Ostrów Wielkopolski (Wielkopolskie Voivodeship) informed about two cases of legionella infection in this facility. On Sunday, the first case of legionella infection in the Lesser Poland Voivodeship was reported . The patient is a ward of a care center; He is in a serious condition in one of the hospitals in the province.

So far, 11 people with confirmed legionella infection and comorbidities have died.

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https://tvn24.pl/rzeszow/rzeszow-os...lla-pierwsze-przypadki-w-wielkopolsce-7310776

 

[Mary Wilson]

Polish authorities investigating deadly Legionnaires' disease outbreak in strategic city on Ukrainian border

Friday 25 August 2023 15:43, UK
Samuel Osborne​

Poland's domestic security agency is investigating whether an outbreak of Legionnaires' disease that has killed seven people is the result of intentional tampering with its water system, authorities have said.

The legionella bacteria that causes the illness has been found in 113 patients in hospital in Rzeszow, in Poland's southeast, a key transport hub for international military support for Ukraine. Some 10,000 US troops and around 400 UK troops are also stationed in the area. ...

Earlier on Friday, private radio RMF reported Internal Security Agency officers were checking local water systems and so far they had found no grounds to suspect sabotage. ...

https://news.sky.com/story/polish-a...n-strategic-city-on-ukrainian-border-12947275

 

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Legionella, 14 dead, more infected. New health information

TVN24 | Rzeszow

August 29, 2023, 9:59 am
Author: ms/over there
Source: tvn24.pl

The Poviat Sanitary and Epidemiological Station in Rzeszów informed on Tuesday about three more deaths of people infected with legionella. A total of 14 patients who have been diagnosed with this bacterium have died. Nine new infections have also been confirmed. In total, the infection in Podkarpacie was confirmed in over 150 people.

On Tuesday, the Rzeszów sanepid in a message posted on its website said: "There have been 14 deaths of people with confirmed Legionella pneumophila infection, all people with comorbidities."

​READ THE FULL SANEPID ANNOUNCEMENT OF AUGUST 29, 2023 >>>​

The health department also announced nine new cases of infection detected. According to the Rzeszów sanitary services, the bacteria has been detected in a total of 153 people. According to the health department, patients hospitalized in hospitals in Rzeszów and the Rzeszów district, Dębica, Przemyśl, Kolbuszowa, Łańcut, Sędziszów Małopolski, Jasło and Lublin are infected.
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https://tvn24.pl/rzeszow/rzeszow-le...e-kolejni-zakazeni-nowe-dane-sanepidu-7312514

 

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Translation Google​

Legionella report. Two more people died, two were confirmed to be infected with legionella

08/30/2023, 11:10
Anna Gorczyca

16 people have already died, 155 people have been confirmed to be infected with legionella. This is the latest information from Rzeszów. The bacteria causes serious respiratory diseases.

According to the Poviat Sanitary and Epidemiological Station in Rzeszów, two more people died last day, whose tests confirmed legionella infection. Two people who were admitted to hospitals on August 26-27 tested positive. In total, since the beginning of the outbreak, the bacterium has caused legionellosis, or Legionnaires' disease (an infectious respiratory disease caused by a bacterium), in 155 people.

Legionellosis in hospitals

Doctors and epidemiologists talk very carefully about stopping the disease. Single patients are discharged from hospitals.

At the University Clinical Hospital in Rzeszów, the first patients with legionellosis were admitted on August 10-11. Since then, 52 people have been hospitalized, five people have died. We had 33 patients on Tuesday. On Wednesday - 28. Five people were discharged from the hospital, including two patients from the nephrology department - explains Andrzej Sroka, spokesman for the USK.

In this facility, patients are treated in two places: in the Podkarpackie Center for Lung Diseases - there are 21 patients here and USK - there are still seven patients here, including two in the ICU.

There are currently 12 people hospitalized in the Provincial Clinical Hospital No. 2. - No new infections since yesterday - informs Tomasz Warchoł, spokesman for KSW No. 2.

There are currently 12 patients in the City Hospital. - We discharged two of them yesterday - says Grzegorz Materna, director of ZOZ No. 1. In this facility, 19 hospitalized people were diagnosed with the bacterium.

Legionella in Europe

The Ministry of Health reminds that every year in Europe there are over 1,000 cases of Legionnaires' pneumonia in travelers. Most people get sick in the summer and autumn months (June to October), after returning home from a holiday in the Mediterranean countries.

Recently, there has also been an increase in legionella infections in Germany.

