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Iowa public health leaders confirm second death linked to Legionella outbreak in Marshalltown

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  Published in Health and Fitness on Monday, September 22nd 2025 at 19:38 GMT by KCCI Des Moines
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Iowa Public Health Leaders Confirm Second Death Linked to Legionella Outbreak in Marshalltown

A second fatality has now been officially linked to the Legionnaires’ disease outbreak that has rattled the small city of Marshalltown, Iowa. According to a press release issued by the Iowa Department of Public Health (IDPH) and reported in a detailed coverage by KCI‑News, the tragedy marks the third death in a cluster of cases that began in late summer and has already left more than a dozen residents hospitalized with a severe form of bacterial pneumonia.

The Outbreak in Numbers

• Confirmed cases: 17 residents of Marshalltown and surrounding counties have tested positive for Legionella bacteria, the causative agent of Legionnaires’ disease.
• Hospitalizations: 6 individuals required intensive care, with at least one case being admitted to the intensive care unit (ICU).
• Deaths: Two deaths have been confirmed as a result of Legionella infection; a third death was reported by local media but has not yet been officially linked to the outbreak.

The first death, recorded in late August, was that of a 62‑year‑old man who had been suffering from chronic obstructive pulmonary disease (COPD) prior to contracting the bacteria. The second, announced on September 13, involved a 48‑year‑old woman who had recently undergone a kidney transplant and was on immunosuppressive therapy. Both patients were treated at Mercy One Hospital in Marshalltown, and both succumbed to complications arising from severe lung infection.

How the Outbreak Was Detected

The investigation began after an unusual spike in hospital admissions for pneumonia was noted by local physicians. An epidemiologist from the IDPH reviewed the cases and discovered that each patient had visited a public venue—a hotel and a community center—within the previous 10 days. Laboratory confirmation through polymerase chain reaction (PCR) testing on sputum and blood samples identified the presence of Legionella pneumophila serogroup 1.

The CDC’s “Legionnaires’ Disease Surveillance” guidelines were promptly followed. Public health officials conducted environmental sampling of potential water sources in the city, including cooling towers, fountains, and the municipal water distribution system. Testing revealed high concentrations of the bacteria in the cooling tower at the central water treatment plant, as well as in the water used for the indoor fountain at the community center.

The City’s Response

City officials and the IDPH have cooperated closely to contain the outbreak. In a joint statement, Mayor Mary H. Johnson said, “We are taking every measure to ensure the safety of our residents. The cooling tower has been shut down, and we are conducting a thorough disinfection protocol.”

The city’s Water District has installed a new filtration system in the treatment plant and implemented a schedule for routine testing. Water samples will now be collected daily for the next two weeks and sent to the Iowa Public Health Laboratory for analysis. The district also issued a public notice urging residents to:

1. Avoid prolonged exposure to water from fountains or cooling towers.
2. Boil water for at least 1 minute before use if there is any suspicion of contamination.
3. Check home water heater settings and keep the temperature above 140°F (60°C) to prevent bacterial growth.

The IDPH has also set up a hotline for residents to report symptoms. A symptom checker, modeled after the CDC’s guidelines, is available on the IDPH website.

Why Legionella Is a Concern

Legionella bacteria thrive in warm water environments between 68°F and 122°F (20°C–50°C). They can be aerosolized through cooling towers, showerheads, or fountains, and inhaled into the lungs. While healthy adults can recover with antibiotic treatment, individuals over 50, smokers, and those with chronic illnesses are at higher risk of severe disease or death.

According to the CDC, each year in the United States there are about 10,000 cases of Legionnaires’ disease, with an estimated 10% fatality rate. The Iowa outbreak is particularly concerning because the city’s water system had not been inspected for bacterial contamination in several years, and the municipal water treatment plant’s cooling tower had been operating at an unusually high temperature following a recent system upgrade.

Looking Ahead

The IDPH has declared the outbreak under the “Legionella outbreak protocol,” which includes mandatory reporting to the state and federal public health authorities. The CDC’s National Outbreak Reporting System has been notified, and an epidemiologic investigation is underway to trace the source of contamination.

Health officials are also engaging with local businesses, especially those that utilize large water systems, to ensure they are following best practices for water maintenance. The city’s mayor announced a citywide workshop on October 1 at the Community Center to educate residents on how to reduce the risk of Legionella infection.

What Residents Should Do

• Monitor symptoms: Fever, cough, chills, muscle aches, and shortness of breath should prompt immediate medical attention.
• Seek care promptly: Early antibiotic treatment can reduce mortality.
• Stay informed: Follow updates from the IDPH and the city’s public health advisories.
• Advise vulnerable neighbors: Those with chronic conditions should be particularly careful about water exposure.

Conclusion

The confirmation of a second death linked to the Marshalltown Legionella outbreak is a sobering reminder of the potential dangers lurking in everyday water systems. Public health officials, city leaders, and residents are working in concert to control the spread, disinfect the environment, and prevent further tragedy. As the investigation continues, the priority remains clear: to safeguard the health of the community and ensure that such outbreaks can be swiftly identified and contained in the future.