Iowa HHS Announces Investigation of Legionnaires’ Disease Cluster in Marshalltown

The Iowa Department of Health and Human Services (Iowa HHS) is investigating a cluster of Legionnaires' disease cases among individuals living in north central Marshalltown. Since the beginning of the investigation, 21 individuals have been diagnosed with Legionnaires' disease and an older adult with underlying health conditions has died. Iowa HHS shares our condolences to the family and friends of this individual.

Legionnaires' disease is caused byLegionellabacteria and thrives in warm water environments and is typically spread through the inhalation of aerosolized water droplets, such as mist from cooling towers, hot tubs, and decorative fountains. Legionnaires' disease is not contagious and most healthy people who are exposed to Legionellabacteria do not get sick.

"Iowans should know that Legionnaires' disease can be effectively treated with antibiotics if diagnosed early. Adults aged 50 and older, those who smoke or individuals with chronic lung conditions should seek medical care promptly if they develop flu-like or respiratory symptoms," said Dr. Robert Kruse, Medical Director at Iowa HHS.

People who are more likely to experience severe illness from Legionnaires' disease include individuals 50 years and older, those with weakened immune systems, those with chronic respiratory conditions (e.g. asthma, COPD) and smokers. Symptoms most associated with pneumonia and Legionnaires' disease include:

• Fever
• Cough
• Shortness of breath
• Muscle aches
• Headaches
• Chest pain
• Gastrointestinal symptoms such as nausea or diarrhea

The risk to anyone who lives or visits Marshalltown is low, however, Iowa HHS recommends that individuals who live and work in this area and who become ill with pneumonia-like illness visit their primary care doctor and discuss this advisory. Iowa HHS has communicated with health care providers to consider testing for Legionnaire's disease (LD) in any patient who develops pneumonia and lives in, works in, or has spent significant time in north central Marshalltown the 14 days before symptom onset.

Additionally, Iowa HHS is asking businesses and property owners to review their water management practices, especially those with cooling towers, hot tubs, or fountains. The following steps are recommended to help mitigate the spread of Legionella:

• Review, maintain and/or establish a water management program.
• Disinfection of cooling towers and water systems to prevent bacteria growth.
• Perform routine water system maintenance and maintain records and logs.
• Perform Legionella testing through accredited laboratories, particularly following any remediation efforts.