Marshall County Public Health (MCPH) Director Sydney Grewell provided another update to the Board of Supervisors near the end of Wednesday morning’s regular meeting as no new cases of Legionnaires’ disease have been reported in almost two weeks, with the total number holding steady at 74 with two deaths.

According to Grewell, the last new positive case was confirmed on Sept. 25, and she noted that Legionella is a reportable disease by law — therefore, any individual who tests positive at a health care facility must be sent on to the Iowa Department of Health and Human Services (HHS) and the local public health department simultaneously through an electric system. Anyone who lives in a neighboring county will receive a follow up interview from their local public health department regardless of outbreak status or where they were tested.

“During this process, they’re asked a series of questions to determine whether they meet the case definition of this particular outbreak, which is if they’ve traveled to, live, work, whatever it may be, in north central Marshalltown,” she said. “If they meet the case definition and have a positive result, that is when they are added to the overall case count, and that case count is updated every day on the Iowa HHS website and updated by Iowa HHS.”

The original theory that a cooling tower in the aforementioned area of Marshalltown continues to be the most plausible one, Grewell said, and officials have identified 12 of them. Each business center has been tested multiple times, and MCPH and Iowa HHS have attempted to find a matching sequence or fingerprint to the cooling towers.

“A positive match helps a lot, but the absence doesn’t mean that we got the wrong track. So just because we’ve tested (and) we don’t find anything doesn’t mean we’re on the wrong track of ‘It’s not a cooling tower,'” she said.

To date, one business has tested positive for Legionella pneumophila serogroup 1 (Lp1), the bacteria they are looking for, but it did not match the patient who was infected that they were hoping to match it with.

“We have taken samples from patients. That did not match the direct sequencing of the Legionella that we found in one of the towers to the patient,” Grewell said. “So still no smoking gun, but the fact that we’ve found Legionella at all means that we have been on the right track, that it has been a cooling tower.”

Each of the 12 businesses with the cooling towers started an additional disinfection in early to mid-September, and two of them have completed full offline remediation, which is considered to be the full disinfection process.

“The fact that we haven’t seen a case in nearly two weeks means that the disinfection process is working, and it makes completing the disinfection process and offline remediation by these businesses even more important to ensure that the bacteria is cleaned out for good,” she said.

Supervisor Kevin Goodman asked if the cooling towers will need to be disinfected yearly going forward, and Grewell said the businesses should have water management plans and hoped they would continue to monitor them more closely in the future.

“We don’t have, in Iowa, any form of regulation. For example, New York has a cooling tower registry, and that is required for them to register their cooling towers and maintain those processes. But we do not have that in Iowa,” she said.

Additionally, the state and county public health do not have any sort of regular inspection framework for the towers as the onus for water management processes and maintenance falls on the business owners themselves. Supervisor Jarret Heil asked Grewell about theories that people aren’t being tested anymore and/or that results aren’t being submitted into the system.

“Like I said, Legionella is reportable by law, so it’s a communicable disease. They have to report it, so, say I go get tested today and I test positive for Legionella, I live in Marshall County, so that has to be sent to Iowa HHS and it would get sent here to Marshall County Public Health. And I would see the result,” she said. “If someone got tested here at UnityPoint Health, for example, and then lived in Polk County just because they were traveling here or they were visiting family, that result would get sent to (the) Polk County Health Department, and that would be followed up with their local health department. And then they have to ask all those questions, and then because of the outbreak, you know, there’s ‘Did you travel to Marshalltown? Did you travel anywhere near?’ And if they say no, then they’re not added to the case count because they don’t meet the case definition. Because Legionella naturally happens in other places around. We see 30 to 70 cases in the state yearly, so it’s not uncommon. It’s just that they don’t meet that case definition for this. So people that are saying ‘We’ve tested positive,’ they might live outside of the county and not have traveled in the area, so they don’t meet that case definition. Or they might not be telling the truth because they have to report it, and the labs directly report it too. There’s no paper. It goes straight to, like I said, to the state and to us directly.”

If someone lives in another state and travels here to visit family, that report would go back to their state’s health department.

“There’s a whole lot of background that happens. We’re definitely not not reporting positive cases,” Grewell said.

At the end of the regular meeting, the board went into closed session to discuss a matter regarding pending litigation.

In other business, the board:

• Approved the consent agenda as listed by a 2-0 vote (Board Chairwoman Carol Hibbs was absent).

• Heard a proclamation recognizing October as Domestic Violence Awareness Month.

• Presented 10-year service awards to Kody Hilderbrand and Bowen Fleming in the Buildings and Grounds Department. Kent Hayes was also recognized for 10 years of service to the Secondary Roads department but was not present for the meeting.

• Approved the 2026 calendar for board meetings and set the non-union floating holidays for Dec. 24 (half day) and Dec. 28 (full day).

• Approved a resolution naming Nan Benson, Maria Vargas-Gonzalez and Cassandra Gerstandt as the new plan sponsors for the Marshall County 457(b) deferred compensation plan.

• Approved a resolution authorizing the Auditor/Recorder to sign on behalf of the Board of Supervisors.

• Approved the construction permit application for a confinement feeding operation at Marshall Ridge Farms LLC.

• Approved the use of the courthouse grounds for Haunt the Block on Oct. 23 after hearing from Marshalltown Central Business District (MCBD) Director Danielle Lekin despite concerns from Assistant County Attorney Kiyoko Kieffer about jury trials potentially being held during the same time frame.

• Again heard from rural resident Mark Wyant about ongoing concerns regarding the condition of his gravel road during the public comment period.

• Heard about a petition for a no engine braking sign on Marsh Avenue west of Marshalltown during the public comment period.

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Contact Robert Maharry at 641-753-6611 ext. 255 or rmaharry@timesrepublican.com.