Hopkins Legionnaire’s outbreak harkens to Mankato’s 1995 incident

Published 10:28 am Monday, October 3, 2016

By Brian Arola

Mankato The Free Press

MANKATO — An ongoing Legionnaires’ disease outbreak in Hopkins reminded some of their own efforts to respond to a similar outbreak in Mankato more than two decades ago.

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The number of cases in Hopkins climbed to 23 last week, putting it above the 20 confirmed cases identified by the Minnesota Department of Health in Mankato back in 1995.

Mankato and Luverne in southwest Minnesota actually both had unrelated outbreaks within weeks of each other that year. Two died in the outbreaks, including Allan Rader, a 56-year-old truck driver from Mankato.

Plenty has changed in the 21 years since Mankato responded to the disease, but the hunt for the source going on in Hopkins isn’t all that dissimilar to what happened here.

The hunt

The response in Mankato started when medical staff at the Immanuel-St. Joseph’s Hospital — now Mayo Clinic Health System — noticed an unusual number of apparent pneumonia cases for late July. Back then there was limited testing for something like Legionnaires’ disease, which can be thought of as a severe form of pneumonia.

The hospital’s chief administrative officer at the time, Jerry Crest, remembers it was a nurse who first noticed the irregularity.

Tests for common pneumonia were coming back negative, leading doctors to suspect another cause for the cases. By Aug. 2, pulmonary specialist Dr. Scott Sanders — who died in 2006 — contacted MDH to alert them of a potential outbreak.

Dr. Richard Danila, now MDH’s deputy epidemiologist, was at the time the organization’s AIDs epidemiologist. A department that can now send dozens to investigate Hopkins back then had about 10 or 11 people like Danila on the ground in Mankato.

He described it as an “all hands on deck” operation to comb through medical records, interview discharged patients and investigate cooling towers — a frequent source for Legionnaires.’

From these interviews and acts of detective work, Danila said it quickly became apparent that all the people suspected of having the disease had either visited the hospital or lived nearby in the hilltop neighborhood.

All 22 cooling towers in the immediate area were then tested. Legionnaires’ disease is caused by a bacteria residing in stagnant water, so they felt fairly sure they’d find their source among the 22 towers.

Crest remembers thinking there was no way the hospital’s cooling tower was the source. They’d maintained it as much as any other place, he said.

“Much to our surprise it was the cooling tower on the roof of the hospital that was the culprit,” he said.

Although ironic, the idea of a health care facility being the cause of a health scare wasn’t that uncommon even in that year alone.

Danila pointed out that the similar outbreak in Luverne also originated from a hospital’s cooling tower.

“Sometimes they are associated with hospitals or medical centers because they’re large buildings to begin with that have cooling towers,” he said.

The offending cooling tower, as well as the others, were cleaned and treated during the investigation process. Doing so puts to rest any risk to the public, which is just one reason why Legionnaires’ didn’t seem to inspire the same fear that a meningitis outbreak the year before in Mankato stirred. One Mankato student died and at least eight others were infected the winter before Legionnaires’ hit the city.

Unlike meningitis, Legionnaires’ is not transferable from person to person. Still, to say concern wasn’t as strong as it was when the meningitis outbreak occurred doesn’t mean there wasn’t any concern. Sen. Kathy Sheran, the City Council president at the time, said it was a tense time for the city until the source was found.

“When you don’t know the source, it creates this vacuum of information out of which people fill in their worries and fears,” she said.

The meningitis outbreak might’ve even helped the community respond to the Legionnaires’ cases, Crest said.

“In a way, it helped us in our reaction,” he said. “We knew about putting together a phone bank and set it up immediately — that was one of the small pieces of how you respond to this kind of thing.”