City wins praise for legionnaires’ work
But outbreak plans still lacking New public health lab needed: Report
Toronto’s response to legionnaires’ disease this fall was “ more organized, efficient and effective” than during the outbreak of SARS in 2003, but there is still an “ enormous” amount of work to be done to prepare for a flu pandemic or other major disease, a new report says.
If the legionnaires’ outbreak had been larger, “the system would have been much more stressed and the outcome could have been much different,” Dr. David Walker, chair of an expert panel appointed by the province to review the situation, told a news conference yesterday.
Ontario hospitals are operating at or near capacity, and a sudden increase in seriously ill patients pushed them to the limit, the report says. During September’s legionnaires’ outbreak at the Seven Oaks Home for the Aged in Scarborough, 133 people were infected, including 70 residents, 37 staff, 21 visitors and five people in the community. Twentythree elderly people died. The outbreak was eventually traced to the home’s air- conditioning cooling tower.
All of the patients received “ exemplary care” at the nursing home and in hospital, the report concludes.
Although it took 10 days to identify the illness, causing anxiety among patients, families and staff, those who became sick were immediately treated with antibiotics — the standard treatment for legionnaires’ — and no deaths could have been avoided. But Ontario urgently needs to replace its public health laboratory. Once a world leader, the facility is antiquated and understaffed, and needs to be moved downtown near the major hospitals, the document says. The provincial coroner’s autopsy suite also needs to be replaced, the report says, adding it is so outdated it can’t safely handle cases of mysterious illness, and those autopsies have to be performed in hospitals instead. Communications between health officials also need improvement. Phone calls and faxes, rather than electronic communications, are often relied upon to send urgent information, it says. The report makes 26 recommendations to improve the public health response system.
Dr. Donald Low, medical director of the public health lab, said there needs to be an “ infusion of expertise, not only to provide the service but to do research and development too, so we can be back on the cutting edge as we were 20 to 25 years ago.” Health Minister George Smitherman acknowledged yesterday that “ we have more progress to make,” especially in improving the capacity of the public health lab, near Islington Ave. and Highway 401.
Fixing that will likely involve moving some of the diseasetracking functions of the lab to the MaRS research facility at College St. and University Ave. to form a “ critical mass” in monitoring outbreaks, with help from experts at the downtown teaching hospitals.