UnitingCare Health strives for excellence in all aspects of our operations, in the continual improvement of the quality of the services we deliver, and in the way we operate within the healthcare industry and wider community.
In line with Queensland Government legislation announced on 4 February 2016, we report on all types of Legionella tested in our hospitals.
Although Legionella is a common occurrence in the environment, our water management regime, based on international best practice standards, continues to reduce the associated risk to patients and staff.
On this page you will find Frequently Asked Questions about Legionella and our water management practices.
At The Wesley Hospital we currently conduct monthly water tests and promptly report these results to Queensland Health and also publish these results on this page.
*Legionella Pneumophila (strain known to cause most water-related Legionella infections)
*Legionella Non Pneumophila (strain that may cause water-related Legionella infections)
To enable a more comprehensive analysis of the water in the hospital’s systems, a more sensitive testing regime which uses a larger water sample was commenced in 2016. The more sensitive test also reduces the need for routine multiple samples from each outlet that is tested.
The Wesley utilises a Brisbane laboratory for Legionella water testing that detects Legionella levels as low as 1 colony per 100 ml. This is 1,000 times more sensitive than the current Australian standard for detection of 10 colonies per 1 ml.
This increases the likelihood of detection in Wesley water samples. The Wesley reports on our website and to Queensland Health Legionella detected at these low levels even though they may be many times lower than the current Australian Standard level of detection.
Frequently Asked Questions
1) Should I be concerned about coming for a consultation or procedure at The Wesley Hospital?
There is no need for concern about coming to The Wesley Hospital for treatment.
The Wesley Hospital undertakes current international best practice guidelines for eradication of Legionella in order to achieve water quality that is as safe as possible. The Wesley Hospital is committed to maintaining treatment and testing on an ongoing basis.
The following are the water testing results for the Wesley for the past three years:
*Commenced testing Ice Machines in 2015
2) Why was Legionella found at the Wesley?
Strains of Legionella bacteria are commonly found in the environment. The Wesley is not the only hospital that has found Legionella in its water supply. The Wesley and all UnitingCare hospitals in Queensland have the most comprehensive water testing and treatment program.
3) Is there any risk of patients, visitors and staff contracting Legionnaires Disease at The Wesley Hospital?
The hospital’s water is entirely safe to use.
It is important to understand that Legionnaires Disease is not spread from person to person.
The Wesley’s water testing and treatment program involves:
- Comprehensive monthly testing of the Wesley’s water systems that goes well beyond the guidelines ordered by Queensland Health for all Queensland hospitals following confirmation of legionella in The Wesley Hospital’s water system.
- The Wesley Hospital has installed an automatic chlorine feeder system throughout to eradicate Legionella.
- Testing of the hospital’s air-conditioning water towers occurs monthly.
4) What is Legionnaires Disease?
Legionnaires Disease is an infection of the lungs (pneumonia) caused by bacteria of the Legionella family. The bacteria is commonly found in the environment, but infection only occurs in “at-risk” people. Legionnaires disease can usually be treated with antibiotics.
5) Who is most impacted by Legionnaires Disease?
Legionnaires Disease most often affects “at-risk” people such as the elderly and particularly those who smoke or who have chronic lung disease. Also at increased risk are those whose immune systems are suppressed by medications or diseases such as cancer, kidney failure, diabetes or HIV-AIDS. Pregnant women with lung disorders or reduced immunity are also at risk. Well patients, children and babies are at very low risk.
6) How is Legionnaires Disease spread?
Legionnaires Disease can occur after a person breathes in contaminated water vapour or dust from such places as air conditioning cooling towers, whirlpool spas, showerheads and other bodies of water. Legionnaires Disease is not spread from person to person or by drinking water.
7) What are the symptoms of Legionnaires Disease?
Legionella Pneumonia symptoms usually begin two to 10 days after exposure, with symptoms such as fever, chills, a cough and shortness of breath. Some people also have muscle aches, headache, tiredness, loss of appetite and diarrhoea.
8) Is the ice at the Wesley safe?
Contracting Legionella from ice occurs when icy water is aspirated into the lungs of an already immune-compromised patient.
While the risk for other patients is very low, at The Wesley, all ice for patient consumption is now sourced directly from either boiled or filtered water without the use of an ice machine.
9) The media has reported that four people contracted Legionella at the Wesley in 2014. Is this correct?
No. Two patients contracted Legionella at the Wesley in June 2013. Since then no patient has contracted Legionella at the hospital until December 2015.
The table in Question 1 shows that the control measures put in place by the Wesley have dramatically reduced the number of positive water tests and therefore the risk to patients.
10) Why is monitoring of a hospital’s water supply important?
As outlined in the enHealth "Guidelines for Legionella Control in the Operation and Maintenance of Water Distribution Systems in Health and Aged Care Facilities" (see FAQ 12 below) sampling and analysis of water in a facility’s water distribution system is vital to:
- ensure that the risk control measures instituted are effective – this is sometimes referred to as operational monitoring.
- determine the presence and extent of Legionella colonisation, both generally and following the implementation of control or remediation measures – this is known as verification monitoring.
Monitoring is part of an effective Legionella risk management strategy. Monitoring provides the ability to assess the effectiveness of maintenance and controls, and detect the presence of Legionella before cases of Legionnaires’ disease occur.
The Wesley Hospital undertakes both operational monitoring and verification monitoring.
Culture is the recommended method for Legionella verification monitoring and this typically takes up to 10 days to obtain a result.
It is important to be aware that failure to detect Legionella by culture does not guarantee the absence of Legionella, as Legionella is difficult to grow on culture media and viable but nonculturable (VBNC) Legionella may be present – see page 29 of the enHealth Guidelines.
11) What happens if Legionella is detected in a water sample?
If Legionella is detected in a water sample, the hospital will immediately advise Queensland Health.
As outlined in the enHealth "Guidelines for Legionella Control in the Operation and Maintenance of Water Distribution Systems in Health and Aged Care Facilities" (see FAQ 12 below) we will then investigate whether the control measures are adequate, and the system control measures are assessed and checked to identify whether any failures have occurred.
If faults are detected, these will be rectified before further sampling to verify the efficacy of the intervention. If verification identifies further positive results, the full system will be reassessed.
Where Legionella is detected in a water sample exposure of vulnerable people in the effected area will be immediately controlled. Where Legionella colonisation has been found, apply appropriate control measures (eg disinfection) to the affected sections or components of the water distribution system, or the entire water distribution system, depending on the extent of identified or potential colonisation – see page 34 of the enHealth Guidelines.
If Legionella is detected in the hospital’s water distribution system, or a case of Legionnaires’ Disease is shown or suspected to be linked to colonisation of the hospital’s water distribution system, one or more of the following control measures will be undertaken as a matter of priority:
- Chlorination and hyperchlorination: This is the chemical clean of the effected area by chlorine.
- Cleaning of fittings or replacement with new or cleaned fitting: This involves removal and disassembly of the components, and inspection and cleaning of individual components in accordance with the manufacturer’s recommendations.
- Implementation of appropriate exposure controls: For example of the installation of Point of Use filters in the effected area (if appropriate or required).
Once appropriate control measures have been implemented or undertaken, normal operation of the system and facility will usually recommence – see page 35 of the enHealth Guidelines.
12) Are there national guidelines for the management of Legionella in hospitals?
The enHealth "Guidelines for Legionella Control in the Operation and Maintenance of Water Distribution Systems in Health and Aged Care Facilities" were endorsed by the Australian Health Protection Principal Committee in December 2015. You can view thesein the enHealth Guidelines.