From: "ECKHOFF, CHUCK" To: jwelch@co.adams.il.us CC: Date: 7/13/2015 12:28:53 PM Subject: Food Handlers Training I am the Dietary Manager from the Illinois Veterans Home and am looking at getting our staff the Food Handlers Training that is required. We have 68 dietary staff employees, of which at least 11 have the FSSMC certification, the remainder would need the Food Handlers Training. I was wondering if there was an approved course structure that one of us with the FSSMC certification could teach here to certify all of our employees? I have searched the internet and find some online courses, but was really looking for something that we could offer here on the grounds. If you have something like this or are aware of something that would qualify I would appreciate the information. I see in my investigations that it can be done via train the trainer with someone taking the course and then using that information to train other, but didn’t know if with all those we have certified in FSSMC that we could do the training ourselves. Any information you or someone else on your staff can provide would be appreciated. Thank you Chuck Chuck Eckhoff, CDM, CFPP Dietary Manager II Illinois Veteran’s Home 1707 N 12th Street Quincy, IL 62301 217-222-8641, ext 324 From: "ECKHOFF, CHUCK" To: "Jerrod Welch" CC: Date: 7/15/2015 9:23:02 AM S u b j ect: RE: Food Handlers Training Thanks for your response and I totally understand you all being busy. There is no big rush on this. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, July 15, 2015 10:22 AM To: ECKHOFF, CHUCK Cc: Health-Environmental Subject: RE: Food Handlers Training Hello Chuck, I am forwarding this to our environmental health staff for a response. We have been tied up with response to the storm, so please give them a week or so to get back with you. Thank you for your inquiry, Jerrod Welch From: ECKHOFF, CHUCK [mailto:CHUCK.ECKHOFF@illinois.gov] Sent: Monday, July 13, 2015 1:29 PM To: Jerrod Welch Subject: Food Handlers Training I am the Dietary Manager from the Illinois Veterans Home and am looking at getting our staff the Food Handlers Training that is required. We have 68 dietary staff employees, of which at least 11 have the FSSMC certification, the remainder would need the Food Handlers Training. I was wondering if there was an approved course structure that one of us with the FSSMC certification could teach here to certify all of our employees? I have searched the internet and find some online courses, but was really looking for something that we could offer here on the grounds. If you have something like this or are aware of something that would qualify I would appreciate the information. I see in my investigations that it can be done via train the trainer with someone taking the course and then using that information to train other, but didn’t know if with all those we have certified in FSSMC that we could do the training ourselves. Any information you or someone else on your staff can provide would be appreciated. Thank you Chuck Chuck Eckhoff, CDM, CFPP Dietary Manager II Illinois Veteran’s Home 1707 N 12th Street Quincy, IL 62301 217-222-8641, ext 324 From : "Jerrod Welch" To: ECKHOFF CHUCK CC: Health-Environmental Date: 7/15/2015 9:21:32 AM S u b j e c t : RE: Food Handlers Training Hello Chuck, I am forwarding this to our environmental health staff for a response. We have been tied up with response to the storm, so please give them a week or so to get back with you. Thank you for your inquiry, Jerrod Welch From: ECKHOFF, CHUCK [mailto:CHUCK.ECKHOFF@illinois.gov] Sent: Monday, July 13, 2015 1:29 PM To: Jerrod Welch Subject: Food Handlers Training I am the Dietary Manager from the Illinois Veterans Home and am looking at getting our staff the Food Handlers Training that is required. We have 68 dietary staff employees, of which at least 11 have the FSSMC certification, the remainder would need the Food Handlers Training. I was wondering if there was an approved course structure that one of us with the FSSMC certification could teach here to certify all of our employees? I have searched the internet and find some online courses, but was really looking for something that we could offer here on the grounds. If you have something like this or are aware of something that would qualify I would appreciate the information. I see in my investigations that it can be done via train the trainer with someone taking the course and then using that information to train other, but didn’t know if with all those we have certified in FSSMC that we could do the training ourselves. Any information you or someone else on your staff can provide would be appreciated. Thank you Chuck Chuck Eckhoff, CDM, CFPP Dietary Manager II Illinois Veteran’s Home 1707 N 12th Street Quincy, IL 62301 217-222-8641, ext 324 From: "Meka, Anu" To: amnda_christian amy_henderson anita_pike Brown_adm carol carrie_skiles curt dale diana_sangmon hugh_montgmery jarod_adms jessica kayla_cass Linda logan logan_Don morgan_hd nancy nina nroegge@casscohealth.org Pam phyllis Pike robin ronda sangmon shay steve steve <_emergency> tdietrich@co.adams.il.us teresa CC: Date: 7/16/2015 7:40:28 AM Subject: Latest CDC Key Messages RE: EVD A t t a c h m e n t s : CDC Key Messages- Ebola Virus Disease 07152015.pdf For awareness… Please review the attached information… the most recent CDC key messages regarding EVD. From: "Meka, Anu" To: amnda_christian amy_henderson anita_pike Brown_adm carol carrie_skiles curt dale diana_sangmon hugh_montgmery jarod_adms jessica kayla_cass Linda logan logan_Don morgan_hd nancy nina nroegge@casscohealth.org Pam phyllis Pike robin ronda sangmon shay steve steve <_emergency> tdietrich@co.adams.il.us teresa CC: Date: 7/16/2015 2:29:24 PM Subject: -MERS-CoV-Worldwide Attachments: NBIC_SLTT_Multiple Countries_MERS 7 16 2015pdf.pdf I know that some of you have been tracking MERS-CoV events and thought that the attached update from the National Biosurveillance Integration Center contained good information that may be of interest. Anu Meka, MPH Regional Section Chief Illinois Department of Public Health Division of Disaster Planning & Readiness 422 South 5th Street, 4th Floor Springfield, IL 62701 Office: (217) 557-3766 Mobile: (217) 836-2619 Fax: (217) 557-3894 anu.meka@illinois.gov From: "Meka, Anu" To: amnda_christian amy_henderson anita_pike Brown_adm carol carrie_skiles curt dale diana_sangmon hugh_montgmery jarod_adms jessica kayla_cass Linda logan logan_Don morgan_hd nancy nina nroegge@casscohealth.org Pam phyllis Pike robin ronda sangmon shay steve steve <_emergency> tdietrich@co.adams.il.us teresa CC: "Swehla, Gina" Date: 7/29/2015 1:45:48 PM Subject: FW: Disease Containment Measures (AWR-323-W) Live Webinar on 8/27/15 Attachments: 20150714_DiseaseContainmentFlyer.pdf Disease Containment Measures CDD v1.1.pdf Containment Measures Registration.pdf From: Griffith, Lisa Sent: Wednesday, July 29, 2015 2:32 PM To: Angarola, Linda; Athar, Masood; Atteberry, Greg; Atteberry, Paula; Barnett, Cara; Blissett, Kristina; Boston, Michaeline; Buhs, Keith; Bussmann, Elizabeth; Carter, Billy; Davis, Dawn; Doering, Emily; Duarte, Elizabeth; Edmiston, Mark R.; Epping, Mike; Fleeharty, Jack; Frye, Patricia; Giachello, Omayra; Gillespie, Kevin; Green, Marilyn; Griffith, Lisa; Harrington, Joseph; Hasler, Allison; Hayes, David W.; Horton, Tena; Hunter, Mark; Kieninger, Brian; Lane, Darla; Lee, Daniel; Little, Carla N.; Lyons, Evelyn M.; Manley, Carolyn; McFarland, Scott; Meka, Anu; Moomey, Tammy; Navon, Livia; Nudelman, Jacob; Orantia, Adelisa; Pamela Thomas-Hall; Patterson, Tricia; Ramos, Joe; Rawls, Winfred; Reagan, Lynne; Reid, Jennifer; Ringenberg, Matthew; Roberts, Louise; Snider, Jeff; Swehla, Gina; Thoele, Ashley; Thompson, Stu; Usherwood, Deborah; Vassmer, Mark C.; Wadhams, Irene; Wilson, Shannon; Yurevich, Greg; Zellers, Sue; Anita Guffey; Brian Churchill; Leone, Tamara; Lisa Wax; Mike Maddox; Paul Banks; Pettineo, Martha; Philip Pugh; Stephanie Kuschel; Steve Baron; Sue Hecht; Troy Erbentraut; Giachello, Omayra; Green, Marilyn; Harrington, Joseph; Hasler, Allison; Hunter, Mark; Thomas.Hankins@djwhospital.org; Adams, Brian; Carlock, Hugh; Dickenson-Ferguson, Amy; Eilers, John; Flesner, Denny; Hoots, Diane; Jason French; Jeffrey Ruffner; Kanhirun, Melissa; Koechle, Brad; Korty, Thomas E; Laura Malenfant; MAJ Leonard Williams (lenny.williams@us.army.mil); Maj Robert B Bland III; Rasch, Paul; Repp, Don; Riemann, Dan; Thompson, Trenton; Langheim, William Cc: McTaggart, Lori; Rawls, Winfred; Moomey, Tammy; Swehla, Gina Subject: Disease Containment Measures (AWR-323-W) Live Webinar on 8/27/15 NEW WEBINAR COURSE TITLE: Disease Containment Measures (AWR-323-W) HOSTS: National Center for Biomedical Research and Training (NCBRT) & NACCHO TARGET AUDIENCE: Professional Disciplines- Emergency Medical Services, Fire Services, Hazardous Materials Personnel, Healthcare, Law Enforcement, Public Health REGISTRATION: Date: 8/27/15 Length: 2 – 5:00 p.m. See attached flyer for complete details and link to enroll. All participants are required to have a FEMA SID prior to enrollment. Course Design document and registration details are attached. Please share this training opportunity with local health departments, hospitals, healthcare coalitions, other IDPH Offices, and state partners involved in preparedness and response activities. Thank you, Lisa Griffith Safety Officer/Training Coordinator Illinois Department of Public Health Office of Preparedness & Response 422 South 5th Street, 4th Floor Springfield, IL 62701 (O) 217.558.3588 Lisa.Griffith@illinois.gov From: "WHITCOMB, DAWN" To: "Chaundra Bishop" CC: Date: 7/31/2015 1:47:37 PM Subject: RE: Friday Night Family Play Night Thanks Chaundra.. I’ve forwarded your email to my boss Mr. Vaca, the Volunteer/Activity Director, Kelvin Roberts and Rick Gengenbacher our Public Affairs officer. I’ll see what they say, but I think it’s a wonderful event! Dawn From: Chaundra Bishop [mailto:cbishop@co.adams.il.us] Sent: Friday, July 31, 2015 11:47 AM To: WHITCOMB, DAWN Subject: Friday Night Family Play Night Hi Dawn, As I mentioned last time I saw you, the health department and the United Way have been working to promote the 5210 initiative aimed at getting residents to adopt healthy living/eating behaviors. From that we have developed Friday Night Family Play Nights which occur on the 3rd Friday of the month promoting that 1 hour of physical activity. We would like to utilize the openness of the grounds at the Veterans’ Home to have our September play night. It would be on September 18th likely beginning at 530pm or 6pm until 7pm or 730pm. I am thinking our activity would be a scavenger hunt—getting the kids and parents walking around the area sighting/finding different things. I don’t think we would need anything from you all except permission to be on the grounds. Let me know your thoughts. Have a great weekend! Chaundra M. Bishop, MS Health Educator Adams County Health Department 330 Vermont Quincy, IL 62301 217.222.8440 ext 128 cbishop@co.adams.il.us From: "WHITCOMB, DAWN" To: "Chaundra Bishop" CC: Date: 8/6/2015 12:26:57 PM Subject: Liability Waiver Attachments: Liability Waiver.docx Chaundra, Here is the waiver form, please sign and return it at your convenience. You can send it back to me either mail or email. Thanks Dawn From: "WHITCOMB, DAWN" To: "Chaundra Bishop" CC: Date: 8/6/2015 10:29:20 AM Subject: RE: Friday Night Family Play Night Hi Chaundra! Got an email from our legal department in Springfield, and they have approved the event. They will be sending me a simple waiver form for you to complete and then we should be good to go. I will forward it to you via email as soon as I get it. Thanks! Dawn From: Chaundra Bishop [mailto:cbishop@co.adams.il.us] Sent: Friday, July 31, 2015 11:47 AM To: WHITCOMB, DAWN Subject: Friday Night Family Play Night Hi Dawn, As I mentioned last time I saw you, the health department and the United Way have been working to promote the 5210 initiative aimed at getting residents to adopt healthy living/eating behaviors. From that we have developed Friday Night Family Play Nights which occur on the 3rd Friday of the month promoting that 1 hour of physical activity. We would like to utilize the openness of the grounds at the Veterans’ Home to have our September play night. It would be on September 18th likely beginning at 530pm or 6pm until 7pm or 730pm. I am thinking our activity would be a scavenger hunt—getting the kids and parents walking around the area sighting/finding different things. I don’t think we would need anything from you all except permission to be on the grounds. Let me know your thoughts. Have a great weekend! Chaundra M. Bishop, MS Health Educator Adams County Health Department 330 Vermont Quincy, IL 62301 217.222.8440 ext 128 cbishop@co.adams.il.us From: "WHITCOMB, DAWN" To: "Chaundra Bishop" CC: "MOYER, TINA" "VACA, BRUCE" Date: 8/10/2015 11:35:22 AM Subject: Liability Form Attachments: DOC034.PDF Chaundra, Attached is the signed form. Thank you.. Dawn Whitcomb Adjutant Illinois Veterans Home at Quincy 1707 North 12th St. Quincy, IL 62301 217-222-8641 ext. 209 From: "Arnold, Melaney" To: Little "Divya Mohan; Adams - Jerrod Welch; Cathy Hayden - Clark; Champaign - Amy Roberts; Champaign - Julie Pryde; Chicago- Cristina Villarreal; Clay -general; Coles County; Coles-DanielStretch; Craig Beintema - Carroll; DeKalb - J Lux; DeWitt-Piatt; DeWitt-Piatt - David Remmert; Douglas - Lana Sanstrom; DuPage - Dave Hass; East Side - Elizabeth Patton; Effingham - Donna Overbeck; Effingham - KarenFeldkamp; Effingham - Linda Hampton; Egyptian - Amy Harrison; Ellen Genrich - Boone; Evanston - Evoda Thomas; Franklin-Williamson - Carrie Eldridge; Franklin-Williamson - Robin Koehl; Franklin-Williamson - Ronda Koch; Hamilton - Sarah CC: D ate: 8/12/2015 8:33:18 AM S ubj ect: IDPH - Immunization A t t a c h m e n t s : 08.12.15 Immunization religious exemption.docx The following news release from IDPH and the Illinois State Board of Education will be issued this afternoon to media statewide. Thank you. School Immunizations – New Certificate of Religious Exemption Requirement Exemption certificate requires health care provider signature SPRINGFIELD – Parents or legal guardians who object, for religious reasons, to their child being immunized for school entrance must submit a Certificate of Religious Exemption, which now must be signed by a health care provider. Signed into law on August 3, 2015, this new legislation requires a health care provider to sign the certificate confirming they have provided education to the parents or legal guardians about the benefits of immunizations and the health risks of not vaccinating students. “Vaccines not only help protect vaccinated individuals, but also help protect entire communities by preventing and reducing the spread of infectious diseases,” said Illinois Department of Public Health (IDPH) Director Nirav D. Shah, M.D., J.D. “Because vaccines are not always 100 percent effective, it is important that as many people as possible are immunized to decrease the amount of disease circulating and help prevent illness and possibly even death.” Educational information given by health care providers may include nationally accepted recommendations from federal agencies such as the Advisory Committee on Immunization Practices, information from vaccine information statements, and vaccine package inserts. “We recognize the importance of providing an option for religious exemption, but we also understand there must be a balance between family rights and the health of all students,” said State Superintendent of Education Tony Smith, Ph.D. “This certificate ensures that parents and students are fully aware of the risks of not being immunized.” The certificate also reflects the parents or legal guardians understanding that their child may be excluded from school in the case of a vaccine-preventable disease outbreak or exposure. Parents or legal guardians must submit the certificate to their local school authority prior to children entering kindergarten, sixth grade, and ninth grade. This new requirement will be in place for religious exemption requests beginning October 16, 2015. The new Certificate of Religious Exemption form will soon be available on both the IDPH and the Illinois State Board of Education (ISBE) websites. ### Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: "Clegg, Whitney" To: 'jcampos@co.adams.il.us' CC: Date: 8/20/2015 9:39:26 AM Subject: legionella state case # Hi Jon, I got your voicemail from earlier this week regarding this case . I left you a voicemail, but have not heard from you, so your question may have been resolved. But I was wondering if the other symptomatic family members were ever sick enough to be hospitalized and/or tested for legionella. Thanks, Whitney Whitney Clegg MD MPH CDC/CSTE Applied Epidemiology Fellow Division of Infectious Diseases Illinois Department of Public Health 312-793-0098 whitney.clegg@illinois.gov From: "Clegg, Whitney" To: 'jcampos@co.adams.il.us' CC: Date: 8/21/2015 2:58:57 PM S u b j e c t : legionella at LTCF follow up Hi Jon, Here are some questions to review with the facility if you are able to contact them. Regarding facility: 1. Any whirlpool spas/hot tubs a. Did the pool you mentioned have any bubbling features 2. Does the facilility have air conditioning? Window units or central? 