Rodeway Inn Legionnaires outbreak: two are sickened

The Rodeway Inn & Suites in Tomahawk, Wisconsin, has reopened to the public after hotel officials voluntarily closed the hotel for almost a week after a second case of Legionnaires’ disease was confirmed in the past year.

Hotel management closed the hotel August 16 in an attempt to discover the source of Legionella bacteria, which causes Legionnaires’ disease. Additionally, the hotel’s water system was remediated during this time.

Health officials said both illnesses involved guests who were diagnosed with Legionnaires’ disease within two weeks of their stay at the hotel. The timetable of the illnesses nor the condition of the patients was released.

Although the hotel – located at 1738 Comfort Drive – has reopened, the pool and whirlpool still are off-limits to guests.

Rodeway Inn outbreak: OK to open

The reopening of the hotel was OK’d by the Lincoln County Health Department (LCHD), which issued a conditional permit based on hotel officials meeting interim requirements to address Legionella issues.

Rodeway Inn management was ordered to install point-of-use filters on faucets and showers to minimize exposure risk to Legionella. It also has been required to work with an environmental expert to develop a water-management plan, which will be used to identify possible hazardous conditions and take steps to minimize the growth and spread of waterborne pathogens.

The LCHD is being aided in its investigation by numerous state and federal agencies, including the Centers for Disease Control and Prevention (CDC), the Wisconsin Department of Health Services (DHS), the Wisconsin Division of Public Health (DPH), and other state partners.

“In the meantime, guests are notified that there still is Legionella,” LCHD director Shelley Hersil said. “It’s being filtered out of the faucets and the showerheads, but it still is in the water system.”

Anyone who plans to stay or visit the hotel is advised to evaluate their risk for possible infection, or to talk to their health-care provider if they have concerns.

Rodeway Inn Legionnaires outbreak: Wisconsin woes

Legionnaires’ disease has proven lethal in Wisconsin in the past year:

• In March, health officials announced three people were diagnosed with the disease over a 12-month span, all within two weeks after stays at Christmas Mountain Resort in Wisconsin Dells, and one person died. The resort’s water system tested positive for Legionella.
• Late last year, an outbreak linked to UW Hospital and Clinic in Madison sickened 14 people, three of whom died. Testing uncovered Legionella in the hospital’s water system.

When the UW Hospital outbreak was first reported last November, Wisconsin DHS respiratory epidemiologist Thomas Haupt said: “We’ve been seeing very high numbers this year of Legionnaires’ disease. It’s a record pace, and it’s not one we’re proud of.”

Wisconsin DHS data shows the state had 63 confirmed cases in 2010. That number increased to 160 in 2013 (at the time the state’s highest number of confirmed cases), 181 in 2017, and 334 in 2018.

A Rodeway Inn Legionnaires outbreak of two illnesses within a year resulted in the voluntary closure of the Tomahawk, Wisconsin, hotel by its management.

Rodeway Inn Legionnaires outbreak: symptoms

Legionnaires’ disease usually develops two to 10 days after exposure to Legionella bacteria, and it frequently begins with these symptoms:

• headaches
• muscle aches
• fever, which can be 104 degrees Fahrenheit or higher, and chills.

By Day 2 or 3, symptoms can worsen to include:

• coughing, which can produce mucus or blood
• shortness of breath, called dyspnea
• chest pains, called pleuritis or pleurisy
• gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
• confusion and other mental changes.

Rodeway Inn Legionnaires outbreak: high-risk groups

Anyone can get Legionnaires’ disease, but people with the highest risk of infection include:

• anyone 50 years old or older
• smokers, either current or former
• anyone with a chronic lung disease, such as chronic obstructive pulmonary disorder (COPD, most commonly bronchitis or emphysema)
• anyone with a compromised immune system
• alcoholics.

After the disease has been diagnosed, hospitalization is almost always required. In the most severe cases, complications can occur, such as:

• endocarditis, which is an infection of the heart’s inner lining that can affect its ability to maintain adequate blood flow through the body.
• kidney failure, which occurs when Legionella toxins damage the kidneys’ ability to eliminate waste from the blood.
• pericarditis, which is swelling of the pericardium, the primary membrane around the heart; this can also affect the ability of the heart to circulate blood.
• respiratory failure, which is caused by changes to the lung tissue, or oxygen loss in arteries supplying the lungs.
• septic shock, which can occur when Legionella toxins enter the bloodstream and cause a drop in blood pressure, leading to the loss of adequate blood supply to the organs.

Rodeway Inn Legionnaires outbreak: about Legionella

Legionnaires’ disease is a severe type of pneumonia or lung infection that, according to the CDC, is contracted by about 25,000 Americans yearly. Only 5,000 cases are reported, however, because of the disease’s nonspecific symptoms.

Legionella bacteria are contracted by inhaling microscopic water droplets (vapor or mist). The bacteria thrive in warm water, and they are found primarily in human-made environments, including but not limited to:

• water systems of large buildings (hotels, hospitals, nursing homes, etc.)
• swimming pools, whirlpools and hot tubs
• bathroom showers and faucets
• air-conditioning system cooling towers
• large plumbing systems
• hot-water heaters and tanks
• physical-therapy equipment
• mist machines and hand-held sprayers
• decorative fountains.