The Ministry recommends that when traveling, pay attention to the following:

• the hotel where you are to stay is not on the list of hotels with an increased risk of infection: https://ecdc.europa.eu/en/legionnaires-disease/threats-and-outbreaks/accommodation-site The European Center for Disease Prevention and Control publishes data addresses of hotels that have not implemented a satisfactory anti-legionella prevention plan despite having reported cases of Legionnaires' pneumonia among their guests;

• whether the hot water in the occupied hotel room has a sufficiently high temperature (50-60 degrees C, i.e. too hot to put your hands in it for more than a few seconds), and the cold water has a sufficiently low temperature (below 20 degrees C );

• if you occupy a room that has not been used before, before using the shower for the first time, you can turn on the tap for a few minutes to let the water run through it (until it reaches the temperature indicated above);

• people at risk of severe infection, eg immunodeficiency, should avoid situations where contaminated aerosols may be generated, eg using a whirlpool bath, etc.
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Legionella - searching for the source of infection

In Podkarpacie, the first legionella infections were detected on August 18. The search for the source of infection is still ongoing. Over 100 samples of cold and hot water were collected in the city of Rzeszów and 8 samples in the neighboring counties. The samples were collected in public utility buildings, in the places of residence of the sick, in hot water supply points for buildings. The results of the first 9 samples did not answer where the infection occurred.

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https://rzeszow.wyborcza.pl/rzeszow...by-zmarly-u-dwoch-kolejnych-potwierdzono.html

 

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Legionella. More people dead, new infections. Sanepid: the epidemic is at the extinction stage

TVN24 | Rzeszow
August 31, 2023, 10:07
Author: bp/over there
Source: tvn24.pl, PAP
...
Two more people with legionella are dead, the Rzeszów health department announced on Thursday. According to the Poviat Sanitary and Epidemiological Station in Rzeszów, the total number of deaths of people infected with this bacterium has increased to 18.

The health department points out that each of the 18 deceased people - nine men and nine women aged 53-98 - had comorbidities.

The health department informs about new infections

Two new cases of infection were also recorded - these are people admitted to the hospital on August 20 and 28. Legionnaires' disease has been confirmed in total since the beginning of the outbreak in 157 (2 new) patients hospitalized in the Podkarpackie Voivodeship.

Most cases of legionella infection were confirmed in Rzeszów (105) and in the Rzeszów poviat (36). In other poviats of Podkarpacie, these are isolated cases.

The source of Legionella pneumophila infection is still unknown. They are to be indicated by an epidemiological investigation conducted by the sanepid.

Legionella. Sanepid: an epidemic at the extinction stage

- The epidemic is currently at the stage of extinction - said the director of the Provincial Sanitary and Epidemiological Station in Rzeszów, Adam Sidor, at a press conference on Thursday.

The head of the Podkarpackie Sanepid noted that the causes of the legionella outbreak are still being determined. He also informed about further results of water samples taken on August 19 and 20 in the apartments of infected people. - We have 10 cold water samples and nine hot water samples. Of these (19 - ed.), we confirmed bacteria at a high level only in warm water, these are three samples (...). In the fourth sample, we also noted an increase in legionella bacteria (...). We are waiting for further test reports on these samples, we are taking these samples, we have over 130 of them at the moment - explained Sidor.

The director reminded that the sanepid was informed about the first signs of an outbreak of legionella infections on August 17. - We started (then - ed.) intensive inspection activities, mainly at service providers, mainly in service entities, in workplaces, also in medical entities, where the subject of our inspection were primarily ventilation and air-conditioning systems, as well as hot and cold water supply systems - he noted head of the Carpathian health department. He added that the subject of the inspection is mainly the technical condition and operating parameters of these installations.

So far, infections have also been detected in the Lesser Poland Voivodeship . As reported on Sunday, a ward of a private retirement home was taken to the district hospital, her condition was described as serious. The services also reported two cases from the Wielkopolskie Voivodeship. They are a married couple, a 53-year-old man and a 54-year-old woman, patients of the hospital in Ostrów Wielkopolski. As reported on Monday by doctor Adam Stangret from the local hospital, the course of infection in infected people was not severe. Since the beginning of the year, 17 cases of infection have been recorded in Wielkopolska, including two fatalities. - We are talking about six cases in the last two weeks, including one of these two deaths recently. He is a 37-year-old man who has traveled a lot – reported Łukasz Wójcik, TVN24 reporter on Tuesday.

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https://tvn24.pl/rzeszow/rzeszow-le...komunikat-sanepidu-dane-z-31-sierpnia-7318537

 

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One new Legionella infection in Rzeszów

PAP/ Wojciech HukSeptember 5, 2023, 13:11

The number of people infected with the Legionella bacteria has increased to 166. No new deaths were recorded, Jaromir Ślączka, director of the Poviat Sanitary and Epidemiological Station in Rzeszów, informed on Tuesday.

According to the announcement of the Sanepid, the first infection took place on July 30 this year, and the peak of the disease was recorded between August 12-16 this year.