3. Does the facility have a cooling tower? 4. Does the facility maintain their fountains? 5. Are there sinks in the patients rooms? If so, do they have aerators? 6. Any humidifiers in the patient’s room? 7. How many residents in the facility? 8. How many residents in the building of the two cases? Regarding both cases: 1. Past medical history of both cases-are they immunocomporised, smokers, chronic lung disease, diabetes, etc? 2. What is the building called that they live in? a. Which floor do they live on? And are there rooms near eachother? 3. Where do the cases shower/bathe? Regarding 1. 2. 3. 4. 5. 6. new case: Age Had she left the facility during the two weeks prior to getting sick? If so, when and where? Does she use any respiratory therapy equipment? Does she walk around the facility’s grounds/near the fountains? Did she use the pool at the facility or go near it? Medical history and smoking history? I know this is a lot but see what you can get prior to leaving. IDPH can also contact the facility if needed. Thanks, Whitney Whitney Clegg MD MPH CDC/CSTE Applied Epidemiology Fellow Division of Infectious Diseases Illinois Department of Public Health 312-793-0098 whitney.clegg@illinois.gov From: "Clegg, Whitney" To: 'jcampos@co.adams.il.us' CC: Date: 8/21/2015 3:07:50 PM Subject: legionella in ltcf We’re going to try to get our environmental health team on the phone quickly and see if we can set up a call between you guys and the facility to facility things easier. From: "Conover, Craig" To: HOUSTON "CATHY S" "DAVE J ;Shay Drummond ;;McCann>" <'jcampos@co.adams.il.us'> Ken Melaney "Whitney ;;GENGENBACHER>" <'jcampos@co.adams.il.us'> "RICK T" CC: "WHITCOMB, DAWN R" Date: 8/21/2015 4:12:13 PM Subject: email contacts-- please add PIO for Veterans Home Veterans’ Home: Bruce Vaca: Administrator HOUSTON, CATHY director of nursing Dave Clifford: engineer Adams County: Shay Drummond: LHD administrator /PIO Jon Campos: CD IDPH Craig Conover: Infectious Disease IDPH—reachable all w/e at 312-519-6972 or 847-869-8814 Whitney Clegg: Infectious Disease IDPH Ken McCann : EH, iDPH Melany Arnold: IDPH PIO _______________________________________ Craig S. Conover, MD Illinois Department of Public Health 122 South Michigan Avenue, 7th floor Chicago, IL 60603 312-814-4845 From: "Conover, Craig" To: VACA "BRUCE L" "CATHY S ;Shay Drummond" CC: Date: 8/21/2015 5:02:17 PM Subject: Fwd: Health Advisory: Legionella cases at IllinoisVeterans' Home--Quincy Note I sent to our agency dir is below. iPhone. itypos. iapologize. Begin forwarded message: From: "Conover, Craig" Date: August 21, 2015 at 5:35:36 PM CDT To: "Shah, Nirav" , "Gentry-Wiseman, Michelle" , "Rayman, Erik" , "Stone, Kyle" , "Arnold, Melaney" , "Little, Divya Mohan" Cc: "Kelly-Shannon, Kate D." , "Echols, Fred" , "Holmes, Tal" , "Morgan, Jodi" , "Culp, David" , "Austin, Connie" , "McCann, Ken" , "Bryars, Debra" , "Clegg, Whitney" , "Albertson, Justin" , "Rawls, Winfred" Subject: Health Advisory: Legionella cases at Illinois Veterans' Home--Quincy Submitted by : Division of Infectious Disease Alert Level: Health Advisory Type of Event : Possible outbreak Location: Quincy, Adams County Setting: Illinois Veteran’s Home (400 residents, http://www.quincyivh.org/index.html) --2 residents (90 yo male and 89 yo female) have been diagnosed with Legionella pneumonia (Positive urine antigen) Objective Information: Assessment: Next Steps: --Onsets were 7/24 and 8/16. Information obtained to date indicates first case did not leave facility during incubation period --Facility has cooling towers and outdoor fountains; cases live in same building and reportedly used same shower room Further investigation and interim measures are indicated; based on available information, source of infection is likely to be at the facility . This may reach media attention. We had a conf call with the facility and LHD at 430 pm today --Requested additional epi information regarding cases --Requested information regarding cooling tower operation and maintenance --Requested information regarding city testing of facility water -- Recommended: turn off outdoor fountains; keep windows of building where cases reside closed (AC is on); do not use bathing room that cases used for now. --Health Alert: provides vital, time-sensitive information for a specific incident or situation; warrants immediate action or attention by health officials, laboratorians, clinicians, and members of the public; and conveys the highest level of importance. --Health Advisory: provides important information for a specific incident or situation; contains recommendations or actionable items to be performed by public health officials, laboratorians, and/or clinicians; may not require immediate action. --Health Update: provides updated information regarding an incident or situation; unlikely to require immediate action. P From: "Conover, Craig" To: McCann Ken Whitney Fred Tal Jodi "Aaron ;; >" <'jcampos@co.adams.il.us'> CC: Date: 8/21/2015 3:17:11 PM Subject: legionella quincy vets home -- 2nd case Attachments: attachment.ics 888-494-4032 Access code : 6749643128# From: "Conover, Craig" To: HOUSTON "CATHY S" "DAVE J" CC: "WHITCOMB, DAWN R" "VACA, BRUCE L" "Shay Drummond" jcampos@co.adams.il.us "McCann, Ken" "Clegg, Whitney" jcampos@co.adams.il.us "GENGENBACHER, RICK T" Date: 8/21/2015 4:24:04 PM Subject: RE: email contacts-- please add PIO for Veterans Home For Veteran’s home: 1. Questions: Regarding facility: 1. Any whirlpool spas/hot tubs a. Does the pool in the physical therapy building have any bubbling features 2. Are there sinks in the patients rooms? If so, do the faucets have aerators? 3. How many shower/bathing rooms in Elmore building? a. Which shower/bathing room did the two cases use? 4. Ice machines on the patient’s floor? 5. Health status of the residents in the Elmore building? Regarding cases: 1. Had the more recent case left the facility during the two weeks prior to getting sick? If so, when and where? 2. Past medical history: is she immunocompromised, chronic lung disease, diabetes, a smoker? 3. Does she use any respiratory therapy equipment? Nebulizer, CPAP, BiPAP, etc. 4. Does she walk around the facility’s grounds/near the fountains? 5. Did she use the pool at the facility or go near it? 6. What floor do they live on? 7. Are the cases’ rooms near each other? What are their room numbers? 8. Any other buildings in the facility that these cases visited during the two week before they got sick? Such as a dining hall or rec room? 2. Guidance/requests. 1. Please provide cooling tower maintenance log information. 2. Please have heightened awareness for evidence of respiratory deterioration or fever/cough at this time, with prompt referral for evaluation if symptoms are concerning. 3. Please turn off outdoor fountains; please keep windows at Elmore bldg. closed; and please use bathing facility other than the one the 2 cases used. From: Conover, Craig Sent: Friday, August 21, 2015 5:12 PM To: HOUSTON, CATHY S; CLIFFORD, DAVE J; Shay Drummond; 'jcampos@co.adams.il.us'; McCann, Ken; Arnold, Melaney; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK T Cc: WHITCOMB, DAWN R Subject: email contacts-- please add PIO for Veterans Home Veterans’ Home: Bruce Vaca: Administrator HOUSTON, CATHY director of nursing Dave Clifford: engineer Adams County: Shay Drummond: LHD administrator /PIO Jon Campos: CD IDPH Craig Conover: Infectious Disease IDPH—reachable all w/e at 312-519-6972 or 847-869-8814 Whitney Clegg: Infectious Disease IDPH Ken McCann : EH, iDPH Melany Arnold: IDPH PIO _______________________________________ Craig S. Conover, MD Illinois Department of Public Health 122 South Michigan Avenue, 7th floor Chicago, IL 60603 312-814-4845 From: "HOUSTON, CATHY" To: Conover Craig DAVE CC: "WINNICKI, LENARD F." "VACA, BRUCE" "Shay Drummond" jcampos@co.adams.il.us "McCann, Ken" "Clegg, Whitney" jcampos@co.adams.il.us Date: 8/21/2015 7:48:16 PM Subject: RE: email contacts-- please add PIO for Veterans Home Please see answers below to questions. Additional: Per Medical Director of IVHQ, Dr. Zorian Trusewych, FCCP: “Current case discussed at length with pulmonologist at Blessing Hospital, Dr. Venu Reddi, regarding radiographs which showed no pattern compatible with Legionella infection, but showed pulmonary congestion from CHF and despite no therapy that would cover Legionella, this frail 90 year old female managed to improve before urine antigen test was known. Dr. Reddi will render formal consult in am, August 22, 2015.” Copy of consultation report will follow on Monday. From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Friday, August 21, 2015 5:24 PM To: HOUSTON, CATHY; CLIFFORD, DAVE Cc: WHITCOMB, DAWN; VACA, BRUCE; 'Shay Drummond'; 'jcampos@co.adams.il.us'; McCann, Ken; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK Subject: RE: email contacts-- please add PIO for Veterans Home For Veteran’s home: 1. Questions: Regarding facility: 1. Any whirlpool spas/hot tubs Whirlpool Bath Tubs on Elmore West and Elmore East. a. Does the pool in the physical therapy building have any bubbling features NO 2. Are there sinks in the patients rooms? YES Elmore East and Elmore II. If so, do the faucets have aerators? Most do. Rm. Elmore II—does. West Rm. —has shared bathroom with sink with Rm --does. 3. How many shower/bathing rooms in Elmore building? 3 Tub/Shower Room on Elmore East and Elmore West. Shower Room only on Elmore II. a. Which shower/bathing room did the two cases use? Elmore West’s and Elmore II’s. 4. Ice machines on the patient’s floor? Ice Machine for building located in basement of building. 5. Health status of the residents in the Elmore building? Many with Respiratory Diagnosis upon admission such as COPD, CHF, etc. Regarding cases: 1. Had the more recent case left the facility during the two weeks prior to getting sick? Nothing to indicate such. If so, when and where? 2. Past medical history: is she immunocompromised, chronic lung disease, diabetes, a smoker? None to all questions. 3. Does she use any respiratory therapy equipment? Nebulizer, CPAP, BiPAP, etc. NO 4. Does she walk around the facility’s grounds/near the fountains? NO 5. Did she use the pool at the facility or go near it? NO 6. What floor do they live on? 1st case Elmore West; 2nd Case Elmore II. 7. Are the cases’ rooms near each other? NO. Separate floors and Ends of building. What are their room numbers? ); 8. Any other buildings in the facility that these cases visited during the two week before they got sick? NO. Such as a dining hall or rec room? NO. These Units have separate dining rooms. 2. Guidance/requests. 1. Please provide cooling tower maintenance log information. Reports will follow on Monday AM. 2. Please have heightened awareness for evidence of respiratory deterioration or fever/cough at this time, with prompt referral for evaluation if symptoms are concerning. Log being maintained. 3. Please turn off outdoor fountains DONE; please keep windows at Elmore bldg. closed Done and staff instructed to maintain closed windows ; and please use bathing facility other than the one the 2 cases used Staff instructed to utilize ONLY Elmore East Tub/Shower Room. From: Conover, Craig Sent: Friday, August 21, 2015 5:12 PM To: HOUSTON, CATHY S; CLIFFORD, DAVE J; Shay Drummond; 'jcampos@co.adams.il.us'; McCann, Ken; Arnold, Melaney; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK T Cc: WHITCOMB, DAWN R Subject: email contacts-- please add PIO for Veterans Home Veterans? Home: Bruce Vaca: Administrator HOUSTON, CATHY director of nursing Dave Clifford: engineer Adams County: Shay Drummond: LHD administrator Jon Campos: CD IDPH Craig Conover: Infectious Disease IDPH?reachable all w/e at 312-519-6972 or 847-869-8814 Whitney Clegg: Infectious Disease IDPH Ken McCann EH, Melany Arnold: IDPH PIO Craig S. Conover, MD Illinois Department of Public Health 122 South Michigan Avenue, 7th floor Chicago, IL 60603 312-814-4845 3pt: From: "HOUSTON, CATHY" To: Conover Craig "DAVE ;Shay Drummond ;;McCann>" <'jcampos@co.adams.il.us'> Ken Melaney "Whitney ;;GENGENBACHER>" <'jcampos@co.adams.il.us'> RICK CC: "Yantis, Ryan" "WINNICKI, LENARD F." Date: 8/21/2015 4:43:14 PM Subject: RE: email contacts-- please add PIO for Veterans Home Veterans’ Home: Bruce Vaca: Administrator HOUSTON, CATHY director of nursing Dave Clifford: engineer Ryan Yantis: PIO Lenard Winnicki: Senior Homes Administrator From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Friday, August 21, 2015 5:12 PM To: HOUSTON, CATHY; CLIFFORD, DAVE; Shay Drummond; 'jcampos@co.adams.il.us'; McCann, Ken; Arnold, Melaney; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK Cc: WHITCOMB, DAWN Subject: email contacts-- please add PIO for Veterans Home Veterans’ Home: Bruce Vaca: Administrator HOUSTON, CATHY director of nursing Dave Clifford: engineer Adams County: Shay Drummond: LHD administrator /PIO Jon Campos: CD IDPH Craig Conover: Infectious Disease IDPH—reachable all w/e at 312-519-6972 or 847-869-8814 Whitney Clegg: Infectious Disease IDPH Ken McCann : EH, iDPH Melany Arnold: IDPH PIO _______________________________________ Craig S. Conover, MD Illinois Department of Public Health 122 South Michigan Avenue, 7th floor Chicago, IL 60603 312-814-4845 From: "Jon Campos" To: Conover Craig CC: Date: 8/21/2015 3:21:50 PM Subject: Accepted: legionella quincy vets home -- 2nd case Attachments: attachment.ics From: "Jon Campos" To: Conover Craig CC: Date: 8/21/2015 3:21:38 PM Subject: Accepted: legionella quincy vets home -- 2nd case Attachments: attachment.ics From: "Jon Campos" To: Clegg Whitney CC: Date: 8/21/2015 3:16:29 PM Subject: RE: legionella in ltcf Ok great Jon Campos RN Communicable Disease Coordinator/LEAD Coordinator Adams County Health Dept. 330 Vermont Quincy, IL 62301 217-222-8440 Ext: 163 217-222-8460 (Fax) jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Clegg, Whitney [mailto:Whitney.Clegg@illinois.gov] Sent: Friday, August 21, 2015 4:08 PM To: Jon Campos Subject: legionella in ltcf We’re going to try to get our environmental health team on the phone quickly and see if we can set up a call between you guys and the facility to facility things easier. From: "McCann, Ken" To: sdrummond@co.adams.il.us CC: "Bell, Scott S." "Martin, Aaron" Date: 8/21/2015 4:13:03 PM Subject: legionella Attachments: pathogens-04-00373.pdf VHA LegionellaDirective_08.13.14.pdf ashraeguideline12-2000 (1).pdf ASHRAE_Final4thPPR+188_09262014.pdf Shay – attached are a couple of documents that you might find helpful. The ASHRAE standard 188 has now been finalized, but it must be purchased so I’m sending the 4th public comment draft. Pretty similar and you can get the gist of the document. We are available to assist any way we can and will be in touch. Thanks ken Ken McCann, MA, LEHP Chief, Division of Environmental