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Legionnaires Disease-Illinois

In this Sept. 10, 2015 photo, kitchen workers Andrew Campbell, right, and Mary Ueberlauer, center, wash serving trays by hand in large vats usually used for cooking at the state veterans home in Quincy, Ill. The temporary measure was required as the home�s drinking water system was disinfected with chlorine to help fight a Legionnaires� disease outbreak that has killed nine residents so far and sickened at least 45 other people at the home, including five workers. (AP Photo/Alan Scher Zagier)

JEFFERSON CITY — Hoping to avoid outbreaks similar to one that left 14 dead at a state-run nursing home in Illinois, Missouri health officials are tightening the requirements for reporting Legionnaires’ disease.

In an emergency rule change published earlier this month, the Missouri Department of Health and Senior Services wants health providers to report evidence of Legionnaires’ within one day, rather than the current three-day period.

Department chief Randall Williams told the Post-Dispatch that a shorter time period will help the state act more aggressively in tamping down the possible spread of the severe form of pneumonia.

“It is incredibly important in these cases to have a very robust process of communication and engagement with your local health department, your state health department and the Centers for Disease Control,” Williams said.

Now, Legionnaires’ will be placed in the same category of diseases that require one-day reporting, such as measles and polio.

The change comes as the number of cases of Legionnaires’ has risen by 500 percent from 2000 to 2017, according to the U.S. Centers for Disease Control and Prevention.

“Due to the staggering increase in number of cases and the inherent danger of Legionellosis, it is imperative for the local health authority or DHSS to be notified within one day of detection in order to take appropriate measures,” the emergency rule notes. “DHSS finds that there is an immediate danger to the public health, safety, or welfare, which requires this emergency action.”

The disease was named after the 1976 American Legion convention in Philadelphia, at which dozens of people caught pneumonia from bacteria that had been breeding in a hotel’s cooling towers.

Legionella bacteria are found naturally in soil and freshwater environments, like lakes and streams. It typically becomes a health concern when it gets trapped in water systems, like it did at the Quincy Veterans Home in Illinois.

Other outbreaks have occurred in pools, hotels, hospitals and prisons.

The disease is not spread from person-to-person contact. Rather, the bacterium makes its way into the lungs of most people who become ill after they breathe in mist or steam infected with Legionella.

In Missouri, 812 people have contracted Legionnaires since 2014 and 44 have died, according to the health department. The highest number of deaths annually were in 2014 and 2016, when 10 people died of the disease.

So far this year, 110 cases have been reported, resulting in five deaths.

An audit of the Quincy facility found that 14 residents died and 66 residents and eight employees or volunteers tested positive for legionella during a 2015 outbreak.

The audit also noted that there were no legionella policies in place and there had been no training on legionella before the outbreak.

Illinois taxpayers could face a potential bill of as much as $24 million to settle all of the lawsuits related to the outbreak.

On Monday, the Georgia Department of Public Health said at least nine people who spent time at a hotel in Atlanta have contracted the disease. The Sheraton hotel voluntarily closed in mid-July after guests tested positive for the disease.

The Atlanta Journal-Constitution said investigators are testing water in pools, fountains, hot tubs, faucets, chillers and other locations at the hotel, which will remain closed until at least mid-August.

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Kurt Erickson is a reporter for the St. Louis Post-Dispatch