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Marshall County public health reports 71 Legionella cases, 2 deaths; cooling towers targeted
Summary
Marshall County public health director Sydney Gruwell told the Board of Supervisors on Sept. 24 that a regional Legionella outbreak has produced 71 confirmed cases and two deaths centered in north-central Marshalltown; 12 business cooling towers have been tested and offline remediation is underway.
Sydney Gruwell, Marshall County public health director, told the Board of Supervisors on Sept. 24 that county health officials have confirmed 71 cases of legionellosis and two deaths linked to a regional outbreak centered in north-central Marshalltown. "At this time, this morning, we have confirmed 71 cases of legionellosis with 2 confirmed deaths," Gruwell said.
Gruwell said 12 business centers with cooling towers have been tested and are the "most likely source at this time." She described a two-step process she said is being used to reduce risk: online disinfection (keeping cooling systems running while treating them) followed by full offline remediation, which requires taking systems offline, draining and cleaning them. "We have yet to have any of these business centers complete this step," Gruwell said, adding that offline remediation is crucial to ensure Legionella has been eliminated.
Officials advised particular caution for people 50 and older, those with underlying medical conditions, people with a smoking history and immunocompromised individuals. Gruwell advised those groups to consult their primary care providers before attending large events in or near the epicenter, and the county recommended moving Oktemperfest activities away from the affected area "out of an abundance of caution." Gruwell noted the Legionella incubation period is two to 14 days and said case counts have begun to taper: "we're getting those 1, maybe 2 cases a day, which is much better than those 5 to 6 cases a day."
Gruwell also told the board that county staff are working with the state environmental health team and the Department of Natural Resources on remediation timelines. She urged residents to follow daily case updates posted by Iowa HHS at 3 p.m.
The board posed follow-up questions on state guidance, the likelihood of another spike and whether masks reduce transmission; Gruwell clarified Legionella is not spread person-to-person but through inhalation of aerosolized contaminated water. No formal policy action was taken; Gruwell said county and state teams are pursuing offline remediation at the tested facilities.