Health Illinois Department of Public Health 525 West Jefferson Str. Springfield, Il 62761 phone: 217-785-2043 fax: 217-785-0253 Ken.McCann@illinois.gov IMPORTANT: This e-mail, including all attachments, constitute State Government records and property that is intended only for the use of the individual or entity to w hich it is addressed. It also may contain information that is privileged, confidential, or otherw ise protected from disclosure under applicable law . If the reader of this transmission is not the intended recipient or the employee or agent responsible for delivering the transmission to the intended recipient, you are hereby notified that any dissemination, distribution, copying or use of this e-mail or its contents is strictly prohibited. If you have received this in error, please notify the sender. From: "Shay Drummond" To: Craig.Conover@illinois.gov CC: Date: 8/21/2015 8:33:15 PM Subject: Fwd: Distribution Monitorin Attachments: 20150821 distribution reports.pdf ATT00001.htm Dr. Conover, Please see the attached guidance from city of Quincy water treatment facility on the testing at the Illinois veterans home/ City of Quincy. Thank you, Shay Drummond MPH-EH, BSN, RN Sent from my iPhone Begin forwarded message: From: "Jeffrey Conte" To: "Shay Drummond" Subject: Distribution Monitoring Reports Here is the information that you requested. If you have any questions or need anything else, please feel free to call me at 316-0982. Sincerely, Jeffrey Conte, P.E. Director of Utilities & Engineering City of Quincy 730 Maine Street Quincy, Illinois 62301 Phone 217.228.4527 Fax 217.221.3608 From: "Shay Drummond" To: Craig.Conover@illinois.gov CC: Date: 8/21/2015 8:33:14 PM Subject: Fwd: Distribution Monitorin Attachments: 20150821 distribution reports.pdf ATT00001.htm Dr. Conover, Please see the attached guidance from city of Quincy water treatment facility on the testing at the Illinois veterans home/ City of Quincy. Thank you, Shay Drummond MPH-EH, BSN, RN Sent from my iPhone Begin forwarded message: From: "Jeffrey Conte" To: "Shay Drummond" Subject: Distribution Monitoring Reports Here is the information that you requested. If you have any questions or need anything else, please feel free to call me at 316-0982. Sincerely, Jeffrey Conte, P.E. Director of Utilities & Engineering City of Quincy 730 Maine Street Quincy, Illinois 62301 Phone 217.228.4527 Fax 217.221.3608 From: "Shay Drummond" To: McCann Ken CC: "Bell, Scott S." "Martin, Aaron" Date: 8/21/2015 4:14:15 PM Subject: Re: legionella Thanks Ken - i will review. Sent from my iPhone > On Aug 21, 2015, at 5:13 PM, McCann, Ken wrote: > > This message cannot be displayed because of the way it is formatted. Ask the sender to send it again using a different format or email program. message/rfc822 From: "Yantis, Ryan" To: HOUSTON "CATHY S" Craig "DAVE J ;Shay Drummond ;;McCann>" <'jcampos@co.adams.il.us'> Ken Melaney Whitney "RICK T" CC: "Yantis, Ryan X" "WINNICKI, LENARD F" Date: 8/21/2015 5:35:56 PM Subject: Re: email contacts-- please add PIO for Veterans Home ​Up and aware - spoke with Len. Thanks From: HOUSTON, CATHY Sent: Friday, August 21, 2015 5:43 PM To: Conover, Craig; CLIFFORD, DAVE J; Shay Drummond; 'jcampos@co.adams.il.us'; McCann, Ken; Arnold, Melaney; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK T Cc: Yantis, Ryan X; WINNICKI, LENARD F Subject: RE: email contacts-- please add PIO for Veterans Home Veterans’ Home: Bruce Vaca: Administrator HOUSTON, CATHY director of nursing Dave Clifford: engineer Ryan Yantis: PIO Lenard Winnicki: Senior Homes Administrator From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Friday, August 21, 2015 5:12 PM To: HOUSTON, CATHY; CLIFFORD, DAVE; Shay Drummond; 'jcampos@co.adams.il.us'; McCann, Ken; Arnold, Melaney; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK Cc: WHITCOMB, DAWN Subject: email contacts-- please add PIO for Veterans Home Veterans’ Home: Bruce Vaca: Administrator HOUSTON, CATHY director of nursing Dave Clifford: engineer Adams County: Shay Drummond: LHD administrator /PIO Jon Campos: CD IDPH Craig Conover: Infectious Disease IDPH—reachable all w/e at 312-519-6972 or 847-869-8814 Whitney Clegg: Infectious Disease IDPH Ken McCann : EH, iDPH Melany Arnold: IDPH PIO _______________________________________ Craig S. Conover, MD Illinois Department of Public Health 122 South Michigan Avenue, 7th floor Chicago, IL 60603 312-814-4845 From: "Clegg, Whitney" To: 'jcampos@co.adams.il.us' CC: Date: 8/22/2015 10:37:49 AM Subject: Legionella Hi Jon, Do you know if the latest case had a fever? Tmax? And do you know if and what abx she received? Thanks, Whitney From: "Conover, Craig" To: "Shay Drummond" CC: Date: 8/22/2015 8:05:46 AM Subject: Re: Distribution Monitorin thx-- also forwarded to EH. From: Shay Drummond Sent: Friday, August 21, 2015 9:33 PM To: Conover, Craig Subject: Fwd: Distribution Monitorin Dr. Conover, Please see the attached guidance from city of Quincy water treatment facility on the testing at the Illinois veterans home/ City of Quincy. Thank you, Shay Drummond MPH-EH, BSN, RN Sent from my iPhone Begin forwarded message: From: "Jeffrey Conte" To: "Shay Drummond" Subject: Distribution Monitoring Reports Here is the information that you requested. If you have any questions or need anything else, please feel free to call me at 316-0982. Sincerely, Jeffrey Conte, P.E. Director of Utilities & Engineering City of Quincy 730 Maine Street Quincy, Illinois 62301 Phone 217.228.4527 Fax 217.221.3608 From: "Conover, Craig" To: HOUSTON "CATHY S" "DAVE J" CC: "WINNICKI, LENARD F" "VACA, BRUCE L" "Shay Drummond" jcampos@co.adams.il.us "McCann, Ken" "Clegg, Whitney" jcampos@co.adams.il.us Date: 8/22/2015 8:06:03 AM Subject: Re: email contacts-- please add PIO for Veterans Home thx From: HOUSTON, CATHY Sent: Friday, August 21, 2015 8:48 PM To: Conover, Craig; CLIFFORD, DAVE J Cc: WINNICKI, LENARD F; VACA, BRUCE L; 'Shay Drummond'; 'jcampos@co.adams.il.us'; McCann, Ken; Clegg, Whitney; 'jcampos@co.adams.il.us' Subject: RE: email contacts-- please add PIO for Veterans Home Please see answers below to questions. Additional: Per Medical Director of IVHQ, Dr. Zorian Trusewych, FCCP: “Current case discussed at length with pulmonologist at Blessing Hospital, Dr. Venu Reddi, regarding radiographs which showed no pattern compatible with Legionella infection, but showed pulmonary congestion from CHF and despite no therapy that would cover Legionella, this frail 90 year old female managed to improve before urine antigen test was known. Dr. Reddi will render formal consult in am, August 22, 2015.” Copy of consultation report will follow on Monday. From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Friday, August 21, 2015 5:24 PM To: HOUSTON, CATHY; CLIFFORD, DAVE Cc: WHITCOMB, DAWN; VACA, BRUCE; 'Shay Drummond'; 'jcampos@co.adams.il.us'; McCann, Ken; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK Subject: RE: email contacts-- please add PIO for Veterans Home For Veteran’s home: 1. Questions: Regarding facility: 1. Any whirlpool spas/hot tubs Whirlpool Bath Tubs on Elmore West and Elmore East. a. Does the pool in the physical therapy building have any bubbling features NO 2. Are there sinks in the patients rooms? YES Elmore East and Elmore II. If so, do the faucets have aerators? Most do. Rm. Elmore II—does. West Rm. —has shared bathroom with sink with Rm does. 3. How many shower/bathing rooms in Elmore building? 3 Tub/Shower Room on Elmore East and Elmore West. Shower Room only on Elmore II. a. Which shower/bathing room did the two cases use? Elmore West’s and Elmore II’s. 4. Ice machines on the patient’s floor? Ice Machine for building located in basement of building. 5. Health status of the residents in the Elmore building? Many with Respiratory Diagnosis upon admission such as COPD, CHF, etc. Regarding cases: 1. Had the more recent case left the facility during the two weeks prior to getting sick? Nothing to indicate such. If so, when and where? 2. Past medical history: is she immunocompromised, chronic lung disease, diabetes, a smoker? None to all questions. 3. Does she use any respiratory therapy equipment? Nebulizer, CPAP, BiPAP, etc. NO 4. Does she walk around the facility’s grounds/near the fountains? NO 5. Did she use the pool at the facility or go near it? NO 6. What floor do they live on? 1st case Elmore West; 2nd Case Elmore II. 7. Are the cases’ rooms near each other? NO. Separate floors and Ends of building. What are their room numbers? 8. Any other buildings in the facility that these cases visited during the two week before they got sick? NO. Such as a dining hall or rec room? NO. These Units have separate dining rooms. 2. Guidance/requests. 1. Please provide cooling tower maintenance log information. Reports will follow on Monday AM. 2. Please have heightened awareness for evidence of respiratory deterioration or fever/cough at this time, with prompt referral for evaluation if symptoms are concerning. Log being maintained. 3. Please turn off outdoor fountains DONE; please keep windows at Elmore bldg. closed Done and staff instructed to maintain closed windows ; and please use bathing facility other than the one the 2 cases used Staff instructed to utilize ONLY Elmore East Tub/Shower Room. From: Conover, Craig Sent: Friday, August 21, 2015 5:12 PM To: HOUSTON, CATHY CLIFFORD, DAVE Shay Drummond; McCann, Ken; Arnold, Melaney; Clegg, Whitney; GENGENBACHER, RICK Cc: WHITCOMB, DAWN Subject: email contacts-- please add PIO for Veterans Home Bruce Vaca: Administrator HOUSTON, CATHY director of nursing Dave Clifford: engineer AdamsLQumx; Shay Drummond; LHD administrator Jon Campos: CD Craig Conover: Infectious Disease IDPH?reachable all w/e at 312-519-6972 or 847-869-8814 Whitney Clegg: Infectious Disease IDPH Ken McCann EH, Melany Arnold: IDPH PIO Craig S. Conover, MD Illinois Department of Public Health 122 South Michigan Avenue, 7th floor Chicago, IL 60603 312-814-4845 .?li a; From: "McCann, Ken" To: Conover Craig "Whitney ;jcampos@co.adams.il.us;Shay Drummond" Aaron Justin "Scott S." CC: Date: 8/22/2015 7:17:08 AM Subject: Re: email contacts-- please add PIO for Veterans Home We'll this isn't very helpful as it doesn't appear they have a common water exposure. I think we need a better handle on where the chiller towers are in relation to this building. Shay/Jon - can you provide any insight on that? We can talk Monday. Ken Sent from my iPhone On Aug 21, 2015, at 8:48 PM, "HOUSTON, CATHY" wrote: Please see answers below to questions. Additional: Per Medical Director of IVHQ, Dr. Zorian Trusewych, FCCP: “Current case discussed at length with pulmonologist at Blessing Hospital, Dr. Venu Reddi, regarding radiographs which showed no pattern compatible with Legionella infection, but showed pulmonary congestion from CHF and despite no therapy that would cover Legionella, this frail 90 year old female managed to improve before urine antigen test was known. Dr. Reddi will render formal consult in am, August 22, 2015.” Copy of consultation report will follow on Monday. From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Friday, August 21, 2015 5:24 PM To: HOUSTON, CATHY; CLIFFORD, DAVE Cc: WHITCOMB, DAWN; VACA, BRUCE; 'Shay Drummond'; 'jcampos@co.adams.il.us'; McCann, Ken; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK Subject: RE: email contacts-- please add PIO for Veterans Home For Veteran’s home: 1. Questions: Regarding facility: 1. Any whirlpool spas/hot tubs Whirlpool Bath Tubs on Elmore West and Elmore East. a. Does the pool in the physical therapy building have any bubbling features NO 2. Are there sinks in the patients rooms? YES Elmore East and Elmore II. If so, do the faucets have aerators? Most do. Rm. Elmore II—does. West Rm. —has shared bathroom with sink with Rm --does. 3. How many shower/bathing rooms in Elmore building? 3 Tub/Shower Room on Elmore East and Elmore West. Shower Room only on Elmore II. a. Which shower/bathing room did the two cases use? Elmore West’s and Elmore II’s. 4. Ice machines on the patient’s floor? Ice Machine for building located in basement of building. 5. Health status of the residents in the Elmore building? Many with Respiratory Diagnosis upon admission such as COPD, CHF, etc. Regarding cases: 1. Had the more recent case left the facility during the two weeks prior to getting sick? Nothing to indicate such. If so, when and where? 2. Past medical history: is she immunocompromised, chronic lung disease, diabetes, a smoker? None to all questions. 3. Does she use any respiratory therapy equipment? Nebulizer, CPAP, BiPAP, etc. NO 4. Does she walk around the facility’s grounds/near the fountains? NO 5. Did she use the pool at the facility or go near it? NO 6. What floor do they live on? 1st case ) Elmore West; 2nd Case ( ) Elmore II. 7. Are the cases’ rooms near each other? NO. Separate floors and Ends of building. What are their room numbers? ); 8. Any other buildings in the facility that these cases visited during the two week before they got sick? NO. Such as a dining hall or rec room? NO. These Units have separate dining rooms. 2. Guidance/requests. 1. Please provide cooling tower maintenance log information. Reports will follow on Monday AM. 2. Please have heightened awareness for evidence of respiratory deterioration or fever/cough at this time, with prompt referral for evaluation if symptoms are concerning. Log being maintained. 3. Please turn off outdoor fountains DONE; please keep windows at Elmore bldg. closed Done and staff instructed to maintain closed windows ; and please use bathing facility other than the one the 2 cases used Staff instructed to utilize ONLY Elmore East Tub/Shower Room. From: Conover, Craig Sent: Friday, August 21, 2015 5:12 PM To: HOUSTON, CATHY S; CLIFFORD, DAVE J; Shay Drummond; 'jcampos@co.adams.il.us'; McCann, Ken; Arnold, Melaney; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK T Cc: WHITCOMB, DAWN R Subject: email contacts-- please add PIO for Veterans Home Veterans’ Home: Bruce Vaca: Administrator HOUSTON, CATHY director of nursing Dave Clifford: engineer Adams County: Shay Drummond: LHD administrator /PIO Jon Campos: CD IDPH Craig Conover: Infectious Disease IDPH—reachable all w/e at 312-519-6972 or 847-869-8814 Whitney Clegg: Infectious Disease IDPH Ken McCann : EH, iDPH Melany Arnold: IDPH PIO _______________________________________ Craig S. Conover, MD Illinois Department of Public Health 122 South Michigan Avenue, 7th floor Chicago, IL 60603 312-814-4845 From: "Shay Drummond" To: McCann Ken CC: "Conover, Craig" "Clegg, Whitney" "Jon Campos" "Martin, Aaron" "DeWitt, Justin" "Bell, Scott S." Date: 8/22/2015 8:08:26 AM Subject: Re: email contacts-- please add PIO for Veterans Home I will go out this afternoon and take some pictures and layout of towers to give you a bette visual. Shay Sent from my iPhone On Aug 22, 2015, at 8:17 AM, McCann, Ken wrote: We'll this isn't very helpful as it doesn't appear they have a common water exposure. I think we need a better handle on where the chiller towers are in relation to this building. Shay/Jon - can you provide any insight on that? We can talk Monday. Ken Sent from my iPhone On Aug 21, 2015, at 8:48 PM, "HOUSTON, CATHY" wrote: Please see answers below to questions. Additional: Per Medical Director of IVHQ, Dr. Zorian Trusewych, FCCP: “Current case discussed at length with pulmonologist at Blessing Hospital, Dr. Venu Reddi, regarding radiographs which showed no pattern compatible with Legionella infection, but showed pulmonary congestion from CHF and despite no therapy that would cover Legionella, this frail 90 year old female managed to improve before urine antigen test was known. Dr. Reddi will render formal consult in am, August 22, 2015.” Copy of consultation report will follow on Monday. From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Friday, August 21, 2015 5:24 PM To: HOUSTON, CATHY; CLIFFORD, DAVE Cc: WHITCOMB, DAWN; VACA, BRUCE; 'Shay Drummond'; 'jcampos@co.adams.il.us'; McCann, Ken; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK Subject: RE: email contacts-- please add PIO for Veterans Home For Veteran’s home: 1. Questions: Regarding facility: 1. Any whirlpool spas/hot tubs Whirlpool Bath Tubs on Elmore West and Elmore East. a. Does the pool in the physical therapy building have any bubbling features NO 2. Are there sinks in the patients rooms? YES Elmore East and Elmore II. If so, do the faucets have aerators? Most do. Rm. Elmore II—does. West Rm. —has shared bathroom with sink with Rm --does. 3. How many shower/bathing rooms in Elmore building? 