Governor Bruce Rauner’s administration recently shifted course and stated that it will rebuild residence halls at the Illinois Veterans Home in Quincy (IVHQ), which housed victims of a Legionnaires’ disease outbreak in which 13 people died among dozens sickened since 2015.

The plan was announced less than two months after the Republican governor said the state would replace the outdated plumbing system, which could be the likely source of the Legionella bacteria that cause outbreak.

“The cost and the disruption and the construction that would be involved, not to mention the time it would take to do this [plumbing replacement] would just not be worth the effort when you think about building a brand-new building,” said Erica Jefferies, director of the Illinois Department of Veterans’ Affairs (IDVA). “We do not want to spend years tearing up 70-year-old buildings to put brand-new piping in when we know that might not be a total solution.”

The plan to tear down several of the dorms on the 130-year old campus in western Illinois would take place within 3 to 5 years.

Legionnaires’ and Illinois

In other recent Illinois-related Legionnaires’ news:

  • Senator William “Sam” McCann (R-Plainview) called for the resignation of Nirav Shah, director of the Illinois Department of Public Health (IDPH). “We have people living in that facility who survived the battlefield, but they may not survive us,” McCann said.
  • The Illinois House passed a unanimous vote (104-0) asking the IVHQ, the IDVA, the IDPH, and Gov. Rauner’s administration to report on what officials “knew and when they knew it” regarding the outbreak.
  • The Illinois House’s veterans’ affairs committee approved a bill (House Bill 4310) that would require IVHQ officials to notify residents, family and staff of a Legionnaires’ disease outbreak within 24 hours. When the first outbreak occurred in 2015, it took officials six days to notify the public, saying they didn’t realize they were dealing with an “epidemic.”
Legionnaires' disease bacteria
Legionella bacteria

Eradication may not be possible

Representatives from the Centers for Disease Control and Prevention (CDC) returned last month to the IVHQ to review testing protocols for individuals with respiratory illness, at the request of the IDPH.

The CDC warned 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 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.

Legionnaires’ facts and figures

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 who become infected with Legionnaires’ disease will die from the infection.

Contracting Legionnella
Legionella bacteria are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor. The bacteria, which grow best in warm water, are found primarily in human-made environments.

Outbreaks have been linked to a number of sources, including:

  • cooling towers of air conditioning systems
  • large plumbing systems
  • water systems such as those used in hospitals, nursing homes, and hotels (IVHQ undertook a nearly $5 million, state-of-the-art rehabilitation of its water-treatment plant in summer 2016)
  • hot tubs and whirlpools
  • physical therapy equipment
  • 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. That, however, is a very rare occurrence.

Who is most susceptible?
Anyone can get the disease, but those most susceptible to 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 (corticosteroids, to name one).

Legionella bacteria was positively identified by the Florida Department of Health in Sarasota County (FDOH) after testing of a hot water heater in the fitness area at the IslandWalk at West Villages gated community in North Port, FL, according to news reports.

However, the FDOH believes the pool and spa area are where people came into contact with the bacteria, despite the fact that those areas returned negative results for the bacteria after testing.

FDOH officials said that by the end of February, 13 residents had been confirmed with Legionnaires’ disease, which is a severe type of pneumonia caused by Legionella infection. No additional cases have been seen in nearly a month, so officials said they believe the threat is contained.

“The temperature of the water heater was lower than it should have been,” Environmental Health Director Tom Higginbotham said. “This was a low-use hot water heater that wasn’t serving any showers, just hand sinks, so I don’t see any negligence at this point.”

Domestic water heaters need to be maintained at 140 degrees Fahrenheit and water delivered at the faucet at a minimum of 122 degrees in order to control the growth of Legionella, according to the Occupational Safety and Health Administration.

The spa and pools have been sanitized, according to IslandWalk officials, and they are replacing the contaminated water heater.

