Bills require VA report infectious diseases to states

By:  Sean D. Hamill

The Legionnaires' disease outbreak at Pittsburgh Veterans' Affairs' facilities continues to spur action from Congress.

A U.S. House bill introduced Monday would require all VA medical facilities nationwide to report patients' cases of infectious diseases to state health departments where they're located, a requirement by which nonfederal hospitals have to abide, but from which VA facilities are exempt.

Rep. Mike Coffman, R-Colo., introduced the bill following the Legionnaires' outbreak at the Pittsburgh VA that sickened 22 patients and killed at least five of them in 2011 and 2012.

"Requiring VA to follow state guidelines for infectious disease reporting is just a common-sense thing to do," Mr. Coffman, who chairs the subcommittee on oversight for the House Veterans' Affairs Committee, said in a statement.

Mr. Coffman's subcommittee chaired a hearing on the Legionnaires' outbreak in February.

His bill is similar to one being developed in the Senate by U.S. Sen. Bob Casey, D-Pa., who in March proposed making the VA report all Legionnaires' cases and later expanded that to include other infectious diseases, including rabies, measles and yellow fever.

"It is clear that changes need to be made to ensure that the right entities are adequately informed so that they can help stop the spread of this kind of infectious disease," Mr. Casey said in a statement Monday.

VA spokesman Mark Ballesteros said the VA does not provide official views on legislation to the public, but added in a statement: "Senior VA leaders at the local and national levels continue to be directly engaged with members of Congress, leaders in the community, stakeholders, employees, and most importantly, veterans, on this issue."

The VA has never been required to report infectious diseases to state agencies, which then feed that data into a national reporting database overseen by the federal Centers for Disease Control and Prevention.

Despite that, the Pittsburgh VA voluntarily submitted data over the years to the Pennsylvania Department of Health's database.

But as reported by the Pittsburgh Post-Gazette in March, when the CDC came to Pittsburgh in November to help it track the Legionnaires' outbreak, the agency could readily find only 16 of the 21 Legionnaires' cases that the CDC believed had occurred in 2011 and 2012 here.

The Pittsburgh VA has never explained why the CDC could not find those five cases immediately in the national system.

Another problem with the reporting system, though, will have to be dealt with on the state level.

Because of the way the state database is designed, Allegheny County Health Department officials could access Legionnaires' cases that afflicted only Allegheny County residents, which meant local health officials knew about only eight of the 21 cases that occurred at the Pittsburgh VA. Twelve of those other 13 cases involved residents from other Pennsylvania counties and one involved a resident from another state.

Acting Health Department director Ron Voorhees said if he and his staff had known about the other 13 cases, it might have acted differently and it may have led to a quicker reaction to the outbreak.