3 Tub/Shower Room on Elmore East and Elmore West. Shower Room only on Elmore II. a. Which shower/bathing room did the two cases use? Elmore West’s and Elmore II’s. 4. Ice machines on the patient’s floor? Ice Machine for building located in basement of building. 5. Health status of the residents in the Elmore building? Many with Respiratory Diagnosis upon admission such as COPD, CHF, etc. Regarding cases: 1. Had the more recent case left the facility during the two weeks prior to getting sick? Nothing to indicate such. If so, when and where? 2. Past medical history: is she immunocompromised, chronic lung disease, diabetes, a smoker? None to all questions. 3. Does she use any respiratory therapy equipment? Nebulizer, CPAP, BiPAP, etc. NO 4. Does she walk around the facility’s grounds/near the fountains? NO 5. Did she use the pool at the facility or go near it? NO 6. What floor do they live on? 1st case Elmore West; 2nd Case Elmore II. 7. Are the cases’ rooms near each other? NO. Separate floors and Ends of building. What are their room numbers? ); ) 8. Any other buildings in the facility that these cases visited during the two week before they got sick? NO. Such as a dining hall or rec room? NO. These Units have separate dining rooms. 2. Guidance/requests. 1. Please provide cooling tower maintenance log information. Reports will follow on Monday AM. 2. Please have heightened awareness for evidence of respiratory deterioration or fever/cough at this time, with prompt referral for evaluation if symptoms are concerning. Log being maintained. 3. Please turn off outdoor fountains DONE; please keep windows at Elmore bldg. closed Done and staff instructed to maintain closed windows ; and please use bathing facility other than the one the 2 cases used Staff instructed to utilize ONLY Elmore East Tub/Shower Room. From: Conover, Craig Sent: Friday, August 21, 2015 5:12 PM To: HOUSTON, CATHY S; CLIFFORD, DAVE J; Shay Drummond; 'jcampos@co.adams.il.us'; McCann, Ken; Arnold, Melaney; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK T Cc: WHITCOMB, DAWN R Subject: email contacts-- please add PIO for Veterans Home Veterans’ Home: Bruce Vaca: Administrator HOUSTON, CATHY director of nursing Dave Clifford: engineer Adams County: Shay Drummond: LHD administrator /PIO Jon Campos: CD IDPH Craig Conover: Infectious Disease IDPH—reachable all w/e at 312-519-6972 or 847-869-8814 Whitney Clegg: Infectious Disease IDPH Ken McCann : EH, iDPH Melany Arnold: IDPH PIO _______________________________________ Craig S. Conover, MD Illinois Department of Public Health 122 South Michigan Avenue, 7th floor Chicago, IL 60603 312-814-4845 From: "Conover, Craig" To: "Shay Drummond" CC: Date: 8/23/2015 11:38:28 AM Subject: Fw: iowa/legionella cx Attachments: legionellacollectioninstructions.pdf Please collect specimen for legionella cx on anyone with sputum production from the facility-- would send to Iowa (see below) or Barnes if urine antigen is positive. Legionella Culture (includes DFA) Bacteriology 10-14 days 87081, 87278 Collection Instructions $29.43 Specimen Requirements: Specimen: Respiratory specimens: Abscess material, aspirates, BAL, fluids, secretions, sputum, or tissue; OR pericardial fluid or blood in SPS Vacutainer® tube. Sputum gives greatest recovery. Container: Sterile container for tissues or respiratory specimens. Collection: Transfer respiratory specimens to a sterile container.Tissue specimens place on gauze moistened w ith sterile non-bacteriostatic saline into sterile container. Transport: Overnight refrigeration (2-8°C). From: "Conover, Craig" To: "Shay Drummond" Whitney Tal Fred Connie CC: "Linda Manley" Date: 8/23/2015 4:31:11 PM Subject: Re: Case Report Form Attachments: case-report-form.pdf ​I also cannot access that form. Will cc Springfield staff for input. CDC case report form attached. This particular scenario will likely require facility specific questions to be generated once specific hypotheses are generated. From: Shay Drummond Sent: Sunday, August 23, 2015 2:55 PM To: Clegg, Whitney; Conover, Craig Cc: Linda Manley Subject: Case Report Form Hi, Both Linda who is at Blessing interviewing patients and myself working from home seem to have a dead link for the case reporting form on the IDPH portal. We can both access the supplemental. Can you please forward us a Legionellosis specific copy so we can be sure and not miss any key questions? Thanks! Shay Shay L. Drummond RN BSN Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 217-222-8440 x 148 fax: 217-222-8460 cell: 217?316?2795 From: "Holmes, Tal" To: Austin Connie "Craig ;;Kelly-Shannon>" <'sdrummond@co.adams.il.us'> "Kate D." Fred Ken CC: Date: 8/23/2015 2:00:36 PM Subject: New Cases of Legionellosis at Veterans's Home Attachments: attachment.ics Call in number: 888-494-4032 Code: 6575947859 From: "Shay Drummond" To: Holmes Tal CC: Date: 8/23/2015 2:02:11 PM Subject: Accepted: New Cases of Legionellosis at Veterans's Home Attachments: attachment.ics From: "Shay Drummond" To: Holmes Tal CC: Date: 8/23/2015 2:01:53 PM Subject: Accepted: New Cases of Legionellosis at Veterans's Home Attachments: attachment.ics From: "Austin, Connie" To: "Shay Drummond" CC: Date: 8/24/2015 9:35:02 AM Subject: Re: Case Report Form Do we know where she works Sent from my iPhone On Aug 24, 2015, at 9:40 AM, Shay Drummond wrote: Connie she is at . This is not near the home it is 4.8 miles from IVH. Here is the hyperlink to locations. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Monday, August 24, 2015 8:25 AM To: Shay Drummond Subject: RE: Case Report Form Do you know how far from the Veterans Home the 38 yr old lives? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 24, 2015 8:15 AM To: Austin, Connie Subject: RE: Case Report Form This is not reflecting the three inpatients that are currently in Blessing Linda is in an 8:15 meeting and is following up as to their status in INEDSS. There are three additional cases. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Monday, August 24, 2015 8:13 AM To: Shay Drummond Subject: RE: Case Report Form I find these Legionella cases for Adams County, not 5 from the facility? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 24, 2015 7:32 AM To: Conover, Craig; Clegg, Whitney; Holmes, Tal; Echols, Fred; Austin, Connie Cc: Linda Manley; Jon Campos; Jerrod Welch Subject: RE: Case Report Form Good morning, Please let me know who will be coming to the Adams County Health Department and their approx. Arrival time. I would like to meet with them prior to going to IVH and review our cases. As of yesterday all patients are in INEDSS and the three that presented over the weekend have had additional questioning per the supplemental sheet as well as IVH specific questions. None report having visited the dentist, or visiting any of the fountains on the grounds. No use of spa, whirlpool or pools or being in the area. No drinking from hallway water fountains. Thanks, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and con?dential use of the designated recipients named above. The documents accompanying this transmission may contain con?dential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been ful?lled. If the reader of this message is not the intended recipient, you are hereby noti?ed that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Conover, Craig Sent: Sunday, August 23, 2015 5:31 PM To: Shay Drummond; Clegg, Whitney; Holmes, Tal; Echols, Fred; Austin, Connie Cc: Linda Manley Subject: Re: Case Report Form I also cannot access that form. Will cc Springfield staff for input. CDC case report form attached. This particular scenario will likely require facility specific questions to be generated once specific hypotheses are generated. From: Shay Drummond Sent: Sunday, August 23, 2015 2:55 PM To: Clegg, Whitney; Conover, Craig Cc: Linda Manley Subject: Case Report Form Hi, Both Linda who is at Blessing interviewing patients and myself working from home seem to have a dead link for the case reporting form on the IDPH portal. We can both access the supplemental. Can you please fonNard us a Legionellosis speci?c copy so we can be sure and not miss any key questions? Thanks! Shay Shay L. Drummond RN BSN Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 217-222?8440 148 fax: 217?222-8460 cell: 217-316-2795 State Case age at 0 Sex at Onset Onset Date Pneumonia (Clinic-Pneumonia (Radio as the patient im Patient Attends?e Current Address Day Care.IFa - 80 Female Yes 05000015 Yes Unknown Home 89 Male Yes No No Residential Facility Home Illinois Vetera 38 Female 0712QI2015 Yes Yes No Home FromTo: "Shay Drummond" CC: Date: 8/24/2015 7:12:31 AM Subject: RE: Case Report Form I find these Legionella cases for Adams County, not 5 from the facility? Age at 0 Sex at Onset Onset Date Pneumonia (Clinic-Pneumonia (Radio as the patient im Patient AttendSiRe Current Address Day Care es Yes 80 Female 050012015 Unknown Home 89 Male 0?!2412015 Yes No No Residential Facility Home Illinois Veterans Ho 30 Female Yes Yes No Home 90 Female 08i1512015 Yes Yes No Home State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Sent: Monday, August 24, 2015 7:32 AM To: Conover, Craig; Clegg, Whitney; Holmes, Tal; Echols, Fred; Austin, Connie Cc: Linda Manley; Jon Campos; Jerrod Welch Subject: RE: Case Report Form Good morning, Please let me know who will be coming to the Adams County Health Department and their approx. Arrival time. I would like to meet with them prior to going to NH and reVIew our cases. As of yesterday all patients are in INEDSS and the three that presented over the weekend have had additional questioning per the supplemental sheet as well as IVH specific questions. None report having visited the dentist, or visiting any of the fountains on the grounds. No use of spa, whirlpool or pools or being in the area. No drinking from hallway water fountains. Thanks, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 Cell: 217-316-2795 PublicHedth CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and con?dential use of the designated recipients named above. The documents accompanying this transmission may contain con?dential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been ful?lled. If the reader of this message is not the intended recipient, you are hereby noti?ed that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Conover, Craig Sent: Sunday, August 23, 2015 5:31 PM To: Shay Drummond; Clegg, Whitney; Holmes, Tal; Echols, Fred; Austin, Connie Cc: Linda Manley Subject: Re: Case Report Form I also cannot access that form. Will cc Springfield staff for input. CDC case report form attached. This particular scenario will likely require facility specific questions to be generated once specific hypotheses are generated. From: Shay Drummond Sent: Sunday, August 23, 2015 2:55 PM To: Clegg, Whitney; Conover, Craig Cc: Linda Manley Subject: Case Report Form Hi, Bo?'i Linda who is at Blessing interviewing patients and myself working from home seem to have a dead link for the case reporting form on the IDPH portal. We can both access the supplemental. Can you please forward us a Legionellosis specific copy so we can be sure and not miss any key questions? Thanks! Shay Shay L. Drummond RN BSN Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 217-222-8440 x 148 fax: 217-222-8460 cell: 217-316-2795 From: "Austin, Connie" To: "Shay Drummond" CC: Date: 8/24/2015 7:24:31 AM Subject: RE: Case Report Form Do you know how far from the Veterans Home the 38 yr old lives? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 24, 2015 8:15 AM To: Austin, Connie Subject: RE: Case Report Form This is not reflecting the three inpatients that are currently in Blessing Linda is in an 8:15 meeting and is following up as to their status in INEDSS. There are three additional cases. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Monday, August 24, 2015 8:13 AM To: Shay Drummond Subject: RE: Case Report Form I find these Legionella cases for Adams County, not 5 from the facility? Age at 0 Sex at Onset Onset Date Pneumonia (Clinicpneumonia (Radio as the patient im Patient Attends.IRe Current Address Day CarelFacility es Yes 80 Female 0512012015 Unknown Home 89 Male 07040015 Yes No No Residential Facility Home Illinois Veterans Ho 30 Female 0?090015 Yes Yes No Home 90 Female 08I150015 Yes Yes No Home State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 . . .H. . From: Shay Drummond Sent: Monday, August 24, 2015 7:32 AM To: Conover, Craig; Clegg, Whitney; Holmes, Tal; Echols, Fred; Austin, Connie Cc: Linda Manley; Jon Campos; Jerrod Welch Subject: RE: Case Report Form Good morning, Please let me know who will be coming to the Adams County Health Department and their approx. Arrival time. I would like to meet with them prior to going to NH and review our cases. As of yesterday all patients are in INEDSS and the three that presented over the weekend have had additional questioning per the supplemental sheet as well as IVH specific questions. None report having visited the dentist, or visiting any of the fountains on the grounds. No use of spa, whirlpool or pools or being in the area. No drinking from hallway water fountains. Thanks, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 Cell: 217-316-2795 it? Publicme CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and con?dential use of the designated recipients named above. The documents accompanying this transmission may contain con?dential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been ful?lled. If the reader of this message is not the intended recipient, you are hereby noti?ed that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Conover, Craig Sent: Sunday, August 23, 2015 5:31 PM To: Shay Drummond; Clegg, Whitney; Holmes, Tal; Echols, Fred; Austin, Connie Cc: Linda Manley Subject: Re: Case Report Form I also cannot access that form. cc Springfield staff for input. CDC case report form attached. This particular scenario will likely require facility specific questions to be generated once specific hypotheses are generated. From: Shay Drummond Sent: Sunday, August 23, 2015 2:55 PM To: Clegg, Whitney; Conover, Craig Cc: Linda Manley Subject: Case Report Form Hi, Bod'i Linda who is at Blessing interviewing patients and myself working from home seem to have a dead link for die case reporting form on dwe IDPH portal. We can both access the supplemental. Can you please fonNard us a Legionellosis speci?c copy so we can be sure and not miss any key questions? Thanks! Shay Shay L. Drummond RN BSN Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 217?222?8440 148 fax: 217?222?8460 cell: 217?316?2795 From: "HOUSTON, CATHY" To: Conover Craig DAVE CC: "WINNICKI, LENARD F." "VACA, BRUCE" "Shay Drummond" jcampos@co.adams.il.us "McCann, Ken" "Clegg, Whitney" jcampos@co.adams.il.us Date: 8/24/2015 6:44:07 AM Subject: RE: email contacts-- please add PIO for Veterans Home Attachments: DOC098.PDF Please see attached “Site Visitation Report” and this statement from Chief Engineer, Dave Clifford: Per Bill Luthin my steamfitter, he does test the cooling tower water each day for PH and conductivity and also a bromine test from time to time. this electronic test is compared to the real time electronic basin monitor. Bills says the testing results are very close in comparison each time . Bill makes adjustments in the water treatment as needed, please know there is no records kept on this daily testing. Additionally the Pool in PT is tested each day as well and records are kept of this. Please let me know if you want these records. I have sent you via fax the latest ISWS site visit report. Please know the portion of the report (101 H.W. ) that indicates the glycol is below the 20% required to prevent bacterial growth. This does not pertain to the cooling tower located at PT. what that is referring to is a closed hot water heating loop that is a sealed system, and also located at a completely different building than Elmore. Please note that the central chiller plant cooling tower is located approximately 350ft per scale drawing from our Elmore building. Additionally, all exterior water fountains have been shut down as a preventive measure as of last night. Please let me know if I can be of more assistance. Thank you. Dave Clifford From: HOUSTON, CATHY Sent: Friday, August 21, 2015 8:48 PM To: 'Conover, Craig'; CLIFFORD, DAVE Cc: WINNICKI, LENARD F.; VACA, BRUCE; 'Shay Drummond'; 'jcampos@co.adams.il.us'; McCann, Ken; Clegg, Whitney; 'jcampos@co.adams.il.us' Subject: RE: email contacts-- please add PIO for Veterans Home Please see answers below to questions. Additional: Per Medical Director of IVHQ, Dr. Zorian Trusewych, FCCP: “Current case discussed at length with pulmonologist at Blessing Hospital, Dr. Venu Reddi, regarding radiographs which showed no pattern compatible with Legionella infection, but showed pulmonary congestion from CHF and despite no therapy that would cover Legionella, this frail 90 year old female managed to improve before urine antigen test was known. Dr. Reddi will render formal consult in am, August 22, 2015.” Copy of consultation report will follow on Monday. From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Friday, August 21, 2015 5:24 PM To: HOUSTON, CATHY; CLIFFORD, DAVE Cc: WHITCOMB, DAWN; VACA, BRUCE; 'Shay Drummond'; 'jcampos@co.adams.il.us'; McCann, Ken; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK Subject: RE: email contacts-- please add PIO for Veterans Home For Veteran’s home: 1. Questions: Regarding facility: 1. Any whirlpool spas/hot tubs Whirlpool Bath Tubs on Elmore West and Elmore East. a. Does the pool in the physical therapy building have any bubbling features NO 2. Are there sinks in the patients rooms? YES Elmore East and Elmore II. If so, do the faucets have aerators? Most do. Rm. Elmore II—does. West Rm. —has shared bathroom with sink with Rm --does. 3. How many shower/bathing rooms in Elmore building? 