In July 2022, the Pennsylvania Department of Health (PADOH) received two reports of laboratory-confirmed cases of Legionnaires' disease in patients who were exposed to the same Philadelphia hospital
An organ transplant may have spread hazardous Legionella bacteria for the first time, according to a recent report published by the U.S. Centers for Disease Control and Prevention on Thursday.
In July 2022, the Pennsylvania Department of Health (PADOH) received two reports of laboratory-confirmed cases of legionnaires' disease in patients who were exposed to the same Philadelphia hospital. Upon further investigation, it was confirmed that both patients had undergone a single lung transplantation from the same donor before the onset of the disease.
The donor, a man aged 30–39 years, had died after falling into a river in Pennsylvania last year. He had been declared brain-dead after rigorous attempts to resuscitate him were unsuccessful.
The initial case of Legionnaires' disease cropped up in a woman between 70 and 79 years old, who had undergone a right lung transplant in May 2022. Just nine days following the transplant, the patient's blood work showed increased white blood cell count and acute anemia, prompting the need for imaging studies.
After a lung specimen was collected in early June, it tested positive for Legionella species. As soon as doctors discovered Legionella in the lavage sample, they immediately began treatment, and the patient bounced back to full health.
The second case involved a man between 60 and 69 years old, known as patient B, who also received a left lung transplant on the same day from the same donor as patient A. Patient B faced several post-surgery issues, like requiring extracorporeal membrane oxygenation and kidney therapy. Fifteen days after the operation, doctors began antibiotic treatment with doxycycline.
Although the patient initially recovered, his health declined during a long hospital stay, and he died six months after the transplant surgery. The cause of death was respiratory failure due to a blocked airway.
Doctors conducted tests on three additional individuals who received organs from the same donor, but they all tested negative for the bacteria. Upon discovering the infections, the Pennsylvania Department of Health launched an investigation to identify the source of the bacteria.
The department conducted water tests at the hospital where the transplant surgeries took place but found no traces of legionella. Gradually, officials began to suspect that the bacteria may have originated from the deceased organ donor, given that legionella bacteria can naturally exist in freshwater.
The deceased donor likely became infected with the bacteria after inhaling the water during the drowning incident. However, one of the limitations noted in the report is that clinical specimens from the donor weren't available for testing, so investigators could not confirm if the donor had a legionella infection before organ donation.
The bacteria found in legionnaires disease thrives in warm water, and with the rising temperatures associated with the climate crisis, there have been considerably more favorable conditions for its growth. The CDC cautions that cases of legionnaires' disease have seen a significant increase over the past decade.
In 2022, an outbreak of legionnaires' disease in New York City's Bronx borough left one dead and 18 sick. Then in August, a spa in Richmond, California, was closed by the county health department after two people who used a jacuzzi tub died from legionnaires’ disease and one fell ill.
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