As Legionnaires’ cases rise, Grand Rapids begins permanently chlorinating water supply

The northeast Minnesota city of Grand Rapids took a major step this week to combat an outbreak of Legionnaires’ disease traced to the city’s water supply. 

On Monday, Grand Rapids began permanently chlorinating its water. City officials hope the action will curb the perplexing outbreak, which started more than a year ago and has sickened nearly two dozen people.

Legionnaires’ disease is a serious pneumonia contracted by breathing in water vapor containing Legionella bacteria — often from showers, hot tubs or fountains. It can be fatal, especially for people over age 50 and those with weakened immune systems.

Health officials have confirmed 23 cases of Legionnaires’ in Grand Rapids since April of last year, up from 15 in March. Twenty people have been hospitalized. So far there have been no deaths, but the outbreak may not be over.

“It certainly is possible that we will have more cases,” said Trisha Robinson, who supervises the waterborne diseases unit at the Minnesota Department of Health. 

The number of cases and the fact that they were linked to the city’s water system makes this an unprecedented outbreak, Robinson said.

Staff from the city, the state health department and the University of Minnesota have been testing water at various locations around the city. So far, they haven’t pinpointed an underlying cause of the outbreak, Robinson said.

“It’s quite possible that that might not be discovered,” she said.

Meanwhile on Monday, the city began disinfecting its water supply with chloramine — a combination of chlorine and ammonia. It’s a permanent change that the city has been preparing for since March, said Julie Kennedy, general manager of Grand Rapids Public Utilities.

“We crammed about a three-year process into three months,” she said.

Disinfection isn’t an overnight fix, Kennedy said. The chloramine needs to be distributed methodically to avoid dislodging iron, manganese or other deposits built up in the pipes, she said.

It will take about a week for the chloramine to make its way through the city, Kennedy said, depending on how much water people use.

Grand Rapids had been one of about 64 municipal water supplies in Minnesota that don’t regularly chlorinate. Health experts say chlorination helps kill bacteria, viruses and other microorganisms that cause disease.

But it’s sometimes met with resistance by residents and businesses who don’t like the taste, or fear health impacts. Kennedy said she’s heard some of those concerns in Grand Rapids.

“What I’ve often heard is, ‘if this is only an issue in buildings, why are we all having to have chlorinated water?’” she said.

Chlorination offers an extra layer of protection to reduce the level of bacteria across the water system, Kennedy said.

The city also has been educating building owners and health care facilities about the importance of having a water management plan, flushing their water lines regularly and keeping the water temperature hot enough to kill bacteria.

Scary experience

Keith Tok’s children are frustrated that the city’s chlorination effort started after their father got sick. He’s a resident of Majestic Pines Senior Living in Grand Rapids.

Earlier this month, the 82-year-old who has congestive heart failure, was hospitalized after developing a severe cough and having trouble breathing. 

His daughter, Sarah Tok, describes the stressful next few days. Her father tested positive for Legionnaires’ and then had to be airlifted to a Twin Cities hospital and intubated. Sarah Tok said he remains in the ICU with a feeding tube, struggling to speak.

“He’s just weak, really weak,” she said.

Her brother, Stephen Tok of Woodbury, wonders whether it’s safe for their father to return home after he’s released from the hospital.

“That’s our big concern is do we put him back in there until we know where this came from?” he said.

Nichole Houg, the executive director of Majestic Pines, informed residents in an email that “a few residents” have tested positive for Legionnaires’. She said the pool was being shut down, and urged residents not to use their shower until further notice.

The facility is “actively establishing hazard controls” while the city of Grand Rapids works through the chlorination process, Houg said to MPR News in an email.

“We will continue to do everything in our power to combat the Legionella in our water supply until this process is completed,” she wrote.

Health officials say there are steps people can take to reduce their risk of getting sick. They include regularly cleaning faucets and showerheads, and setting their water heater to at least 120 degrees.

Anyone with symptoms — including fever, cough, shortness of breath and headache — should seek medical attention.

The city also is advising Grand Rapids residents that the chlorination reacting with iron or manganese could temporarily cause the water to become black or reddish-brown.

They’re advised to let their water run for a few minutes to flush the pipes of discolored water before using it for drinking, cooking or laundry.

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