IslandWalk at the West Villages
The pool and spa area at IslandWalk remain temporarily closed until health officials give the all clear.

IslandWalk at the West Villages

IslandWalk at the West Villages is an 830-acre, gated, lakefront community of luxury single-family homes, patio homes, and townhomes surrounded by lakes and preserves. The community’s features include a resort center, fitness center, movement studio, resort and lap pools, and sports courts.

North Port is located in southern Sarasota County.

Residents or visitors to the IslandWalk gated community who are exhibiting pneumonia- or flu-like symptoms (see symptoms below) should seek immediate medical attention from their primary health-care provider.

Legionnaires’ facts and figures

Legionnaires’ disease – also called legionellosis and Legionella pneumonia – is a severe type of pneumonia or lung infection. According to the Centers for Disease Control and Prevention (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 who become infected with Legionnaires’ disease will die from the infection.

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

Outbreaks have been linked to a number of sources, such as:

  • hot water tanks and heaters
  • showers and faucets
  • swimming pools
  • hot tubs and whirlpools
  • equipment used in physical therapy
  • mist machines and hand-held sprayers
  • the cooling towers of air conditioning systems
  • large plumbing systems
  • water systems such as those used in hospitals, nursing homes, and hotels
  • 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 is 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 at risk for infection?
Anyone can get the disease, but those most susceptible to infection include:

  • people 50 years of age or older
  • smokers, current and former
  • heavy drinkers of alcoholic beverages
  • people with chronic lung disease
  • people with compromised immune systems
  • recipients of organ transplants
  • individuals who are on specific drug protocols (corticosteroids, to name one).

Symptoms are numerous
Legionnaires’ disease is similar to other types of pneumonia (lung infection). Symptoms can resemble flu-like symptoms in the following forms:

  • cough
  • shortness of breath
  • fever
  • muscle aches
  • headaches
  • gastrointestinal symptoms, such as nausea, vomiting, and diarrhea.

New testing conducted at the Robinson Renaissance office building in downtown Oklahoma City no longer showed the existence of Legionella bacteria, according to a report by that city’s KFOR-TV.

At least six employees who worked in the building tested positive for Legionella bacteria infection in February, according to KFOR-TV sources, which is why testing was ordered. Laboratory testing at that time returned evidence of the bacteria in one of the building’s cooling systems.

Legionella is the bacteria that causes Legionnaires’ disease – a potentially deadly type of pneumonia – and a milder, flu-like condition known as Pontiac fever.

No additional information regarding the condition of the sickened employees or the severity of their illness was made available.

Officials confirmed that regular screenings of the building’s cooling tower will be added to the building’s maintenance schedule in an effort to identify potential issues, so that problems can be remediated more quickly.

Employees or recent visitors to the Robinson Renaissance building or the surrounding area who may be exhibiting flu-like or respiratory illness (see symptoms below), or who have concerns about their health, should immediately contact their medical provider.

The 13-story Robinson Renaissance building is located at 119 N. Robinson Ave. It is owned by the Commissioners of the Land Office state agency, which paid $8.95 million for the 174,140-square-foot, U-shaped building in 2014. It was originally called the Perrine Building when it opened in 1927.

Legionnaires' disease bacteria

How is Legionella contracted?

Legionella bacteria are contracted by inhaling microscopic water droplets in the form of 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, such as:

  • cooling towers in air conditioning systems
  • large plumbing systems
  • hot-water tanks and heaters
  • hot tubs and whirlpools
  • swimming pools
  • showers and faucets
  • decorative fountains
  • mist machines
  • equipment used in physical therapy.

What are the symptoms?
The symptoms of Legionnaires’ disease – also called legionellosis or Legionella pneumonia – are similar to other forms of pneumonia or flu, which is why so many cases go unreported annually. Early symptoms can include the following:

  • chills
  • fever (potentially 104 degrees or higher)
  • headaches
  • loss of appetite
  • muscle aches.