3 Tub/Shower Room on Elmore East and Elmore West. Shower Room only on Elmore II. a. Which shower/bathing room did the two cases use? Elmore West’s and Elmore II’s. 4. Ice machines on the patient’s floor? Ice Machine for building located in basement of building. 5. Health status of the residents in the Elmore building? Many with Respiratory Diagnosis upon admission such as COPD, CHF, etc. Regarding cases: 1. Had the more recent case left the facility during the two weeks prior to getting sick? Nothing to indicate such. If so, when and where? 2. Past medical history: is she immunocompromised, chronic lung disease, diabetes, a smoker? None to all questions. 3. Does she use any respiratory therapy equipment? Nebulizer, CPAP, BiPAP, etc. NO 4. Does she walk around the facility’s grounds/near the fountains? NO 5. Did she use the pool at the facility or go near it? NO 6. What floor do they live on? 1st case Elmore West; 2nd Case Elmore II. 7. Are the cases’ rooms near each other? NO. Separate floors and Ends of building. What are their room numbers? ); 8. Any other buildings in the facility that these cases visited during the two week before they got sick? NO. Such as a dining hall or rec room? NO. These Units have separate dining rooms. 2. Guidance/requests. 1. Please provide cooling tower maintenance log information. Reports will follow on Monday AM. 2. Please have heightened awareness for evidence of respiratory deterioration or fever/cough at this time, with prompt referral for evaluation if symptoms are concerning. Log being maintained. 3. Please turn off outdoor fountains DONE; please keep windows at Elmore bldg. closed Done and staff instructed to maintain closed windows ; and please use bathing facility other than the one the 2 cases used Staff instructed to utilize ONLY Elmore East Tub/Shower Room. From: Conover, Craig Sent: Friday, August 21, 2015 5:12 PM To: HOUSTON, CATHY S; CLIFFORD, DAVE J; Shay Drummond; 'jcampos@co.adams.il.us'; McCann, Ken; Arnold, Melaney; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK T Cc: WHITCOMB, DAWN R Subject: email contacts-- please add PIO for Veterans Home Veterans’ Home: Bruce Vaca: Administrator HOUSTON, CATHY director of nursing Dave Clifford: engineer Adams County: Shay Drummond: LHD administrator /PIO Jon Campos: CD IDPH Craig Conover: Infectious Disease IDPH—reachable all w/e at 312-519-6972 or 847-869-8814 Whitney Clegg: Infectious Disease IDPH Ken McCann : EH, iDPH Melany Arnold: IDPH PIO Craig S. Conover, MD Illinois Department of Public Health 122 South Michigan Avenue, 7th floor Chicago, IL 60603 312-814-4845 ?n From: "Meka, Anu" To: amnda_christian amy_henderson anita_pike Brown_adm carol carrie_skiles curt dale diana_sangmon hugh_montgmery jarod_adms jessica kayla_cass Linda logan logan_Don morgan_hd nancy nina nroegge@casscohealth.org Pam phyllis Pike robin ronda sangmon shay steve steve <_emergency> tdietrich@co.adams.il.us teresa CC: "Swehla, Gina" Date: 8/24/2015 3:56:42 PM Subject: FW: Training and Exercise Guidance Document Attachments: TE Grant Guidance Memo 082115.PDF IDPH Training and ExerciseGuidance Document for LHD CRI HPP BP4 082115.pdf Please find attached the TEE guidance that goes along with our PHEP grant. This will replace the one we have from 2012. I will go over this during our regional meeting again (tentatively 9/14 as our regional meeting date – verifying with SCHD for their conf room) Thanks Anu From: Moomey, Tammy Sent: Friday, August 21, 2015 4:35 PM To: Angarola, Linda; Athar, Masood; Atteberry, Greg; Buhs, Keith; Bussmann, Elizabeth; Carter, Billy; Davis, Dawn; Duarte, Elizabeth; Edmiston, Mark R.; Epping, Mike; Fleeharty, Jack; Frye, Patricia; Gillespie, Kevin; Griffith, Lisa; Horton, Tena; Kanhirun, Melissa; Kieninger, Brian; Little, Carla N.; Lyons, Evelyn M.; McFarland, Scott; Meka, Anu; Navon, Livia; Patterson, Tricia; Ramos, Joe; Reagan, Lynne; Reid, Jennifer; Ringenberg, Matthew; Snider, Jeff; Swehla, Gina; Thoele, Ashley; Usherwood, Deborah; Vassmer, Mark C.; VasudhaKilaru, Sri; Wadhams, Irene; Wilson, Shannon; Yurevich, Greg Cc: Rawls, Winfred; Moomey, Tammy Subject: Training and Exercise Guidance Document Importance: High OPR Staff, Please see the attached memo and guidance document. ERCs, REMSCs, Please distribute this memo and guidance document to your PHEP, CRI and HPP grantees. Mark Vassmer will be posting in EGrAMS. Tammy Moomey Tammy Moomey Assistant to the Deputy Director Illinois Department of Public Health Office of Preparedness & Response ‥ Tammy.Moomey@illinois.gov ⁽ 217.785.9224 217.720.7391 7 217.557.3894 ․ 422 South 5th Street, 4th Floor, Springfield, IL 62701 From: "Shay Drummond" To: Holmes "Tal <" "\(Tal.Holmes@illinois.gov\);>" "Connie <" "\(Connie.Austin@Illinois.gov\);>" "Fred <" "\(Fred.Echols@Illinois.gov\)>" CC: "Jerrod Welch" Date: 8/24/2015 6:49:40 AM Subject: FW: email contacts-- please add PIO for Veterans Home Attachments: DOC098.PDF Please see the EH information and attached document related to systems. Shay From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Monday, August 24, 2015 7:44 AM To: Conover, Craig; CLIFFORD, DAVE Cc: WINNICKI, LENARD F.; VACA, BRUCE; Shay Drummond; Jon Campos; McCann, Ken; Clegg, Whitney; Jon Campos Subject: RE: email contacts-- please add PIO for Veterans Home Please see attached “Site Visitation Report” and this statement from Chief Engineer, Dave Clifford: Per Bill Luthin my steamfitter, he does test the cooling tower water each day for PH and conductivity and also a bromine test from time to time. this electronic test is compared to the real time electronic basin monitor. Bills says the testing results are very close in comparison each time . Bill makes adjustments in the water treatment as needed, please know there is no records kept on this daily testing. Additionally the Pool in PT is tested each day as well and records are kept of this. Please let me know if you want these records. I have sent you via fax the latest ISWS site visit report. Please know the portion of the report (101 H.W. ) that indicates the glycol is below the 20% required to prevent bacterial growth. This does not pertain to the cooling tower located at PT. what that is referring to is a closed hot water heating loop that is a sealed system, and also located at a completely different building than Elmore. Please note that the central chiller plant cooling tower is located approximately 350ft per scale drawing from our Elmore building. Additionally, all exterior water fountains have been shut down as a preventive measure as of last night. Please let me know if I can be of more assistance. Thank you. Dave Clifford From: HOUSTON, CATHY Sent: Friday, August 21, 2015 8:48 PM To: 'Conover, Craig'; CLIFFORD, DAVE Cc: WINNICKI, LENARD F.; VACA, BRUCE; 'Shay Drummond'; 'jcampos@co.adams.il.us'; McCann, Ken; Clegg, Whitney; 'jcampos@co.adams.il.us' Subject: RE: email contacts-- please add PIO for Veterans Home Please see answers below to questions. Additional: Per Medical Director of IVHQ, Dr. Zorian Trusewych, FCCP: “Current case discussed at length with pulmonologist at Blessing Hospital, Dr. Venu Reddi, regarding radiographs which showed no pattern compatible with Legionella infection, but showed pulmonary congestion from CHF and despite no therapy that would cover Legionella, this frail 90 year old female managed to improve before urine antigen test was known. Dr. Reddi will render formal consult in am, August 22, 2015.” Copy of consultation report will follow on Monday. From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Friday, August 21, 2015 5:24 PM To: HOUSTON, CATHY; CLIFFORD, DAVE Cc: WHITCOMB, DAWN; VACA, BRUCE; 'Shay Drummond'; 'jcampos@co.adams.il.us'; McCann, Ken; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK Subject: RE: email contacts-- please add PIO for Veterans Home For Veteran’s home: 1. Questions: Regarding facility: 1. Any whirlpool spas/hot tubs Whirlpool Bath Tubs on Elmore West and Elmore East. a. Does the pool in the physical therapy building have any bubbling features NO 2. Are there sinks in the patients rooms? YES Elmore East and Elmore II. If so, do the faucets have aerators? Most do. Rm. Elmore II—does. West Rm. —has shared bathroom with sink with Rm -does. 3. How many shower/bathing rooms in Elmore building? 3 Tub/Shower Room on Elmore East and Elmore West. Shower Room only on Elmore II. a. Which shower/bathing room did the two cases use? Elmore West’s and Elmore II’s. 4. Ice machines on the patient’s floor? Ice Machine for building located in basement of building. 5. Health status of the residents in the Elmore building? Many with Respiratory Diagnosis upon admission such as COPD, CHF, etc. Regarding cases: 1. Had the more recent case left the facility during the two weeks prior to getting sick? Nothing to indicate such. If so, when and where? 2. Past medical history: is she immunocompromised, chronic lung disease, diabetes, a smoker? None to all questions. 3. Does she use any respiratory therapy equipment? Nebulizer, CPAP, BiPAP, etc. NO 4. Does she walk around the facility’s grounds/near the fountains? NO 5. Did she use the pool at the facility or go near it? NO 6. What floor do they live on? 1st case ) Elmore West; 2nd Case Elmore II. 7. Are the cases’ rooms near each other? NO. Separate floors and Ends of building. What are their room numbers? ); 8. Any other buildings in the facility that these cases visited during the two week before they got sick? NO. Such as a dining hall or rec room? NO. These Units have separate dining rooms. 2. Guidance/requests. 1. Please provide cooling tower maintenance log information. Reports will follow on Monday AM. 2. Please have heightened awareness for evidence of respiratory deterioration or fever/cough at this time, with prompt referral for evaluation if symptoms are concerning. Log being maintained. 3. Please turn off outdoor fountains DONE; please keep windows at Elmore bldg. closed Done and staff instructed to maintain closed windows ; and please use bathing facility other than the one the 2 cases used Staff instructed to utilize ONLY Elmore East Tub/Shower Room. From: Conover, Craig Sent: Friday, August 21, 2015 5:12 PM To: HOUSTON, CATHY S; CLIFFORD, DAVE J; Shay Drummond; 'jcampos@co.adams.il.us'; McCann, Ken; Arnold, Melaney; Clegg, Whitney; 'jcampos@co.adams.il.us'; GENGENBACHER, RICK T Cc: WHITCOMB, DAWN R Subject: email contacts-- please add PIO for Veterans Home Veterans’ Home: Bruce Vaca: Administrator HOUSTON, CATHY director of nursing Dave Clifford: engineer Adams County: Shay Drummond: LHD Director of Clinical and Environmental Serices/PIO Jon Campos: CD IDPH Craig Conover: Infectious Disease IDPH?reachable all w/e at 312-519-6972 or 847-869-8814 Whitney Clegg: Infectious Disease IDPH Ken McCann EH, Melany Arnold: IDPH PIO Craig S. Conover, MD Illinois Department of Public Health 122 South Michigan Avenue, 7th floor Chicago, IL 60603 312-814-4845 From: "Shay Drummond" To: Austin Connie CC: Date: 8/24/2015 7:43:36 AM Subject: Re: Case Report Form Getting that info as we speak Sent from my iPhone On Aug 24, 2015, at 8:25 AM, Austin, Connie wrote: Do you know how far from the Veterans Home the 38 yr old lives? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 24, 2015 8:15 AM To: Austin, Connie Subject: RE: Case Report Form This is not reflecting the three inpatients that are currently in Blessing Linda is in an 8:15 meeting and is following up as to their status in INEDSS. There are three additional cases. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Monday, August 24, 2015 8:13 AM To: Shay Drummond Subject: RE: Case Report Form I find these Legionella cases for Adams County, not 5 from the facility? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 24, 2015 7:32 AM To: Conover, Craig; Clegg, Whitney; Holmes, Tal; Echols, Fred; Austin, Connie Cc: Linda Manley; Jon Campos; Jerrod Welch Subject: RE: Case Report Form Good morning, Please let me know who will be coming to the Adams County Health Department and their approx. Arrival time. I would like to meet with them prior to going to IVH and review our cases. As of yesterday all patients are in INEDSS and the three that presented over the weekend have had additional questioning per the supplemental sheet as well as IVH specific questions. None report having visited the dentist, or visiting any of the fountains on the grounds. No use of spa, whirlpool or pools or being in the area. No drinking from hallway water fountains. Thanks, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Sunday, August 23, 2015 5:31 PM To: Shay Drummond; Clegg, Whitney; Holmes, Tal; Echols, Fred; Austin, Connie Cc: Linda Manley Subject: Re: Case Report Form ​I also cannot access that form. Will cc Springfield staff for input. CDC case report form attached. This particular scenario will likely require facility specific questions to be generated once specific hypotheses are generated. From: Shay Drummond Sent: Sunday, August 23, 2015 2:55 PM To: Clegg, Whitney; Conover, Craig Cc: Linda Manley Subject: Case Report Form Hi, Both Linda who is at Blessing interviewing patients and myself working from home seem to have a dead link for the case reporting form on the IDPH portal. We can both access the supplemental. Can you please forward us a Legionellosis specific copy so we can be sure and not miss any key questions? Thanks! Shay Shay L. Drummond RN BSN Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 217-222-8440 x 148 fax: 217-222-8460 cell: 217-316-2795 FromCC: Date: 8/24/2015 7:15:17 AM Subject: RE: Case Report Form This is not reflecting the three inpatients that are currently in Blessing Linda is in an 8:15 meeting and is following up as to their status in INEDSS. There are three additional cases. From: Austin, Connie Sent: Monday, August 24, 2015 8:13 AM To: Shay Drummond Subject: RE: Case Report Form I find these Legionella cases for Adams County, not 5 from the facility? 