- Total until September 4 this year. 166 confirmed cases were recorded, including 112 in Rzeszów and 38 in the Rzeszów district, said director PSSE in Rzeszów.

The remaining cases, i.e. 16, occurred in other poviats.

So far, 19 people who have been diagnosed with Legionella have died. All had comorbidities, most were between 60 and 90 years of age.


https://nowiny24.pl/jedno-nowe-zakazenie-bakteria-legionella-w-rzeszowie/ar/c14-17862139

 

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Legionella in Rzeszów. Another person infected with the bacteria died at the USK

By Rzeszów News-September 12, 2023 10:26 am

A 91-year-old resident of Rzeszów died after being diagnosed with Legionella bacteria - reported the University Clinical Hospital in Rzeszów.

As Andrzej Sroka, spokesman for the Registry Office, said on Tuesday (September 12), the deceased woman was hospitalized at the Podkarpackie Center for Lung Diseases at Rycerska Street and had comorbidities. This is the eighth death of a USK patient in whom Legionella was confirmed.

Currently, there are 7 patients with legionellosis in the hospital: 6 in the "pulmonary" hospital, which is subordinated to the Regional Hospital in Rzeszów, and 1 in the hospital at Szopena Street. Additionally, 19 patients are hospitalized due to pneumonia - in PCPD.

A 91-year-old mix from Rzeszów is already the 24th death victim of Legionella.

Legionella causes legionellosis (Legionnaires' disease), an acute pneumonia caused by inhaling contaminated water. The epidemic in Rzeszów broke out on August 17. 166 infections have been recorded so far - there have been no new cases for five days.

– Most of the patients who are still hospitalized have completed treatment for legionellosis, but are still hospitalized due to other diseases – said Jaromir Ślączka, director of the Rzeszów Sanitary Epidemiological Station, on Tuesday.

The source of Legionella infections is still unknown.

https://rzeszow-news.pl/legionella-w-rzeszowie-w-usk-zmarla-kolejna-osoba-zakazona-bakteria/

 

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Legionellosis - Poland

14 September 2023

Situation at a glance

As of 11 September 2023, a total of 166 cases of legionellosis,including 23 deaths, have been reported from Poland. Legionellosis, more commonly known as Legionnaires' disease, is a pneumonia-like illness, caused by a bacterium, that varies in severity from mild to a severe illness and sometimes fatal form of pneumonia.


This observed increase in confirmed cases, and associated hospitalizations and deaths seen since mid-August, is unusual, considering that the number of cases is higher than the annual number reported in Poland since 2016.

Polish health authorities are coordinating cluster investigation activities, active case finding to identify additional cases, and public health activities to prevent transmission and limit the emergence of new cases, through preventive control measures. Since 7 September, no new cases have been reported, although the infection source has not yet been identified. Investigations are still ongoing to find the source of the outbreak.

Most people develop Legionnaires' disease by inhaling the bacteria from water or soil. To date there has been no reported direct human-to-human transmission.

Description of the situation

On 18 August 2023, public health authorities in Rzeszów, Poland, announced the detection of a cluster of 158 suspected community-acquired pneumonia cases, including 15 laboratory-confirmed cases of legionellosis among patients admitted to several hospitals in Rzeszów.

Between 18 August and 11 September 2023, a total of 166 laboratory-confirmed cases, all hospitalized, and 23 associated deaths (CFR of 14%) have been reported. Most cases, 67% (n=112), were recorded in the city of Rzeszów, 23% (n=38) of cases in Rzeszów county, and 10% (n=16) cases in other locations.

Figure 1: Geographic distribution of confirmed Legionellosis cases in Poland between 18 August and 11 September 2023.



Preliminary results from an ongoing epidemiological investigation indicate that the first cases developed symptoms on 30 July, while most cases developed symptoms between 12-16 August. Adults between 60 and 90 years are the most affected age group. The most recently reported case has an onset date of 29 August. All 23 related deaths had underlying comorbidities and were between the ages of 53 and 98 (11 females and 12 males).

Figure 2: Number of confirmed Legionellosis cases reported in Rzeszow by Epidemic week





Laboratory results

Only hospitalized cases are tested for Legionella spp. The majority of the cases were confirmed through urine antigen tests and 11 cases were confirmed through respiratory samples by PCR. Culture and sequencing were not possible as the cases were treated with antibiotics.


Between 18 August to 11 September 2023, a total of 379 facility inspections were carried out. A total of 222 samples of hot and cold water were taken and investigations are ongoing.

Epidemiology of Legionellosis

Legionellosis is an infection caused by Legionella bacteria. The Legionella bacteria can cause a mild illness, Pontiac fever, non-pneumonic form of the disease, and Legionnaires’ disease, a severe pneumonia form of illness that can be fatal. Most people catch Legionnaires' disease by inhaling the bacteria from water or soil.