After the first few days, symptoms can worsen to include:

  • chest pain when breathing (called pleuritic chest pain, due to inflamed lungs)
  • confusion and agitation
  • a cough, which may bring up mucus and blood
  • diarrhea (about one-third of all cases result in gastrointestinal problems)
  • nausea and vomiting
  • shortness of breath.

The incubation period – the amount of time between breathing in the bacteria and developing symptoms – is usually 2 to 10 days after exposure and can be as much as 16 days.

Newly released emails from the Illinois governor’s office illustrate how state officials worked to control the release of information to the public during the 2015 Legionnaires’ disease outbreak at the Illinois Veterans Home in Quincy (IVHQ).

The state conceded that the first news release confirming eight cases of Legionnaires’ disease at IVHQ in August 2015 did not occur until six days after officials realized they were dealing with an “epidemic.”

In all, 12 people died and 53 others were sickened during the 2015 outbreak.

The state is currently battling an outbreak at the veterans home for the fourth consecutive year after four residents were sickened with Legionnaires’ in February. There were six confirmed illnesses due to the deadly infection in 2017, including the 13th death since 2015.

The released emails include exchanges between state and local public health officials and the state agency – the Illinois Department of Veterans Affairs (IDVA) – that oversees the IVHQ.

In one of the email threads, a spokesperson for the IDVA wrote “there is no cause for alarm.” In another, Robert Merrick, an epidemiologist at Blessing Hospital in Quincy, described a draft of the news release as “smoke to cover people’s butts.”

Governor Bruce Rauner’s staff attempted to keep the messages secret, denying open records act requests from Chicago’s WBEZ Radio, which was the first to receive the emails upon their eventual release.

WBEZ was also the first to report last year that 11 families are suing the state of Illinois for negligence, asserting that the deaths at the home were preventable.

Rauner, a Republican seeking a second term this year, defends his administration’s handling of the crisis, going so far as to say he “wouldn’t have done anything differently.”

Rauner’s opponents say the emails show his administration was more concerned with perception – in both the media and by the public – than they were about finding a solution and repairing the predicament.

In related Illinois news:

Governor aide to oversee Legionnaires’ response
On Friday, Gov. Rauner named Michael Hoffman as his senior advisor with operational oversight of the IVHQ to address the ongoing health crisis at the facility. Hoffman, who is a retired Marine officer, is the acting director of the Illinois Department of Central Management Services (CMS).

Dave MacDonna, Illinois Department of Veterans’ Affairs public information officer, said Hoffman will have “operational oversight of the Legionella eradication effort.” Hoffman’s appointment does not change the responsibilities of IVHQ administrator Troy Culbertson or Department of Veterans’ Affairs Director Erica Jeffries.

Before Hoffman’s service in state government, he spent more than 15 years on active duty as a Marine Corps infantry officer. During his military service, he served in Iraq and Afghanistan and was awarded two Bronze Stars, one for valor in combat. He has been acting head of CMS since January 2016.

Legionnaires' disease
Legionella bacteria

What is Legionnaires’ disease? 

Legionnaires’ disease – also called Legionellosis and Legionella pneumonia – is a severe type of pneumonia or lung infection. According to the Centers for Disease Control and Prevention (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 who become infected with Legionnaires’ disease will die from the infection.

How do you contract Legionnaires’?
Legionella bacteria are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor. The bacteria, which grow best in warm water, are found primarily in human-made environments.

Outbreaks have been linked to a number of sources, including:

  • the cooling towers of air conditioning systems
  • large plumbing systems
  • water systems such as 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 is 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 at risk for infection?
Anyone can get the disease, but those most susceptible to infection include:

  • people 50 years of age or older
  • smokers, current and former
  • heavy drinkers of alcoholic beverages
  • people with chronic lung disease
  • people with compromised immune systems
  • recipients of organ transplants
  • individuals who are on specific drug protocols (corticosteroids, to name one).