80 Female 0512012015 09 Male 071240015 Yes No 38 Female 0?!29!2015 Yes Yes 90 Female 081150015 Yes Yes ealth veterinarian Division of Infectious Disease Illinois Department of Public Health 525 Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 . . . From: Shay Drummond Sent: Monday, August 24, 2015 7:32 AM To: Conover, Craig; Clegg, Whitney; Holmes, Tal; Echols, Fred; Austin, Connie Cc: Linda Manley; Jon Campos; Jerrod Welch Subject: RE: Case Report Form State Case Age at 0 Sex at Onset Onset Date Pneumonia (Clinic'Pneumonia (Radio es Yes Unknown Home No Residential Facility Home No Home No Home as the patient im Patient Current Address Day CarelFacility N- Veterans H0 Good morning, Please let me know who will be coming to the Adams County Health Department and their approx. Arrival time. I would like to meet with them prior to going to IVH and review our cases. As of yesterday all patients are in INEDSS and the three that presented over the weekend have had additional questioning per the supplemental sheet as well as IVH specific questions. None report having visited the dentist, or visiting any of the fountains on the grounds. No use of spa, whirlpool or pools or being in the area. No drinking from hallway water fountains. Thanks, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Sunday, August 23, 2015 5:31 PM To: Shay Drummond; Clegg, Whitney; Holmes, Tal; Echols, Fred; Austin, Connie Cc: Linda Manley Subject: Re: Case Report Form I also cannot access that form. Will cc Springfield staff for input. CDC case report form attached. This particular scenario will likely require facility specific questions to be generated once specific hypotheses are generated. From: Shay Drummond Sent: Sunday, August 23, 2015 2:55 PM To: Clegg, Whitney; Conover, Craig Cc: Linda Manley Subject: Case Report Form Hi, Both Linda who is at Blessing interviewing patients and myself working from home seem to have a dead link for the case reporting form on the IDPH portal. We can both access the supplemental. Can you please forward us a Legionellosis specific copy so we can be sure and not miss any key questions? Thanks! Shay Shay L. Drummond RN BSN Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 217-222-8440 x 148 fax: 217-222-8460 cell: 217-316-2795 From: "Shay Drummond" To: Austin Connie "Tal\(Tal.Holmes@illinois.gov\);" CC: Date: 8/24/2015 8:40:13 AM Subject: RE: Case Report Form Connie she is at . This is not near the home it is 4.8 miles from IVH. Here is the hyperlink to locations. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Monday, August 24, 2015 8:25 AM To: Shay Drummond Subject: RE: Case Report Form Do you know how far from the Veterans Home the 38 yr old lives? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 24, 2015 8:15 AM To: Austin, Connie Subject: RE: Case Report Form This is not reflecting the three inpatients that are currently in Blessing Linda is in an 8:15 meeting and is following up as to their status in INEDSS. There are three additional cases. From: Austin, Connie Sent: Monday, August 24, 2015 8:13 AM To: Shay Drummond Subject: RE: Case Report Form find these Legionella cases for Adams County, not 5 from the facility? Age at 0 Sex at Onset Onset Date Pneumonia (Clinianeumonia (Radio as the patient im Patient AttendSiRe Current Address Day CareiFacility es Yes 80 Female 0512012015 Unknown Home 89 Male 0712412015 Yes No No Residential Facility Home Illinois Veterans Ho 38 Female 0712912015 Yes Yes No Home 90 Female 0811512015 Yes Yes No Home State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond Sent: Monday, August 24, 2015 7:32 AM To: Conover, Craig; Clegg, Whitney; Holmes, Tal; Echols, Fred; Austin, Connie Cc: Linda Manley; Jon Campos; Jerrod Welch Subject: RE: Case Report Form Good morning, Please let me know who will be coming to the Adams County Health Department and their approx. Arrival time. I would like to meet with them prior to going to NH and review our cases. As of yesterday all patients are in INEDSS and the three that presented over the weekend have had additional questioning per the supplemental sheet as well as IVH specific questions. None report having visited the dentist, or visiting any of the fountains on the grounds. No use of spa, whirlpool or pools or being in the area. No drinking from hallway water fountains. Thanks, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 Cell: 217-316-2795 PublicHedth CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and con?dential use of the designated recipients named above. The documents accompanying this transmission may contain con?dential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been ful?lled. If the reader of this message is not the intended recipient, you are hereby noti?ed that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Conover, Craig Sent: Sunday, August 23, 2015 5:31 PM To: Shay Drummond; Clegg, Whitney; Holmes, Tal; Echols, Fred; Austin, Connie Cc: Linda Manley Subject: Re: Case Report Form I also cannot access that form. Will cc Springfield staff for input. CDC case report form attached. This particular scenario will likely require facility specific questions to be generated once specific hypotheses are generated. From: Shay Drummond Sent: Sunday, August 23, 2015 2:55 PM To: Clegg, Whitney; Conover, Craig Cc: Linda Manley Subject: Case Report Form Hi, Bo?'i Linda who is at Blessing interviewing patients and myself working from home seem to have a dead link for the case reporting form on the IDPH portal. We can both access the supplemental. Can you please forward us a Legionellosis specific copy so we can be sure and not miss any key questions? Thanks! Shay Shay L. Drummond RN BSN Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 217-222-8440 x 148 fax: 217-222-8460 cell: 217-316-2795 From: "Shay Drummond" To: Bell "Scott S. <" "\(Scott.S.Bell@Illinois.gov\);>" CC: Date: 8/24/2015 9:29:12 AM Subject: Regional Meeting Hi Scott, Perhaps we should do a segment on Legionellosis? This outbreak is continuing to ramp up this morning. Can you also confirm the regional meeting date in September -I am getting conflicting dates/times. Thanks!!! Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: "Shay Drummond" "Jon Campos" CC: Date: 8/25/2015 2:15:26 PM Subject: FW: L pneumophila urine antigen testing From our lab director, if this is desired for future urine antigens. I spoke with Memorial Hospital lab Director in Springfield. They provide urine antigen tests for Legionella pneumophila; the turnaround is most likely same day if delivered by early afternoon. Ideally the hospital could submit these and pay for them. If necessary we could work something out with the lab for payment for urine antigens for this situation. Bernard (Tom) Johnson Chief, Division of Laboratories Illinois Department of Public Health 825 N. Rutledge St. Springfield, IL 62702 Phone: 217-782-6562 Cell: 309-222-1312 Fax: 217-524-7924 Email: Bernard.Johnson@Illinois.gov From: "Austin, Connie" To: "Shay Drummond" "Jon Campos" CC: "Morgan, Jodi" "Conover, Craig" "Johnson, Bernard T." "Kelly-Shannon, Kate D." "Holmes, Tal" Date: 8/25/2015 1:59:00 PM Subject: FW: Respiratory illness at large Veterans home in Illinois Attachments: CDC RVDP Specimen Submission Guidelines v1.8.pdf Shay/Jon, Had a conversation and some email with CDC about the respiratory panel. There is a viral respiratory group and a bacterial so they would work together to get the testing done. My suggestion is that specimens be collected on hospitalized patients that the physicians think would be the best candidates. if specimens as listed in the email below can be collected, if they could be transported (hopefully by car for rapid transit) to the IDPH lab in Springfield for shipping to CDC that works the best because they are very particular about shipping requirements/forms. CDC requests that specimens arrive prior to the weekend, not to arrive on the weekend. Tom, What form would they be able to fill out that will give you enough information to do the DASH form? Or do you want them to attempt the DASH form? From CDC… We prefer to have an NP/OP collected on each patient. For those with pneumonia or lower resp findings please also collect a lower resp specimen. The link to the instructions is attached. If you have previously collected stored specimens we could test those as long as they have been refrigerated. Keep the specimens refrigerated. If you cannot send until next week you will need to freeze the specimens that were collected 72hrs earlier. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Bell, Scott S." To: "Shay Drummond" CC: Date: 8/25/2015 6:31:55 AM Subject: RE: Regional Meeting Sept 2. Times vary depending on speakers. As early as 9:30 and as late as 3:00. Typically 10-2:30. Regarding a Legoinella presentation, you might ask Ken if someone is available. It’s possible there is already a PowerPoint about Legionella investigations in general and you could add on your recent experience. Did you get any response to my request for speakers from Central Office? From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 24, 2015 10:29 AM To: Bell, Scott S. Subject: Regional Meeting Hi Scott, Perhaps we should do a segment on Legionellosis? This outbreak is continuing to ramp up this morning. Can you also confirm the regional meeting date in September -I am getting conflicting dates/times. Thanks!!! Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "HOUSTON, CATHY" To: "Shay Drummond" CC: "HOUSTON, CATHY" "PERRINE, HOLLY" "KELLEY, LINDSEY" Date: 8/25/2015 8:37:35 AM Subject: Illinois Veteran's Home Attachments: Legionella 08-15 See attached on Mr. .docx , updated on others re: bathing. (Elmore East) Takes a shower routinely in the Elmore East Tub room. (Elmore West) Takes tub bath/whirlpool tub on Elmore West (Elmore II) Takes shower on Elmore II (Fletcher II) Takes shower on Fletcher II (Fifer) Due to condition—bed bath given in room The additional information you requested on information. Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 CATHY.S.HOUSTON@illinois.gov will be sent before Noon. She has returned to IVHQ and we are in process of interviewing her for more From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/25/2015 2:43:22 PM Subject: IVHQ Resident information Attachments: DOC099.PDF The attached was faxed to our unit today. H&P on Please note History of Present Illness: This is…… from the Illinois Veterans Home where there is a legionella outbreak….. Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 CATHY.S.HOUSTON@illinois.gov From: "HOUSTON, CATHY" To: "Shay Drummond" CC: "PERRINE, HOLLY" "KELLEY, LINDSEY" "HOUSTON, CATHY" Date: 8/25/2015 10:35:00 AM Subject: RE: Illinois Veteran's Home Attachments: Legionella .docx Shay, Attached is new timeline for . From: HOUSTON, CATHY Sent: Tuesday, August 25, 2015 9:38 AM To: Shay Drummond Cc: HOUSTON, CATHY; PERRINE, HOLLY; KELLEY, LINDSEY Subject: Illinois Veteran's Home See attached on , updated on others re: bathing. (Elmore East) Takes a shower routinely in the Elmore East Tub room. (Elmore West) Takes tub bath/whirlpool tub on Elmore West (Elmore II) Takes shower on Elmore II (Fletcher II) Takes shower on Fletcher II (Fifer) Due to condition—bed bath given in room The additional information you requested on Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 CATHY.S.HOUSTON@illinois.gov will be sent before Noon. She has returned to IVHQ and we are in process of interviewing her for more information. From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/25/2015 2:57:00 PM Subject: RE: IVHQ Resident information We asked and she said they did take and do the urine. She will let us know or probably you will know also the results. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, August 25, 2015 3:53 PM To: HOUSTON, CATHY Subject: RE: IVHQ Resident information Thanks Cathy! I was wanting to find out if your staff that we interviewed yesterday had a good visit with her physician and if they order a urine antigen. Do you have a phone number for ? Or do you want to ask her and let me know? Also we have gotten CDC guidance and recommendations to do lab testing for viral and bacterial respiratory illnesses and that is going across Dr. Merrick’s desk right now. Stay tuned! From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Tuesday, August 25, 2015 3:43 PM To: Shay Drummond Subject: IVHQ Resident information The attached was faxed to our unit today. H&P on . Please note History of Present Illness: This is…… from the Illinois Veterans Home where there is a legionella outbreak….. Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 CATHY.S.HOUSTON@illinois.gov From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/25/2015 2:04:12 PM S u b j e c t : RE: Resident/Family Working on those name as we speak. This is a higher incidence of illness this past few days than normal for sure. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, August 25, 2015 2:54 PM To: HOUSTON, CATHY Subject: RE: Resident/Family Thanks I am getting ready to get on a call with their risk management and the folks at Blessing. Any other questions for Blessing? Also I had sent a list of names and wanted to clarify/verify what hall that they were from I have 2 more to add – Also from your facility prospective – is this a normal number of admits with similar symptoms? I am also trying to get data from ED. Thank you and I will send an update to you from the call. From: HOUSTON, CATHY [mailto:CATHY S HOUSTON@illinois.gov] Sent: Tuesday, August 25, 2015 2:41 PM To: Shay Drummond Subject: RE: Resident/Family Shay, I feel like a real tattle tale here…. family came in this afternoon for his care plan meeting even though he is in the hospital. They announced to the staff in the care plan meeting that staff at Blessing told them that IVHQ has an outbreak of Legionaire’s Disease. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, August 25, 2015 2:15 PM To: HOUSTON, CATHY Subject: Resident/Family Hi there, Thanks for being on the call I wanted to get the name of the patient that the Doc made the comment so we can make sure that doc gets the memo on talking to patients and risk management. I am planning a call for three with Linda and if you have any other questions that we or you want answered. Talk to you at three. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONF DENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. f the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. f you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/25/2015 1:40:56 PM Subject: RE: Resident/Family Shay, I feel like a real tattle tale here…. family came in this afternoon for his care plan meeting even though he is in the hospital. They announced to the staff in the care plan meeting that staff at Blessing told them that IVHQ has an outbreak of Legionaire’s Disease. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, August 25, 2015 2:15 PM To: HOUSTON, CATHY Subject: Resident/Family Hi there, Thanks for being on the call I wanted to get the name of the patient that the Doc made the comment so we can make sure that doc gets the memo on talking to patients and risk management. I am planning a call for three with Linda and if you have any other questions that we or you want answered. Talk to you at three. