A bacterial infection that plagued New York City for weeks has traveled nearly 1,000 miles to two more states. 

Cases of Legionnaires’ disease in Marshall County, Iowa, have seen a sharp increase, doubling to 68 since the announcement of a cluster on Thursday, September 4.

Officials from the Iowa Department of Health remain uncertain about the outbreak’s source in the county, which has a population of about 40,000. An investigation has been initiated to uncover its origins.

Their primary concern is examining 12 cooling towers, which are large air conditioning units for sizable buildings in the north-central area of town. These are suspected to be the most probable sources of the contaminated aerosolized water droplets.

Legionnaires’ disease spreads through aerosolized droplets that carry the bacterium Legionella. This bacterium can remain airborne in water droplets for several hours, though this duration varies significantly with factors like relative humidity and the specific bacterial strain.

Characterized by pneumonia, the disease causes a severe lung infection often starting with a high fever that may exceed 104 degrees Fahrenheit (40 degrees Celsius). Symptoms quickly escalate to include a persistent, dry cough and significant shortness of breath.

The illness affects the whole body, manifesting muscle aches, headaches, and mental confusion, as well as severe gastrointestinal issues such as nausea, diarrhea, and abdominal pain. In extreme cases, the infection can result in coughing up blood.

Sydney Grewell, the county’s health department director, said the scale of the outbreak is unlike anything the community or the state has experienced.

The recent outbreaks mirror a major incident in Manhattan, where tainted cooling towers sickened 114 people and resulted in seven fatalities throughout Harlem and Morningside Heights

Earlier this month, it was announced that a deadly outbreak of Legionnaires’ disease, which first tore through New York City neighborhoods, has now spread to the city’s northern suburbs, claiming new lives.

Health officials in Westchester County announced two fatalities, one in White Plains and another in New Rochelle, and confirmed 35 additional cases. 

The outbreak echoes a recent crisis in Manhattan, where 114 people were sickened across Harlem and Morningside Heights, leading to seven deaths traced to contaminated cooling towers.

While the source of the Westchester cluster remains under investigation, Health Commissioner Dr Sherlita Amler pointed to the summer’s prolonged stretch of 90-degree days as a key factor, creating the warm, stagnant water conditions in which the lethal Legionella bacteria thrive.

Meanwhile, in Michigan, a deadly outbreak of Legionnaires’ disease at a retirement community claimed the lives of two residents this summer, prompting an urgent investigation by health officials.

The deceased, both residents of Allegria Village in Dearborn, contracted bacterial pneumonia in June and July. While their identities have not been released, officials confirmed they had recently moved into separate units within the continuing care facility.

The Wayne County Health, Human and Veterans Services department is leading the investigation, which is still in its early stages, to determine the source of the contamination and ensure the safety of other residents and staff.

Up to 18,000 people are hospitalized with Legionnaires’ disease each year in the US, and about one in 10 die. It’s more common between June and October, in part because air conditioners run more than any other time of year and cooling towers are typically the cause of outbreaks.

The number of Legionnaires’ disease cases in Marshall County, Iowa, has surged to 68, doubling the total in just over a week

Despite launching an investigation, health officials in Iowa have not yet identified the source of the outbreak in the county, which has a population of approximately 40,000 people

The Legionella bacteria thrive in warm water. Summer weather creates ideal conditions for it to multiply to dangerous levels in human-made water systems. 

Iowa health officials have not said how many of the 68 patients in that state have been hospitalized. In Marshall County, one death has been recorded: Father Bernard ‘Bernie’ Charles Grady, 82.

The retired Catholic priest, described by his brother Peter as a ‘remarkable’ and ‘incredible’ man, became the outbreak’s first and, so far, only fatality according to SiouxLand Proud.

Specialized testing confirmed he had been infected by the bacteria. 

His illness began suddenly with dizziness during dinner on August 22nd. A week later, after suffering from congestive heart failure, he passed away in a Waterloo hospital.

The extremely high fevers associated with Legionnaires’ disease drastically increase the body’s metabolic rate. This means the heart has to work much harder and faster to deliver oxygen and nutrients to fight the infection.

Infections are more likely to be severe in seniors, who have weaker immune systems than younger populations.  

In severe cases, the bacterial infection can spread to the bloodstream, leading to sepsis, which in turn can cause a dramatic drop in blood pressure. 

in Michigan, a deadly outbreak of Legionnaires’ disease at a retirement community has claimed the lives of two residents this summer, prompting an urgent investigation by health officials

To compensate, the heart must pump even more vigorously, which can overwhelm a heart that is already weakened or has pre-existing conditions.

In the US, an estimated 250 to 800 people die from Legionnaires’ disease each year, based on reported case data, which represents only a fraction of actual cases.

The symptoms of Legionnaires’ disease are indistinguishable from those of many other types of pneumonia. 

Without a specific reason to suspect Legionella, a doctor will often diagnose and treat it as community-acquired pneumonia, without ever identifying the exact cause.

Health department director Grewell said: ‘This is something I’ve never experienced. I don’t think this is something that Marshall County has experienced, and I don’t think this is something the state has experienced as well, especially of this magnitude.

‘We have seen some trends in the patients that we are seeing, which is why we narrowed the focus to northcentral Marshalltown. Those people have visited the area, traveled to the area, and that’s where our cooling towers are primarily located.’