Argentina Legionella: WHO report, latest news from Tucumán

news desk @bactiman63

The World Health Organization (WHO) today issued an outbreak statement on the situation in the province of Tucuman, Argentina:


As of September 3, 2022, a cluster of 11 cases of severe pneumonia, including four deaths, were reported in the city of San Miguel de Tucumán, Tucuman province, Argentina. Legionella spp. was isolated in samples from four cases. Legionellosis is a pneumonia-like illness that ranges in severity from a mild febrile illness to a severe and sometimes fatal form of pneumonia. The cases were initially reported as pneumonia of unknown cause. Legionella bacteria were identified as the causative organism on September 3.

All cases presented with bilateral pneumonia, fever, myalgia, abdominal pain and dyspnea between August 18 and 25, 2022 and are epidemiologically linked to a healthcare facility. Of the 11 cases, eight are facility health workers; three are patients at the health facility. Three of the four deaths involved health workers.

Health authorities are coordinating cluster investigation activities, active case finding to identify additional cases, contact tracing and public health activities to limit the spread.

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Additionally, Argentine officials announced new inclusion criteria (computer translated):

In a new press conference, the head of the health portfolio, Dr. Luis Medina Ruiz, explained that the change in criteria includes patients, health personnel and caregivers who have been at the sanatorium in August private, or has had surgery and has compatible symptoms such as fever or respiratory symptoms.

Image/Robert Herriman

“We would like to inform you that, having a known etiology of this epidemic linked to the private sanatorium, we have considered with the Minister of the Nation, Dr. Carla Vizzotti, a change in the inclusion criteria for this outbreak. Initially, when we detected two patients with bilateral pneumonia that coincided with joint labor and we also could not find its etiology, that was what we had as an inclusion criterion. Today, knowing that this is a bacterium that does not always cause bilateral pneumonia, we include any healthcare personnel, patient or family caregiver who has been in the month of August or who has undergone surgery in the patient selection criteria. in this private sanitarium and has a compatible symptom like fever or respiratory symptoms, not necessarily bilateral pneumonia,” he reported.

“That’s why we are including at least 8 new patients today, including 1 patient, 2 healthcare personnel and 5 caregivers of hospitalized, post-surgical or neurological patients. Of these 8 patients, there is one who has a severe comorbidity, due to a stroke and who also suffers from pneumonia, he is the only one who is serious We are very sorry for the death of the two patients yesterday, who were on mechanical life support for their pneumonia bilateral, and very seriously affected with serious comorbidities. One of them was 81 years old and the other 64 years old, in summary today we have 6 deceased, 9 patients who are at home with outpatient medical monitoring, since the clinic they present is of moderate or mild severity,

Likewise, the official pointed out that it is a bacteria that is not transmitted from person to person and having found the cause gives them a lot of certainty on the measures to be taken. “Initially, we had taken the measure to isolate the sanatorium without removing the patients, because not knowing the etiology, it could have been a virus or a battery which could have spread in the community. . Knowing today that it is a bacterium has allowed us to take other measures concerning this epidemic.

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Regarding the private sanatorium, the minister stressed: “We must first analyze the responsibility, today we are with the sanatorium closed, patients cannot enter, neither outpatients nor inpatients, and from ‘today or tomorrow a team of experts will come since Legionella is not an easy bacterium to find, it requires a special technique”.

At the same time, Medina Ruiz clarified that the ministry carries out tests on the state of the water, whether it is drinkable, whether it contains residual chlorine, whether it contains germs and whether it has not been found; for the conditions were within the limits of the adequate. “The public sector has permanent epidemiological surveillance, in the event of seriously ill patients, the cause is sought, this does not happen everywhere. Here we saw patients who came from the private sector, we took action on this and investigated the cause thoroughly. And not finding it is when it all kicks in. I think the next steps will depend on the results in the coming weeks. »

At the same time, he added: “There are no patients who are not related to the private sanatorium in August, and this is the situation where the limits are. Today we have a little more certainty. This disease has the characteristic of being self-limited; it’s very different from COVID which we don’t know when it ends. With this bacterium no, most people can have an asymptomatic or mild symptomatic picture, and it is self-limited. This means that when the disease begins, the body itself limits and cures it. He will not have a relapse because he has no new contact with the germ, ”he detailed.

Similarly, he noted, “Anyone who starts with symptoms like fever, flu-like symptoms: body aches, headache, cough, cold, dyspnea. In some patients diarrheal pictures. We will check them for at least two weeks, from when the sanitarium closes and there is no one else working inside, until we are sure there is no has more patients.

Medina Ruiz, pointed out that hospitalized patients receive specific treatment. Pneumonia is a very common cause of death in the elderly and with comorbidities, the cause is not always known and it happens every year and every winter. Pneumonia is usually fatal, due to the flu virus.

“Today all the compromised patients are under strict surveillance, in therapy with professionals with a lot of experience and of course we are going to have very smooth communication with the family. It will be timely, we are going to have a press conference an times a day, then with official communications when relevant information emerges,” she warned.

Finally, the official explained: “The way this disease spreads is through water vapour, air conditioning, the shower when it disperses the water, when it is breathed in. The bacterium does not enter through the mouth when you touch water, it has a particular mode of contagion and entry into the body. In a way, this generates epidemics and this mode of contagion does not give rise to human-to-human contagion, that is to say that for the person next to me to become infected, he needs a cloud of particles entering the lung.

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