Officials at Brooke Army Medical Center believe they’ve identified the likely source of the Legionella bacteria that infected an employee in early February, after two different incidents of employees becoming infected with Legionnaires’ disease since last August, according to multiple news reports.

Extensive testing was conducted in Building 15 after two cases of Legionnaires’ were confirmed in August, but no source for the bacteria was found at that time.

The latest round of testing revealed that Legionella bacteria, the bacteria that causes Legionnaires’ disease, was present in a hot-water heater.

After the newest illness was confirmed in early February, all personnel and patients were moved out of the affected building on Feb. 6 – the second time the building was vacated since August. It remains shuttered and secured until officials are assured the building is safe.

“We are fully cooperating with local and regional public health officials to ensure there is no further risk for exposure moving forward,” said Col. Traci Crawford, BAMC deputy commanding officer. “BAMC leadership is fully committed to providing a safe environment for all patients and staff.”

All three individuals infected with Legionnaires’ disease were civilian employees. All three have recovered, according to hospital officials.

Patients, employees or recent visitors to Building 15 or the surrounding area (Building 15 is adjacent to the hospital) who may be exhibiting symptoms of Legionnaires’ disease (see below) or concerns about their health should immediately contact their medical provider.

Legionnaires’ disease facts 

Legionnaires’ disease – also known as Legionellosis or Legionnaires’ pneumonia – is a respiratory disease caused by Legionella bacteria. The bacteria also can create a less serious infection called Pontiac fever, which has symptoms similar to a mild case of the flu.

How do you get Legionella?
Legionella bacteria are contracted by inhaling microscopic water droplets in the form of 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, such as:

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

What are the symptoms?
The symptoms of Legionnaires’ disease look like other forms of pneumonia or even flu, which is why so many cases go unreported every year. Early symptoms can include the following:

  • chills
  • fever (potentially 104 degrees or higher)
  • headaches
  • loss of appetite
  • muscle aches.

After the first few days of the disease presenting, symptoms can worsen to include:

  • chest pain when breathing (called pleuritic chest pain, due to inflamed lungs)
  • confusion and agitation
  • a cough, which may bring up mucus and blood
  • diarrhea (about one-third of all cases result in gastrointestinal problems)
  • nausea and vomiting
  • shortness of breath.

The incubation period – the amount of time between breathing in the bacteria and developing symptoms – is usually 2 to 10 days after exposure and can be as much as 16 days.

A gated community in North Port, FL, has been infected with a potentially sizeable Legionnaires’ disease outbreak, according to multiple news reports. Three illnesses have been confirmed, and up to 25 people may have been infected.

The Florida Department of Health in Sarasota County (SCHD) is investigating the outbreak at the IslandWalk at the West Villages community. Officials at IslandWalk temporarily have shut down the pool and spa after being advised of the illnesses.

According to an email sent out by a spokesperson for the facility: “The pool and spa were closed within 30 minutes of being contacted, and residents were notified. The facilities will remain closed pending further testing. We are working with the Sarasota Department of Health to get this issue resolved. Our first priority is the safety of our residents.”

The outbreak was first diagnosed at IslandWalk by Dr. Ahmed Farooq, an infectious disease physician with Venice Regional Bayfront Health. Dr. Farooq contacted the health department after he discovered the first case, then told the Sarasota Herald-Tribune that he determined that IslandWalk’s hot tub was the common denominator after diagnosing the second case.

Reports vary on outbreak size

Farooq could not provide a definitive number of illnesses, but he said quite a few cases have been treated.

A report on keephealthcare.org stated an “IslandWalk resident who called the Herald-Tribune said as many as 25 people may have been affected.” Another report by WFLA-TV said, “residents say at least 11 people were taken to area hospitals for treatment.”

A Sarasota Memorial Hospital spokesperson told the Herald-Tribune: “Three cases were diagnosed at the hospital last weekend.”

