The embattled Illinois Veterans Home in Quincy (IVHQ) continues to come under heavy scrutiny after it was announced that three new cases of Legionnaires’ disease had been confirmed this month. The outbreak is the fourth in the past four years at the western Illinois long-term care and living facility.

The Illinois Senate overwhelmingly passed a resolution Thursday calling for an audit of the state’s response to the outbreaks. The resolution, which was passed 46-0, designates the Illinois auditor general to perform an examination of the Illinois Department of Veterans’ Affairs (IDVA) and probe their management of the outbreaks, which continue to plague the facility even after more than $6 million in upgrades to the water system were performed.

All of the currently infected residents are recovering and in stable condition.

After the confirmation of the latest round of illnesses, the IDVA announced it would boost disinfection levels in the water to further reduce potential exposure to residents or staff. The following preventative measures also have been enacted:

  • Laminar flow devices, which are filters that reduce the aeration of the water as it flows from the faucet, are being installed on all sinks.
  • Bathing has been limited to showers, which are protected with Legionella-blocking Pall filters.
  • Temperature checks will be conducted on residents every two hours while they are awake, and full vital signs will be recorded every four hours.

There were six confirmed cases of Legionnaires’ disease at IVHQ last year, including the death of one person, raising the number who have died at the facility because of the disease to 13 since 2015. There were more than 50 illnesses and 12 deaths during the 2015 outbreak.

Legionnaires' disease
Legionella bacteria

CDC: Eradication may not be possible

Representatives from the Centers for Disease Control and Prevention (CDC) returned this week to the IVHQ to review testing protocols for individuals with respiratory illness, at the request of the Illinois Department of Public Health (IDPH).

The CDC had warned last month in a 20-page report that the “complete eradication of Legionella in any large, complex building water system may not be possible.” The information was compiled in response to last year’s Legionnaires’ disease outbreak at the IVHQ.

“There is no known safe level of Legionella in building water systems, and cases have been associated with very low levels of bacteria,” the report concluded.

Despite efforts to eliminate Legionella from the IVHQ, the ST36 strain of the bacterium has been identified in the IVHQ water system in each of the past three years.

“It is probable that this strain persists in protective biofilm, scale, and sediment that are present in the plumbing infrastructure,” according to the CDC report.

Politicians look for answers

In December, Illinois Senator Dick Durbin (Dem.) called for the closure of the IVHQ. In January, he changed course.

“I don’t believe (closure) is necessary as long as we have a plan to move forward to make it even safer,” Durbin told the Chicago Tribune. “At the time that I made the statement, there was no plan in place, no suggestion of a plan.”

Illinois Governor Bruce Rauner (Rep.) completed a weeklong stay at the facility on Jan. 10 to show his commitment to finding a solution and learn more about the facilities’ water-management plan. Rauner showered and drank tap water every day during his stay.

Afterward, Rauner announced the state would replace the plumbing at the 130-year-old site. He also said he would assemble a task force to determine whether a state-of-the-art dorm should be built, and whether a safer groundwater source was available.

What is Legionnaires’ disease? 

Legionnaires’ disease – also called Legionellosis and Legionella pneumonia – is a severe type of pneumonia or lung infection. According to the CDC, an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur each year, but only 5,000 cases are reported because of its nonspecific signs and symptoms.

Ten percent of those infected with Legionnaires’ disease will die from the infection.

How do you catch Legionnaires’ disease? 

Legionella bacteria are contracted by inhaling microscopic water droplets (usually mist or vapor). The bacteria, which grow best in warm water, are found primarily in human-made environments.

Outbreaks have been linked to a range of sources:

  • cooling towers in air conditioning systems
  • large plumbing systems
  • water systems like those used in hospitals, nursing homes and hotels
  • hot tubs and whirlpools
  • equipment used in physical therapy
  • mist machines and hand-held sprayers
  • hot water tanks and heaters
  • showers and faucets
  • swimming pools
  • decorative fountains.

People also can contract Legionnaires’ disease when they “aspirate” contaminated drinking water – that is, choking or coughing while drinking can cause water to go down the wrong pipe into the lungs.

It’s also possible to contract Legionnaires’ disease from home plumbing systems, although the vast majority of outbreaks have occurred in large buildings because complex systems amplify the conditions for bacteria to grow and spread more easily.

Who is most susceptible? 

Anyone can get the disease, but those at the highest risk of infection include:

  • people 50 or older
  • smokers, both current and former
  • heavy drinkers of alcohol
  • people with chronic lung disease
  • people with compromised immune systems
  • recipients of organ transplants
  • individuals who are on specific drug protocols (for instance, corticosteroids).

Another illness in Illinois

The Illinois Department of Human Services also announced Wednesday that a patient at the Chester Mental Health Center had contracted Legionnaires’ disease. The patient is being treated and is in stable condition in the southern Illinois facility, the state’s only maximum-security forensic mental health facility for adult males.