The Rodeway Inn & Suites in Tomahawk, Wisconsin, reopened to the public August 20 after voluntarily closing for almost a week after a second case of Legionnaires’ disease was confirmed within 12 months.
The hotel, located at 1738 Comfort Drive, shut its doors August 16 to find the source of the Legionella – the bacteria that causes Legionnaires’ disease – and to remediate its water system.
Both illnesses involved hotel guests who were diagnosed with Legionnaires within two weeks of their stay, health officials said. The timetable of the illnesses was not released, nor was the condition of the patients and whether either required hospitalization.
Although the hotel has reopened, the pool and whirlpool remain off-limits to guests.
Rodeway Inn outbreak: OK to open
The hotel’s reopening was authorized by the Lincoln County Health Department (LCHD), which issued a conditional permit based on the hotel meeting interim requirements to address Legionella issues. The hotel was ordered to install point-of-use filters on faucets and showers to minimize exposure risk to Legionella.
Hotel officials also have been required to work with an environmental expert to develop a water-management plan, which will be used to identify possible hazardous conditions and take steps to minimize the growth and spread of Legionella and other waterborne pathogens.
The LCHD is being aided in its investigation by the Wisconsin Department of Health Services (DHS), Division of Public Health (DPH), Centers for Disease Control and Prevention (CDC), and other state partners.
“In the meantime, guests are notified that there still is Legionella,” LCHD director Shelley Hersil said. “It’s being filtered out of the faucets and the showerheads, but it still is in the water system.”
Individuals planning to stay or visit the hotel are advised to evaluate their risk for possible infection or talk to their health provider if they have concerns.
Rodeway Inn outbreak: high risk
Anyone can get Legionnaires’ disease, but those at the highest risk of infection include:
- people 50 or older
- smokers (current or former)
- heavy drinkers of alcoholic beverages
- people with chronic lung disease
- people with weakened immune systems.
After it has been diagnosed, hospitalization is often necessary. In the most severe cases, complications can occur; they include:
- respiratory failure: caused by changes to the lung tissue, or oxygen loss in arteries supplying the lungs.
- septic shock: this can occur when Legionella produce toxins that enter the bloodstream and cause a drop in blood pressure, leading to the loss of adequate blood supply to the organs.
- kidney failure: those same Legionella toxins can damage the kidneys’ ability to eliminate waste from the blood.
- endocarditis: an infection of the inner lining of the heart that can affect the ability of the heart to maintain adequate blood flow through the body.
- pericarditis: swelling of the pericardium, which is the primary membrane around the heart. This can also affect the ability of the heart to circulate blood throughout the body.
Rodeway Inn outbreak: Legionella homes
Legionnaires’ disease 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 in the United States every year. However, only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms.
Legionella are contracted by inhaling microscopic water droplets in the form of mist or vapor. The bacteria, which thrive in warm water, are found primarily in human-made environments, such as:
- water systems of large buildings (hotels, hospitals, nursing homes, etc.)
- air-conditioning system cooling towers
- large plumbing systems
- hot-water heaters and tanks
- bathroom showers and faucets
- swimming pools
- whirlpools and hot tubs
- physical-therapy equipment
- mist machines and hand-held sprayers
- decorative fountains.
Rodeway Inn outbreak: symptoms
Legionnaires’ disease usually develops two to 10 days after exposure to Legionella bacteria. It frequently begins with the following signs and symptoms:
- muscle pain
- fever, which can be 104 degrees Fahrenheit or higher.
By the second or third day, other signs and symptoms develop, including:
- cough, which can bring up mucus and sometimes blood
- shortness of breath
- chest pain
- gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
- confusion and other mental changes.
Although the disease primarily affects the lungs, it occasionally can cause infections in wounds and other parts of the body, including the heart.
Legionnaires’ disease is not contagious – that is, it cannot be passed from person to person. The condition is treatable with antibiotics when diagnosed early enough, although if that does not occur, it can lead to severe complications.
Rodeway Inn outbreak: Wisconsin woes
Legionnaires’ disease has proven very lethal in outbreaks within the state of Wisconsin in the past year as four patients have died:
- In March, health officials announced three people were diagnosed with the disease over a 12-month span, all within two weeks after stays at Christmas Mountain Resort in Wisconsin Dells, and one person died. The resort’s water system tested positive for Legionella.
- In late 2018, a Legionnaires’ disease outbreak linked to UW Hospital and Clinic in Madison sickened 14 people with three deaths. Testing uncovered Legionella in the hospital’s water system.