Pool and spa are likely sources

“The really important thing is identifying the source,” said Michael Drennon,  SCHD director of disease intervention. “We believe it may be the pool or spa area in the community that these individuals live in. We want to do some specialized testing of the water sources there.”

Said Tom Higginbotham, SCHD environmental health director: “We’re going to test the irrigation system [and] anything else that we think could be a potential source,”

The community’s irrigation system draws water out of untreated lakes. Legionella, which is the bacteria that causes Legionnaires’ disease, is found naturally in such freshwater environments.

Test results are expected by mid-March.

IslandWalk at the West Villages
A Legionnaires’ outbreak has struck IslandWalk at the West Villages in North Port, FL.

IslandWalk at the West Villages

IslandWalk at the West Villages is an 830-acre, gated, lakefront community of luxury single-family homes, patio homes, and townhomes surrounded by lakes and preserves. The community’s features include a resort center, fitness center, movement studio, resort and lap pools, and sports courts.

North Port is located in southern Sarasota County.

Residents or visitors to the IslandWalk gated community who are exhibiting pneumonia- or flu-like symptoms (see symptoms below) should seek immediate medical attention from their primary health-care provider.

Legionella facts and figures

After Legionella grow and multiply in a community’s water system, the contaminated water spreads in droplets small enough to inhale. When the bacteria reach the lungs, they can cause people to become ill with Legionnaires’ disease.

Legionella become a health concern when they grow and spread in human-made environments, such as:

  • pools and hot tubs
  • showers and faucets
  • decorative fountains and water features
  • hot-water tanks and heaters
  • large plumbing systems, like those used in hotels, assisted living facilities, and gated communities
  • cooling towers (air-conditioning units for large buildings).

Individuals at increased risk
Most healthy people exposed to Legionella do not get sick. People who meet any of the following criteria are at higher risk:

  • people 50 or older
  • current or former smokers
  • people with undisclosed illnesses, such as diabetes, kidney failure or liver failure
  • people with weakened immune systems
  • people with chronic lung disease
  • people with cancer.

Symptoms are numerous
Legionnaires’ disease is similar to other types of pneumonia (lung infection). Symptoms can resemble flu-like symptoms in the following forms:

  • cough
  • shortness of breath
  • fever
  • muscle aches
  • headaches
  • gastrointestinal symptoms, such as nausea, vomiting, and diarrhea.

The Illinois Department of Public Health (IDPH) said a state resident visiting the capitol city of Springfield was diagnosed with Legionnaires’ disease, according to multiple news reports.

The news comes after positive tests of Legionella bacteria – the bacteria that causes Legionnaires’ disease – were reported at the Capitol Complex and the Comptroller’s building since late January.

It is not known where the person was exposed to Legionella. The IDPH is investigating the person’s recent travel itinerary, including examining the hotel where the individual stayed during their January visit as well as the Capitol Complex, which they visited. The hotel was not identified.

No further information regarding the state resident was made available by public health officials.

Capitol Complex clear of Legionella

Follow-up testing at two locations in the Capitol Complex that tested positive last month has come back negative for Legionella, according to Henry Haupt, a spokesperson for the Secretary of State’s office, which oversees the complex. Those locations are:

  • The women’s restroom in the basement of the Michael J. Howlett Building, which is next door to the Capitol.
  • An industrial humidifier in the south wing of the Capitol building.

Nine retests in the restroom and seven in the humidifier were conducted after the areas were drained and disinfected and the water system flushed.

Since the positive Legionella test at the complex, workers have removed aerators from faucets and disabled showers throughout the buildings.

Information about follow-up testing at a third location – the cooling tower in the Central Management Services’ (CMS) computer center – that also tested positive was not available to Haupt because CMS operates it.

State officials also confirmed a positive test for Legionella at the State Comptroller building. The Comptroller building and the Capitol Complex do not share the same water system.

