People awaiting heart transplants at the Veterans Administration Medical Center should not be alarmed by the hospital's two cases of Legionnaires' disease, a spokesman said Friday.
When donor organs become available, the surgeries will be done at the VA if the source of the bacterium has been found, hospital spokesman Warren Longley said.Or they will be performed at either the University of Utah Medical Center or LDS Hospital. Both are also members of the UTAH-Cardiac transplant program. VA Hospital officials confirmed Friday that two heart transplant patients had been afflicted with the disease.
One was listed in good condition and scheduled to be released from the hospital Friday, Longley said. The second remained in critical condition in the hospital's surgical intensive care unit.
That patient - identified by the Sheridan (Wyoming) Press as William "Tink" Badget - was in "reverse isolation." He was placed in a private area "so other patients are not affected by his situation," Longley said.
Family members reported that "his new heart is showing no signs of rejection," but Legionnaires' disease is compromising his respiratory system. Badget is Sheridan's first heart transplant recipient, so his condition has been monitored regularly by the Sheridan news media since his transplant surgery at Salt Lake's VA Hospital Sept. 18.
By late Friday the source of the bacterium had not been identified. But hospital officials are convinced that the cases were isolated and the disease will not spread throughout the medical facility.
A form of pneumonia, Legionnaires' disease was named after an outbreak that killed 29 members of the American Legion who were attending a convention in a Philadelphia hotel in 1976.
The bacterium responsible for the deaths and subsequent national publicity was isolated and the genus named Legionella.
No major outbreaks have plagued Utah. But little clusters of Legionnaires' disease are reported regularly in homes and workplaces.
"It's really common. Legionellosis should be considered just another pneumonia in the hospital situation," state epidemiologist Craig Nichols said. "Simply having a few cases in your hospital is not an indicator of failure to comply with infection control practices. It indicates that the hospital is following correct procedures."
According to Nichols, these procedures include culturing all cases of pneumonia in transplant patients to identify organisms present so proper treatment can be applied.
"It is very clear that Legionella is in the environment all the time, but most people don't get Legionellosis," Nichols said. "The real concern would be a major outbreak among the general population of the hospital. That would indicate a major contaminate - like an air condition source, a cooling tower."
Nichols said in that situation the hospital would have to do environmental monitoring and decontamination - especially for patients like heart transplant patients whose immune systems are compromised.
According to Nichols the bacterium breeds best in warm, moist conditions. In most outbreaks the source of infection has been the water or air-conditioning system in a large public building. Infection occurs following the inhalation of droplets of heavily contaminated water - from air-conditioning outlets and showers, for example.
Six or seven years ago the U. hospital had an outbreak of the disease that was traced to contaminated water coming from shower heads.
"Since that time we monitor constantly for it and periodically cleanse our water system, which prevents its recurrence," said U. Hospital spokesman John Dwan.