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Biological Health Hazard – Legionellosis (fatal): Flint, Michigan

2016/04/14

LEGIONELLOSIS – USA (02): (MICHIGAN) FATAL, NOSOCOMIAL, 2014-2015, RFI
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Published Date: 2016-04-14 10:23:54
Subject: PRO/EDR> Legionellosis – USA (02): (MI) fatal, nosocomial, 2014-15, RFI
Archive Number: 20160414.4159246

Date: Tue 12 Apr 2016
Source: Food Poisoning Bulletin [edited]

A statement that 2 more people in the Flint area [Michigan] have been added to the death toll of the legionnaires’ disease outbreak has been released by the Michigan Department of Health and Human Services (MDHHS). That outbreak may be linked to the city’s contaminated water supply.

Public health officials reviewed hospital data and discovered 3 more cases; 2 of those people died. Now 12 people are dead from legionnaires’ disease in that city in this particular outbreak. 91 confirmed cases of the illness were diagnosed from June 2014 through October 2015, after a city manager appointed by Republican governor Rick Snyder, changed the city’s water supply from the Detroit Water and Sewerage Department to the Flint River to save money.

Residents immediately noticed that the water coming out of their taps was smelly and murky. This water was so corrosive, in fact, that it began leaching lead from the aging pipes throughout the city. Many children have been diagnosed with lead poisoning in that city after the switch. “To date, 91 cases and 12 deaths have been identified in total for 2014 and 2015 in Genesee County,” said Dr Eden Wells, Chief Medical Executive with the MDHHS. Of the 3 additional cases, 2 were not appropriately reported, and the 3rd was reported in a different area.

Attorney Eric Hageman represents clients sickened with legionnaires’ disease and the families of those who have died from the illness. Contact him by calling 1-888-377-8900. The poor water quality may have been a factor in the increase in legionnaires’ disease cases. The water from the Flint River was high in organic matter that feed the pathogenic _Legionella_ bacteria. The number of legionnaires’ disease cases over the time frame specified would normally be about a dozen.

The symptoms of legionnaires’ disease include chills, fever, cough, muscle aches, shortness of breath, confusion, fatigue, loss of appetite, and diarrhea. The symptoms are very similar to pneumonia, but legionnaires’ disease has a much higher fatality rate. This illness is not usually diagnosed until a large number of people start presenting with the same symptoms. People who are most at risk for contracting this illness are over the age of 50, current or former smokers, people with chronic lung diseases, and those with a weakened immune system. The fatality rate of legionnaires’ disease is usually around 30 percent.

About 50 of those sickened and some of those who died in this outbreak were patients at the [McLaren] Flint hospital that is served by the City of Flint municipal water system in the 2 weeks before they got sick. _Legionella_ bacteria were found in the hospital’s water supply.

[Byline: Linda Larsen]

Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[There are now a total of 91 confirmed cases of legionnaires’ disease diagnosed from June 2014 through October 2015, with 12 deaths in the city of Flint, Michigan, when only 12 cases would have been expected to have occurred during this period. 50 of the 91 cases were hospitalized in the 2 weeks before they got sick at the McLaren Flint hospital that is served by the City of Flint municipal water system. The incubation period for legionnaires’ diseases is 2 to 10 days after exposure, which implicates exposure to a water source in the hospital for their illness.

However, to make a definitive link between a suspected water source and legionnaires’ disease requires matching the genotype of a strain of the _Legionella_ bacillus isolated from a Flint patient with the genotype of a _Legionella_ strain isolated from a suspected water source at McLaren Flint Hospital. Were _Legionella_ isolated from suspected water sources at McLaren Flint Hospital? If _Legionella_ were isolated, were the positive water sources remediated? Were genotypes obtained from clinical and environmental isolates and did the genotypes match? Further information in this regard concerning the Flint outbreak would be welcomed from knowledgeable sources.

The increase in cases of legionnaires’ disease in Flint happened after Flint switched its water source in April 2014 from the city of Detroit’ water supply to the Flint River, which runs through the city of Flint. Flint switched back to Detroit water in October 2015.

The Flint River water was said to be highly corrosive: 19 times more so than the supply from the Great Lakes, according to researchers from Virginia Tech, which led to higher iron levels and lower chlorine levels (http://flintwaterstudy.org/about-page/about-us/). Failure to use anti-corrosive treatment on the Flint River water is believed to have led to higher iron levels. The lack of treatment of Flint River water to make it less corrosive is believed to have also contributed to increasing amounts of lead leaching into the city’s water supply since April 2014, when the city changed its water source to the river, according to researchers from Virginia Tech (http://flintwaterstudy.org/about-page/about-us/).

The city of Flint, Michigan, located along the Flint River, 66 miles (106 km) northwest of Detroit, with a population of 102 434 in 2010, is the largest city and county seat of Genesee County (https://en.wikipedia.org/wiki/Flint,_Michigan).
The state of Michigan can be located on the HealthMap/ProMED-mail interactive map at http://healthmap.org/promed/p/652. – Mod.ML]

See Also

Legionellosis – USA: (MI) fatal, corrosive water supply, lg. bldgs, 2014-15, RFI 20160115.3937657

2015
—-
Legionellosis – USA (19): (WA) grocery produce misters susp, RFI 20151029.3751553
Legionellosis – USA (18): (CA) prison, update, RFI 20151003.3687586
Legionellosis – USA (17): (New York City) new outbreak, update, RFI 20151002.3686650
Legionellosis – USA (16): (New York City) new outbreak, RFI 20150930.3679911
Legionellosis – USA (15): (IL) fatal, veterans home, update, RFI 20150924.3668124
Legionellosis – USA (14): (IL,CA) fatal, veterans home, prison, update, RFI 20150905.3625315
Legionellosis – USA (13): (New York City) new outbreak, RFI 20150904.3622929
Legionellosis – USA (12): (IL) fatal, veterans home, update, RFI 20150903.3620340
Legionellosis – USA (11): (NY, CA, IL) RFI 20150829.3610573
Legionellosis – USA (10): (New York City) outbreak over, source found, RFI 20150821.3592871
Legionellosis – USA (09): (NY) new outbreak, RFI 20150814.3577511
Legionellosis – USA (08): (New York City) update 20150813.3573605
Legionellosis – USA (07): (New York City) update 20150807.3563228
Legionellosis – USA (06): (New York City) comment 20150806.3562791
Legionellosis – USA (05): (New York City) fatal, update 20150805.3559468
Legionellosis – USA (04): (New York City) fatal, update 20150803.3553750
Legionellosis – USA (03): (New York City) fatal 20150731.3549644
Legionellosis – USA (02): (WA) motel 20150705.3485674
Legionellosis – USA: (New York City) alert, RFI 20150516.3367043
………………………………………….sb/ml/mj/dk

Source:
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases

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