In mid-February, a patient at the Chester Mental Health Center contracted the disease at the state’s only maximum-security forensic mental health facility for adult males.

Woes continue to plague Veterans Home

The state also is battling a Legionnaires’ disease outbreak at the Illinois Veterans Home in Quincy (IVHQ) for the fourth consecutive year after the fourth resident of 2018 was confirmed with the disease.

There were six confirmed cases at IVHQ last year, including the death of one person. The 2017 outbreak increased the number who have died at the facility because of Legionnaires’ disease to 13 since 2015. There were more than 50 illnesses and 12 deaths during the 2015 outbreak.

Nearly 300 cases of Legionnaires’ disease are reported in Illinois each year, according to the IDPH.

What is Legionnaires’ disease? 

Legionnaires’ disease – also called Legionellosis and Legionella pneumonia – is a severe type of pneumonia or lung infection. According to the Centers for Disease Control and Prevention (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 who become infected with Legionnaires’ disease will die from the infection.

How do you catch Legionnaires’? 

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

Outbreaks have been linked to a number of sources, including:

  • the cooling towers of air conditioning systems
  • large plumbing systems
  • water systems such as 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 is 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 years of age or older
  • smokers, current and former
  • heavy drinkers of alcoholic beverages
  • people with chronic lung disease
  • people with compromised immune systems
  • recipients of organ transplants
  • individuals who are on specific drug protocols (corticosteroids, to name one).

A fourth case of Legionnaires’ disease since Feb. 12 was confirmed at the Illinois Veterans Home in Quincy (IVHQ) after a positive laboratory testing, according to the Illinois Department of Public Health (IDPH) and the Illinois Department of Veterans’ Affair (IDVA). The resident is recovering and in stable condition.

It is the fourth consecutive year the IVHQ has had to deal with a Legionnaires’ disease outbreak. There were six confirmed cases of Legionnaires’ at IVHQ last year, including the death of one person. That outbreak increased 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.

Representatives from the Centers for Disease Control and Prevention (CDC) returned to IVHQ last week, at the request of the IDPH, to review testing protocols, and offer additional support and guidance. Staff from the CDC are working with IVHQ and IDPH officials to complete the following checklist:

  • Conduct environmental and epidemiological assessments to identify potential exposure sources.
  • Increase clinical testing protocols for people with respiratory illness to include not only testing for Legionella, but also for influenza and other respiratory viruses.
  • Conduct clinical and environmental sample testing at the CDC.
  • Identify public health and infection control interventions.
  • Partner in communications with the local hospital to streamline testing.

Illinois Senator promises federal help

Democratic Illinois Senator Tammy Duckworth, who is a retired U.S. Army Lieutenant Colonel and former director of the IDVA, toured IVHQ this week and said she would work to get federal money to battle the Legionella problem at the home.

She also took a shot at Governor Bruce Rauner for not having fixed the problem.

“What he has failed to do is communicate accurately and completely with Sen. Durbin and myself,” Duckworth said. “We stand ready to help and find the federal resources.”

Duckworth said Rauner has made no formal request for assistance from the federal government to address the issues at the IVHQ.

Earlier this month, Rauner unveiled his 2019 budget proposal, which included an allocation of “$50 million for capital improvements to the Quincy Veterans’ Home in response to the health and safety concerns” caused by the Legionnaires’ disease outbreaks.

Sen. Tammy Duckworth was deployed to Iraq as a Black Hawk helicopter pilot for the Illinois Army National Guard. On Nov. 12, 2004, her helicopter was hit by an RPG and Duckworth lost her legs and partial use of her right arm.

Gubernatorial opponent slams Rauner

“What the hell is wrong with this Governor?” Rep. Jeanne Ives said in reference to the IVHQ situation. “Veterans and their families are getting sick and dying, Governor. Get them out of there now.”

Ives is running against Rauner in the GOP gubernatorial primary.