Legionnaires’ disease, the pneumonic form, has an incubation period of 2 to 10 days (but up to 16 days have been recorded in some outbreaks). It is an important cause of community- and hospital-acquired pneumonia, and although uncommon, Legionnaires’ disease may cause outbreaks of public health significance. Initially, symptoms are fever, mild cough, loss of appetite, headache, malaise and lethargy, with some patients also experiencing muscle pain, diarrhoea and confusion. The severity of Legionnaires’ disease ranges from a mild cough to rapidly fatal pneumonia. Untreated Legionnaires’ disease usually worsens during the first week.

Mortality from Legionnaires’ disease depends on the severity of the disease, the use of antibiotic treatment, the setting where Legionella was acquired, and whether the patient has underlying conditions, including immunosuppression. The death rate may be as high as 40–80% in untreated immunosuppressed patients and can be reduced to 5–30% through appropriate case management, depending on the severity of the clinical signs and symptoms. Overall, the death rate is usually between 5–10%.


Public health response

• Meetings of the crisis staff at the Mayor of Rzeszów are held daily.
• Water samples were collected from the water supply system, residences of the sick, healthcare facilities, cooling towers, and installations in buildings located in Rzeszów, the Rzeszów poviat, and the Ropczyce and Sędziszów poviat.
• An epidemiological investigation, including interviews with patients or relatives, is underway to determine the source of infection.
• Mapping all positive cases, water sampling sites, and cooling towers is underway.
• Public fountains, public water sprays, and other public water sources have been shut down temporarily.
• Rzeszów Municipal Water and Sewage Company carried out the routine disinfection of the water supply in the city of Rzeszów and adjacent towns on 27 August 2023.
• Health care units and long-term care facilities have been instructed to carry out additional inspections of their water systems.
• Public health advice has been developed and shared across multiple channels.

WHO risk assessment


Legionellosis varies in severity from a mild febrile illness to a severe and sometimes fatal form of pneumonia and is caused by exposure to Legionella species found in contaminated water and potting mixes. Outbreaks of Legionella have been linked to poorly maintained water systems, particularly cooling towers or evaporative condensers associated with air conditioning and industrial cooling, hot and cold-water systems in public and private buildings, and whirlpool spas.

Infection can also occur by aspiration of contaminated water or ice, particularly in susceptible hospital patients. To date, there is no reported human-to-human transmission. Legionnaires' disease requires treatment with antibiotics, and currently, no vaccine is available for Legionnaires' disease.

Sporadic outbreaks of Legionnaires' disease have been reported previously in Poland. Between 2017 and 2021, Poland reported between 38 to 74 cases of Legionnaires’ disease annually to the European Surveillance System (TESSy). In 2022, this increased to 111 reported cases.


Robust surveillance and response activities are being implemented during the current outbreak, and case numbers have been reduced. Nonetheless, without an identified source of Legionella bacteria, there is a continued risk of developing Legionellosis for people working or living in the affected areas. Older adults, smokers, and people with weakened immune systems are particularly susceptible to the disease.


Travel-associated Legionnaires’ disease (TALD) is a frequent phenomenon, with, on average, about 20% of the cases of legionellosis detected in Europe considered to be travel-associated. The outbreak is reported in the south-eastern city of Rzeszów, the main hub for humanitarian aid for Ukraine and the transit hub for international military support for Ukraine; therefore, TALD may be expected in people visiting Rzeszów.

According to the European Center for Disease Prevention and Control (ECDC), in 2021, the EU/EEA witnessed the highest annual notification rate of Legionnaires’ disease, with 2.4 cases per 100 000 population. The cause of the increased reported incidence observed during that period in Europe remains unclear. Legionnaires’ disease is a notifiable disease in the EU, and the events are closely followed up through ECDC and European Legionnaires’ Disease Surveillance Network (ELDSNet).


WHO advice


WHO recommends the continuation of laboratory analyses, case identification and clinical care, contact tracing, outbreak investigation to identify the source(s), implementation of measures to prevent further infections, and enhancement of Infection, Prevention and Control (IPC) measures. IPC measures in health facilities have been enhanced during the COVID-19 pandemic and should be reinforced to prevent healthcare-associated transmission, including measures to control waterborne pathogens. WHO does not recommend any specific different measures for travellers. In case of symptoms suggestive of respiratory illness during or after travel, travellers are encouraged to seek medical attention and share their travel history with their healthcare provider. Countries with Legionella cases reported after travel to Poland should notify their regional IHR focal points.

WHO advises against applying any travel or trade restrictions on Poland based on the current information available on this event.


https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON487