Missouri public health officials deserve credit for taking action to prevent outbreaks of Legionnaires’ disease similar to what happened next door in Illinois and around the country. The deaths of more than a dozen residents in a single Illinois nursing home sounds an alarm that no state should ignore. Missouri’s new rule requiring immediate notification of any evidence of the disease is exactly the right call.
Legionnaires’ disease is a severe form of pneumonia caused by waterborne bacteria. It’s generally transmitted by breathing in contaminated mist. Named for an outbreak at the American Legion convention in Philadelphia in 1976, the bacteria can breed in air conditioning ducts, swimming pools, plumbing systems and other areas of enclosed water.
For reasons that are still unclear, reported cases have been growing nationally lately, with a five-fold increase over the past 20 years. In 2017 alone, close to 7,500 cases were reported nationally. The actual number of undiagnosed cases of the disease is certain to bump the numbers higher.
Legionnaires’ disease has a roughly 10% fatality rate, and there is no vaccine. So prevention — via scrupulous clean-water maintenance practices — is crucial. Illinois learned that the hard way during its years-long series of outbreaks at the Quincy Veterans Home beginning in 2015. The Civil War-era facility’s aging water systems ushered in an epidemic that was worsened by a lack of urgency in the response of state officials, who took their time declaring a public health crisis because, under state and federal regulations, they could.
The lack of urgency might well have been a matter of government policy failing to keep up with the growing threat from what used to be a much more rare condition. It could also explain why, until this month, Missouri’s policy allowed local health providers to wait up to three days before reporting evidence of the disease to state and federal health officials.
As the Post-Dispatch’s Kurt Erickson reports, the state’s dangerously lackadaisical approach to a potentially deadly infection has now been remedied. The Missouri Department of Health and Senior Services has published an emergency rule change requiring such reporting to be made within one day, lending a far more appropriate urgency to the issue.
The rule notes “the staggering increase in number of cases and the inherent danger of Legionellosis,” the bacterium that causes the infection, creating “an immediate danger to the public health.”
As DHSS Director Randall Williams told the Post-Dispatch, a “robust process of communication and engagement” with local, state and federal health officials is crucial to addressing a disease that literally hangs in the air; that process must start with those who operate the facilities affected. It’s now up to nursing homes — as well as hotels, public swimming venues and anywhere else this threat may be growing — to treat it with the same level of seriousness.