Ives said that if she were governor, she’d seek emergency federal funds. “This is a three-year crisis, and nothing has been done,” she said.

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 the respiratory illness will die from the infection.

How do you catch Legionnaires’ disease? 

Legionella bacteria are contracted by inhaling microscopic water droplets, usually in the form of 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:

  • large plumbing systems
  • water systems like those used in hospitals, nursing homes, and hotels
  • cooling towers in air conditioning systems
  • hot tubs and whirlpools
  • physical-therapy equipment
  • 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 years of age or older
  • smokers, current and former
  • heavy drinkers of alcohol
  • people with chronic lung disease
  • people with weakened immune systems
  • recipients of organ transplants
  • individuals who are on specific drug protocols (such as corticosteroids).

More Legionella found in Illinois state offices

Elsewhere in Illinois, Legionella bacteria was detected in the hot water supply after testing at the state Comptroller’s office, according to an e-mail sent to staff Tuesday from Assistant Comptroller Marvin Becker.

Testing was ordered after the bacteria was found at the state Capitol Complex in January. The water supplies between the Capitol and the comptroller’s building are separate from each other.

Officials say they’re not aware of any Legionnaires’ disease illnesses affecting any state employees or the public from either the Comptroller’s office or the Capitol Complex.

The Illinois State Comptroller building is located at 325 West Adams Street in Springfield.

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.

The 2014-15 Legionnaires’ disease outbreak in Flint, MI, was caused by low chlorine levels in the municipal water system, according to a pair of new studies published recently in the Proceedings of the National Academy of Sciences and the journal mBio.

The outbreak, attributed to the ongoing Flint water crisis, killed 12 people and sickened nearly 90. The number of deaths produced by the water crisis increased to 13 in December. 

The studies were conducted by Michele Swanson and colleagues at the University of Michigan in Ann Arbor, Sammy Zahran of Colorado State University, and a team of researchers at Wayne State University in Detroit. Swanson has been studying Legionnaires’ disease for 25 years.

The research suggests that a complex set of factors is responsible for low chlorine levels during the crisis. Chlorine is responsible for killing microbes in the water. Lead, iron and organic matter in the water supply, however, can lead to decreases in the amount of chlorine available to kill bacteria.

A switch of Flint’s water source in April 2014 from Lake Huron to the Flint River introduced such heavy metals into Flint’s water system, causing the chlorine levels to lower and leading to the deadly outbreak.

“The really striking finding from our research is that the amount of chlorine that needs to be present is actually influenced by other factors in this large municipal water system,” says Swanson. “So, for example, during the Flint water crisis, the amount of chlorine that needed to be present to reduce the risk of disease was much higher than normal.”

The outbreak ended when the city switched back to its original water source.

According to NPR, the results of the study may be referenced in the ongoing court cases against six state and local water officials facing charges of involuntary manslaughter related to the Legionnaires’ disease deaths during the Flint water crisis.

 

Flint Water Treatment Plant

Chlorination explained

Chlorination is the process of adding chlorine to drinking water to disinfect it and kill germs, according to the Centers for Disease Control and Prevention (CDC). Different processes can be used to achieve safe levels of chlorine in drinking water.

Chlorine is available as compressed elemental gas, sodium hypochlorite solution (naOCI) or solid calcium hypochlorite (Ca(OCI)₂. While the chemicals could be harmful in high doses, when they are added to water, they mix and spread, resulting in low levels that kill germs but are safe to drink.

There are drawbacks to chlorination, according to the CDC:

  • relatively low protection against protozoa
  • lower disinfection effectiveness in turbid waters
  • potential taste and odor objections
  • potential long-term effects of chlorination by-products.

The benefits of chlorination, however, are numerous:

  • proven reduction of most bacteria and viruses in water
  • residual protection against recontamination
  • ease-of-use and acceptability
  • proven reduction of diarrheal disease incidence
  • scalability and low cost.