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Jerrod Welch" To: Morgan Jodi CC: Date: 8/25/2015 11:30:13 AM Subject: Accepted: legionella update IVH Attachments: attachment.ics From: "Johnson, Bernard T." To: Austin "Connie ;Shay Drummond ;Jon Campos" CC: "Morgan, Jodi" "Conover, Craig" "Kelly-Shannon, Kate D." "Holmes, Tal" Date: 8/25/2015 2:09:45 PM S u b j ect: RE: Respiratory illness at large Veterans home in Illinois Connie: They can fill out the standard Communicable Disease form information completely. If they have someone available by phone for follow up questions if the CD form is not complete it would be helpful. Tom Bernard (Tom) Johnson Chief, Division of Laboratories Illinois Department of Public Health 825 N. Rutledge St. Springfield, IL 62702 Phone: 217-782-6562 Cell: 309-222-1312 Fax: 217-524-7924 Email: Bernard.Johnson@Illinois.gov From: Austin, Connie Sent: Tuesday, August 25, 2015 2:59 PM To: Shay Drummond; Jon Campos Cc: Morgan, Jodi; Conover, Craig; Johnson, Bernard T.; Kelly-Shannon, Kate D.; Holmes, Tal Subject: FW: Respiratory illness at large Veterans home in Illinois Shay/Jon, Had a conversation and some email with CDC about the respiratory panel. There is a viral respiratory group and a bacterial so they would work together to get the testing done. My suggestion is that specimens be collected on hospitalized patients that the physicians think would be the best candidates. if specimens as listed in the email below can be collected, if they could be transported (hopefully by car for rapid transit) to the IDPH lab in Springfield for shipping to CDC that works the best because they are very particular about shipping requirements/forms. CDC requests that specimens arrive prior to the weekend, not to arrive on the weekend. Tom, What form would they be able to fill out that will give you enough information to do the DASH form? Or do you want them to attempt the DASH form? From CDC… We prefer to have an NP/OP collected on each patient. For those with pneumonia or lower resp findings please also collect a lower resp specimen. The link to the instructions is attached. If you have previously collected stored specimens we could test those as long as they have been refrigerated. Keep the specimens refrigerated. If you cannot send until next week you will need to freeze the specimens that were collected 72hrs earlier. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "McCann, Ken" To: "Shay Drummond" "Jon Campos" "Jerrod Welch" CC: "Culp, David" "Conover, Craig" "Austin, Connie" "Morgan, Jodi" "Mitchell, Joe" "DeWitt, Justin" "Martin, Aaron" "Bell, Scott S." Date: 8/25/2015 3:19:46 PM Subject: Quincy facility Jerrod/Shay – below are recommendations from us for your review and forwarding the facility. We recognize that these don’t answer all the questions and additional conversations will be necessary. We thought this would be a good start and we’ll see how things develop in the coming days. Let us know of thoughts/concerns. We’ll assume you will take care of communicating with the facility unless you tell us otherwise. Thanks ken +++++++++++++++++ The following recommendations are based upon 2 currently confirmed cases which were the focus of the environmental investigation at the facility Monday, August 24. These recommendations may change with additional epidemiologic information on current or additional cases. Additional environmental samples will be necessary if additional cases are confirmed. Consideration should be given to retaining the services of an environmental consultant with experience and expertise regarding legionella investigation and mitigation to assist with additional investigation and possible mitigation efforts. Elmore Infirmary · Tub rooms located in Elmore East and Elmore West: o Replace tub spray heads with point-of-use filtration heads capable of filtering legionella bacteria. · · o Contact the Apollo tub manufacturer to discuss possible methods to increase levels of sanitization of the tubs. The manufacturer should be able to recommend additional sanitization methods that won’t adversely affect the tubs. Tubs should be sanitized prior to use. o Documentation of tub sanitization should maintained. o Tubs can be used once these steps are completed and documented. Routine maintenance of the water system should include monitoring residual chlorine levels and temperatures in representative end-use plumbing fixtures. All monitoring should be adequately documented. We recommend the implementation of a water system management plan consistent with the American Society of Heating, Refrigeration and Air-Conditioning Engineer’s (ASHRAE) Standard 188. A draft version for public comment is attached. However, a read only version of the final standard is available from: https://www.ashrae.org/standards-research--technology/standards--guidelines/other-ashrae-standards-referenced-in-code. Elements of such a plan would include water quality monitoring at site specific intervals as well as contingency plans for responding to positive test results. A plan should also include a system flushing program to ensure all plumbing fixtures in the Elmore Infirmary are flushed on a regular basis to eliminate potential stagnant potable water in the plumbing system. Other Recommendations · Drain and discontinue use of outdoor fountains. Ken McCann, MA, LEHP Chief, Division of Environmental Health Illinois Department of Public Health 525 West Jefferson Str. Springfield, Il 62761 phone: 217-785-2043 fax: 217-785-0253 Ken.McCann@illinois.gov IMPORTANT: This e-mail, including all attachments, constitute State Government records and property that is intended only for the use of the individual or entity to w hich it is addressed. It also may contain information that is privileged, confidential, or otherw ise protected from disclosure under applicable law . If the reader of this transmission is not the intended recipient or the employee or agent responsible for delivering the transmission to the intended recipient, you are hereby notified that any dissemination, distribution, copying or use of this e-mail or its contents is strictly prohibited. If you have received this in error, please notify the sender. From: "Morgan, Jodi" To: Conover Craig Connie "Kate D. ;sdrummond@co.adams.il.us;jcampos@co.adams.il.us;;HOUSTON>" "CATHY S" CC: Date: 8/25/2015 11:13:17 AM Subject: legionella update IVH Attachments: attachment.ics Purpose of call is to review current status and discuss next steps. From: "Morgan, Jodi" To: Conover Craig Connie "Kate D. ;sdrummond@co.adams.il.us;jcampos@co.adams.il.us;;HOUSTON>" "CATHY S" David CC: Date: 8/25/2015 11:16:20 AM Subject: legionella update IVH Attachments: attachment.ics Purpose of call is to review current status and discuss next steps. Call in information: 888-494-4032 Code: 6575947859# From : "Morgan, Jodi" To: "Shay Drummond" Connie CC: Date: 8/25/2015 5:01:56 PM Subject: RE: Respiratory illness at large Veterans home in Illinois If they can get good sputum specimens, then both,. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, August 25, 2015 5:58 PM To: Austin, Connie; Morgan, Jodi Subject: FW: Respiratory illness at large Veterans home in Illinois Can you confirm if you want sputums and NP/OP or just NP/OP? From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Tuesday, August 25, 2015 2:59 PM To: Shay Drummond; Jon Campos Cc: Morgan, Jodi; Conover, Craig; Johnson, Bernard T.; Kelly-Shannon, Kate D.; Holmes, Tal Subject: FW: Respiratory illness at large Veterans home in Illinois Shay/Jon, Had a conversation and some email with CDC about the respiratory panel. There is a viral respiratory group and a bacterial so they would work together to get the testing done. My suggestion is that specimens be collected on hospitalized patients that the physicians think would be the best candidates. if specimens as listed in the email below can be collected, if they could be transported (hopefully by car for rapid transit) to the IDPH lab in Springfield for shipping to CDC that works the best because they are very particular about shipping requirements/forms. CDC requests that specimens arrive prior to the weekend, not to arrive on the weekend. Tom, What form would they be able to fill out that will give you enough information to do the DASH form? Or do you want them to attempt the DASH form? From CDC… We prefer to have an NP/OP collected on each patient. For those with pneumonia or lower resp findings please also collect a lower resp specimen. The link to the instructions is attached. If you have previously collected stored specimens we could test those as long as they have been refrigerated. Keep the specimens refrigerated. If you cannot send until next week you will need to freeze the specimens that were collected 72hrs earlier. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Morgan, Jodi" To: Austin "Connie ;; >" CC: "Conover, Craig" "Morgan, Jodi" Date: 8/25/2015 2:17:01 PM Subject: resp outbreak, some IC recommendations Hi Shay, Here is the A to Z page I referenced: https://dph.partner.illinois.gov/communities/communicabledisease/CDAZ/Pages/Respiratory%20Disease%20Outbreak%20Management.aspx Some additional recommendations for a respiratory outbreak (some are more applicable for person to person transmission) are listed below. Please review. Contact me with any questions. Note that some of these should be in place already or can be implemented until we have more information. Notify IDPH Regulatory Division of outbreak. Communicate daily with local health department or provide additional updates as indicated. Implement daily surveillance for respiratory illness for all residents, healthcare workers, other staff, and visitors. Continue daily surveillance for at least seven days after onset of most recent case, or as requested by local health department. Maintain a line list of all ill residents and staff. An example of information needed and line list can be provided. Maintain a log of staff call-ins. Monitor for respiratory symptoms. Report on line list and to local health department daily. Consider halting admissions of new residents to the facility. Develop a plan for readmissions, (to an unaffected unit). Place ill residents in private rooms, if possible. If this is not possible, ill residents can be placed with other ill residents with same symptoms or stay in their own rooms. They should not be moved between units (unless recommended after consultation with local public health department). Residents with respiratory illness should stay in their rooms and out of common areas. If they need to come out of their rooms, they should wear face masks, if tolerated, and use respiratory etiquette. Notify the receiving department or facility of the resident’s illness in advance so that precautions can be taken. Advise healthcare personnel to observe Droplet Precautions (i.e., wearing a surgical or procedure mask for close contact), in addition to Standard Precautions, when caring for a resident with symptoms of a respiratory infection, particularly if fever is present. These precautions should be maintained until it is determined that the cause of symptoms is not an infectious agent that requires Droplet Precautions. Transmission-based precautions may be recommended and should be based on the pathogen when known. Refer to CDC Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings Appendix A For suspected or confirmed influenza, use droplet precautions for residents for 7 days after illness onset or until 24 hours after the resolution of fever and respiratory symptoms, whichever is longer. Additional Infection Control Measures Encourage Influenza vaccination for residents and staff when available. Emphasize importance of hand hygiene and respiratory etiquette. Cohort staff- --Staff should not float between units. Personnel should not go back and forth between different areas of the facility. Assign employees to care for the same group of patients each shift, if possible. Do not allow movement of residents between units. Residents should not be relocated to other units during an outbreak. (May change with additional test results and recommendations from Public Health.) Activities should be limited to the smallest groups possible and be held within units. Ill residents should not participate in group activities. If transmission is ongoing, cancel group activities. If transmission is ongoing, serve meals in resident rooms. Education: All staff and residents should be made aware of the outbreak. Review sick/call-in policy with staff; no working while ill or until free of fever for 24 hours, without fever-reducing medication. Remind staff and residents to use respiratory hygiene and cough etiquette. Visual aids such as a “Cover Your Cough” poster can be used as reminders http://www.cdc.gov/flu/protect/covercough.htm Conduct in-services on respiratory hygiene and cough etiquette to help remind and educate employees. Ensure all shifts receive education. Remind staff and residents to increase hand hygiene during an outbreak. Make sure that supplies for hand washing and hand sanitizer are readily available. Environmental Hygiene: Adhere to routine cleaning procedures, especially the cleaning of surfaces that are frequently touched, such as hand rails, elevator buttons, and door knobs. Environmental staff should be made aware of the outbreak so that they can concentrate on cleaning these surfaces, especially if time or resources are limited. If possible, increase frequency of cleaning of frequently touched surfaces. Staff Employees with fever should not work until they have not had fever for 24 hours without the use of fever-reducing medications. Employees with respiratory illness and no fever should be evaluated for appropriateness of patient care duties. Employees with respiratory illness and no fever who remain at work should wear a facemask during resident care activities, perform frequent hand hygiene, and adhere to respiratory hygiene and cough etiquette. Visitors People visiting an ill resident should limit their visits to only that resident and should be instructed on hand hygiene and the use of PPE. Consider posting signage to alert visitors that an outbreak is occurring and that they should refrain from visiting if they have respiratory symptoms or are at high risk of complications if they become ill. Discourage visitors from visiting multiple residents or traveling to more than one area of the facility. Have the following supplies readily available: Soap and paper towels for hand washing Tissues for staff, residents, and visitors PPE- Facemasks, gowns, gloves, and eye protection Hand sanitizer for staff, residents, and visitors No-touch trash receptacles for used tissue disposal Resources: CDC Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Available at http://www.cdc.gov/hicpac/pdf/isolation/isolation2007.pdf CDC Guidelines for the Prevention of Healthcare Associated Pneumonia, 2003. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5303a1.htm 2014 IDPH Guidelines for the Prevention and Control of Influenza Outbreaks in Illinois Long Term Care Facilities, available at http://www.idph.state.il.us/flu/CDCS_Influenza_Outbreak_Guidance_for_Long_Term_Care_Facilities.pdf From: "Shay Drummond" To: Morgan Jodi CC: Date: 8/25/2015 11:15:59 AM Subject: Accepted: legionella update IVH Attachments: attachment.ics From: "Shay Drummond" To: HOUSTON "CATHY <" "\(CATHY.S.HOUSTON@illinois.gov\);>" "BRUCE <" "\(BRUCE.VACA@illinois.gov\)>" CC: "Jon Campos" "Jerrod Welch" "Tony Dede" Date: 8/25/2015 3:37:34 PM Subject: Environmental Reccomendations Bruce and Cathy, Below are the starting recommendations from the environmental health side of our visit. I will be following with a separate email with infection control issues as we discussed on the call this morning. The following recommendations are based upon 2 currently confirmed cases which were the focus of the environmental investigation at the facility Monday, August 24. These recommendations may change with additional epidemiologic information on current or additional cases. Additional environmental samples will be necessary if additional cases are confirmed. Consideration should be given to retaining the services of an environmental consultant with experience and expertise regarding legionella investigation and mitigation to assist with additional investigation and possible mitigation efforts. Elmore Infirmary · Tub rooms located in Elmore East and Elmore West: o Replace tub spray heads with point-of-use filtration heads capable of filtering legionella bacteria. o Contact the Apollo tub manufacturer to discuss possible methods to increase levels of sanitization of the tubs. The manufacturer should be able to recommend additional sanitization methods that won’t adversely affect the tubs. Tubs should be sanitized prior to use. o Documentation of tub sanitization should maintained. o Tubs can be used once these steps are completed and documented. · Routine maintenance of the water system should include monitoring residual chlorine levels and temperatures in representative end-use plumbing fixtures. All monitoring should be adequately documented. · We recommend the implementation of a water system management plan consistent with the American Society of Heating, Refrigeration and Air-Conditioning Engineer’s (ASHRAE) Standard 188. A draft version for public comment is attached. However, a read only version of the final standard is available from: https://www.ashrae.org/standards-research--technology/standards--guidelines/other-ashrae-standards-referenced-in-code. Elements of such a plan would include water quality monitoring at site specific intervals as well as contingency plans for responding to positive test results. A plan should also include a system flushing program to ensure all plumbing fixtures in the Elmore Infirmary are flushed on a regular basis to eliminate potential stagnant potable water in the plumbing system. Other Recommendations · Drain and discontinue use of outdoor fountains. Please let me know if you have any questions or need help securing resources. We will be in continued communication as we receive additional lab results. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Austin "Connie \(Connie.Austin@Illinois.gov\);Jon Campos" CC: Date: 8/25/2015 9:48:41 AM Subject: FW: Illinois Veteran's Home Attachments: Legionella 08-15 .docx Please see this additional history on these patients. From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Tuesday, August 25, 2015 9:38 AM To: Shay Drummond Cc: HOUSTON, CATHY; PERRINE, HOLLY; KELLEY, LINDSEY Subject: Illinois Veteran's Home See attached on updated on others re: bathing. (Elmore East) Takes a shower routinely in the Elmore East Tub room. l (Elmore West) Takes tub bath/whirlpool tub on Elmore West (Elmore II) Takes shower on Elmore II (Fletcher II) Takes shower on Fletcher II (Fifer) Due to condition—bed bath given in room The additional information you requested on Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 CATHY.S.HOUSTON@illinois.gov will be sent before Noon. She has returned to IVHQ and we are in process of interviewing her for more information. From: "Shay Drummond" To: Austin "Connie \(Connie.Austin@Illinois.gov\);" CC: Date: 8/25/2015 4:57:41 PM Subject: FW: Respiratory illness at large Veterans home in Illinois Attachments: CDC RVDP Specimen Submission Guidelines v1.8.pdf Can you confirm if you want sputums and NP/OP or just NP/OP? From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Tuesday, August 25, 2015 2:59 PM To: Shay Drummond; Jon Campos Cc: Morgan, Jodi; Conover, Craig; Johnson, Bernard T.; Kelly-Shannon, Kate D.; Holmes, Tal Subject: FW: Respiratory illness at large Veterans home in Illinois Shay/Jon, Had a conversation and some email with CDC about the respiratory panel. There is a viral respiratory group and a bacterial so they would work together to get the testing done. My suggestion is that specimens be collected on hospitalized patients that the physicians think would be the best candidates. if specimens as listed in the email below can be collected, if they could be transported (hopefully by car for rapid transit) to the IDPH lab in Springfield for shipping to CDC that works the best because they are very particular about shipping requirements/forms. CDC requests that specimens arrive prior to the weekend, not to arrive on the weekend. Tom, What form would they be able to fill out that will give you enough information to do the DASH form? Or do you want them to attempt the DASH form? From CDC… We prefer to have an NP/OP collected on each patient. For those with pneumonia or lower resp findings please also collect a lower resp specimen. The link to the instructions is attached. If you have previously collected stored specimens we could test those as long as they have been refrigerated. Keep the specimens refrigerated. If you cannot send until next week you will need to freeze the specimens that were collected 72hrs earlier. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: To: Austin CC: Date: 8/25/2015 4:18:11 PM Subject: Legionella 08-15- Attach ments: Legionella 08-15 -.docx - timeline From: To: HOUSTON . CC: Date: 8/25/2015 2:53:03 PM Subject: RE: IVHQ Resident information Thanks Cathy! was wanting to find out if your staff that we interviewed yesterday had a good visit with her physician and if they order a urine antigen. Do you have a phone number for -Or do you want to ask her and let me know? Also we have gotten CDC guidance and recommendations to do lab testing for viral and bacterial respiratory illnesses and that is going across Dr. Merrick?s desk right now. Stay tuned! From: HOUSTON, CATHY Sent: Tuesday, August 25, 2015 3:43 PM To: Shay Drummond Subject: IVHQ Resident information The attached was faxed to our unit today. 0 Please note History of Present Illness: This is .. from the Illinois Veterans Home where there is a legionella Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 From: "Shay Drummond" To: HOUSTON CATHY CC: Date: 8/25/2015 3:31:21 PM Subject: RE: IVHQ Resident information Great, Thanks! From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Tuesday, August 25, 2015 3:57 PM To: Shay Drummond Subject: RE: IVHQ Resident information We asked and she said they did take and do the urine. She will let us know or probably you will know also the results. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, August 25, 2015 3:53 PM To: HOUSTON, CATHY Subject: RE: IVHQ Resident information Thanks Cathy! I was wanting to find out if your staff that we interviewed yesterday had a good visit with her physician and if they order a urine antigen. Do you have a phone number for want to ask her and let me know? Also we have gotten CDC guidance and recommendations to do lab testing for viral and bacterial respiratory illnesses and that is going across Dr. Merrick’s desk right now. Stay tuned! From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Tuesday, August 25, 2015 3:43 PM To: Shay Drummond Subject: IVHQ Resident information The attached was faxed to our unit today. H&P on . Please note History of Present Illness: This is…… from the Illinois Veterans Home where there is a legionella outbreak….. Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 CATHY.S.HOUSTON@illinois.gov Or do you From: "Shay Drummond" To: McCann "Ken ;Jon Campos ;Jerrod Welch" CC: "Culp, David" "Conover, Craig" "Austin, Connie" "Morgan, Jodi" "Mitchell, Joe" "DeWitt, Justin" "Martin, Aaron" "Bell, Scott S." Date: 8/25/2015 3:21:00 PM Subject: RE: Quincy facility Thank you Ken, we will review and convey to IVHQ. From: McCann, Ken [mailto:Ken.McCann@Illinois.gov] Sent: Tuesday, August 25, 2015 4:20 PM To: Shay Drummond; Jon Campos; Jerrod Welch Cc: Culp, David; Conover, Craig; Austin, Connie; Morgan, Jodi; Mitchell, Joe; DeWitt, Justin; Martin, Aaron; Bell, Scott S. Subject: Quincy facility Jerrod/Shay – below are recommendations from us for your review and forwarding the facility. We recognize that these don’t answer all the questions and additional conversations will be necessary. We thought this would be a good start and we’ll see how things develop in the coming days. Let us know of thoughts/concerns. We’ll assume you will take care of communicating with the facility unless you tell us otherwise. Thanks ken +++++++++++++++++ The following recommendations are based upon 2 currently confirmed cases which were the focus of the environmental investigation at the facility Monday, August 24. These recommendations may change with additional epidemiologic information on current or additional cases. Additional environmental samples will be necessary if additional cases are confirmed. Consideration should be given to retaining the services of an environmental consultant with experience and expertise regarding legionella investigation and mitigation to assist with additional investigation and possible mitigation efforts. Elmore Infirmary · Tub rooms located in Elmore East and Elmore West: o Replace tub spray heads with point-of-use filtration heads capable of filtering legionella bacteria. o Contact the Apollo tub manufacturer to discuss possible methods to increase levels of sanitization of the tubs. The manufacturer should be able to recommend additional sanitization methods that won’t adversely affect the tubs. Tubs should be sanitized prior to use. o Documentation of tub sanitization should maintained. o Tubs can be used once these steps are completed and documented. · Routine maintenance of the water system should include monitoring residual chlorine levels and temperatures in representative end-use plumbing fixtures. All monitoring should be adequately documented. · We recommend the implementation of a water system management plan consistent with the American Society of Heating, Refrigeration and Air-Conditioning Engineer’s (ASHRAE) Standard 188. A draft version for public comment is attached. However, a read only version of the final standard is available from: https://www.ashrae.org/standards-research--technology/standards--guidelines/other-ashrae-standards-referenced-in-code. Elements of such a plan would include water quality monitoring at site specific intervals as well as contingency plans for responding to positive test results. A plan should also include a system flushing program to ensure all plumbing fixtures in the Elmore Infirmary are flushed on a regular basis to eliminate potential stagnant potable water in the plumbing system. Other Recommendations · Drain and discontinue use of outdoor fountains. Ken McCann, MA, LEHP Chief, Division of Environmental Health Illinois Department of Public Health 525 West Jefferson Str. Springfield, Il 62761 phone: 217-785-2043 fax: 217-785-0253 Ken.McCann@illinois.gov IMPORTANT: This e-mail, including all attachments, constitute State Government records and property that is intended only for the use of the individual or entity to w hich it is addressed. It also may contain information that is privileged, confidential, or otherw ise protected from disclosure under applicable law . If the reader of this transmission is not the intended recipient or the employee or agent responsible for delivering the transmission to the intended recipient, you are hereby notified that any dissemination, distribution, copying or use of this e-mail or its contents is strictly prohibited. If you have received this in error, please notify the sender. From : "Shay Drummond" To: HOUSTON CATHY CC: Date: 8/25/2015 1:53:39 PM S u b j e c t : RE: Resident/Family Thanks I am getting ready to get on a call with their risk management and the folks at Blessing. Any other questions for Blessing? Also I had sent a list of names and wanted to clarify/verify what hall that they were from I have 2 more to add – Also from your facility prospective – is this a normal number of admits with similar symptoms? I am also trying to get data from ED. Thank you and I will send an update to you from the call. From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Tuesday, August 25, 2015 2:41 PM To: Shay Drummond Subject: RE: Resident/Family Shay, I feel like a real tattle tale here…. family came in this afternoon for his care plan meeting even though he is in the hospital. They announced to the staff in the care plan meeting that staff at Blessing told them that IVHQ has an outbreak of Legionaire’s Disease. From: Shay Drummond [mailto:sdrummond@co adams il us] Sent: Tuesday, August 25, 2015 2:15 PM To: HOUSTON, CATHY Subject: Resident/Family Hi there, Thanks for being on the call I wanted to get the name of the patient that the Doc made the comment so we can make sure that doc gets the memo on talking to patients and risk management. I am planning a call for three with Linda and if you have any other questions that we or you want answered. Talk to you at three. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: HOUSTON "CATHY <" "\(CATHY.S.HOUSTON@illinois.gov\);>" "BRUCE \(BRUCE.VACA@illinois.gov\); HOLLY.PERRINE@illinois.gov;" CC: "Manley, Linda \(Linda.Manley@blessinghealthsystem.org\)" "Roberts, Vickie" "Jon Campos" "Merrick, Robert \(Robert.Merrick@blessinghealthsystem.org\)" Date: 8/25/2015 4:09:17 PM Subject: Respiratory Outbreak Infection Control Measures Good afternoon, Following up from our earlier call some infection control measures the guidance below are measures that I know many are a routine part of your facility. Please review and let me know if you have questions or concerns. As this event is evolving by the hour I wanted to let you know to feel free to call my cell phone at 217-316-275. As we get additional patient labs back this guidance may shift. Thank you, Shay https://dph.partner.illinois.gov/communities/communicabledisease/CDAZ/Pages/Respiratory%20Disease%20Outbreak%20Management.aspx Notify IDPH Regulatory Division of outbreak. Communicate daily with local health department or provide additional updates as indicated. Implement daily surveillance for respiratory illness for all residents, healthcare workers, other staff, and visitors. Continue daily surveillance for at least seven days after onset of most recent case, or as requested by local health department. Maintain a line list of all ill residents and staff. An example of information needed and line list can be provided. Maintain a log of staff call-ins. Monitor for respiratory symptoms. Report on line list and to local health department daily. Halt admissions of new residents to the facility. Develop a plan for readmissions, (to an unaffected unit). Place ill residents in private rooms, if possible. If this is not possible, ill residents can be placed with other ill residents with same symptoms or stay in their own rooms. They should not be moved between units (unless recommended after consultation with local public health department). Residents with respiratory illness should stay in their rooms and out of common areas. If they need to come out of their rooms, they should wear face masks, if tolerated, and use respiratory etiquette. Notify the receiving department or facility of the resident’s illness in advance so that precautions can be taken. Advise healthcare personnel to observe Droplet Precautions (i.e., wearing a surgical or procedure mask for close contact), in addition to Standard Precautions, when caring for a resident with symptoms of a respiratory infection, particularly if fever is present. These precautions should be maintained until it is determined that the cause of symptoms is not an infectious agent that requires Droplet Precautions. Transmission-based precautions may be recommended and should be based on the pathogen when known. Refer to CDC Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings Appendix A For suspected or confirmed influenza, use droplet precautions for residents for 7 days after illness onset or until 24 hours after the resolution of fever and respiratory symptoms, whichever is longer. Additional Infection Control Measures Encourage Influenza vaccination for residents and staff when available. Emphasize importance of hand hygiene and respiratory etiquette. Cohort staff- --Staff should not float between units. Personnel should not go back and forth between different areas of the facility. Assign employees to care for the same group of patients each shift, if possible. Do not allow movement of residents between units. Residents should not be relocated to other units during an outbreak. (May change with additional test results and recommendations from Public Health.) Activities should be limited to the smallest groups possible and be held within units. Ill residents should not participate in group activities. If transmission is ongoing, cancel group activities. If transmission is ongoing, serve meals in resident rooms. Education: All staff and residents should be made aware of the outbreak. Review sick/call-in policy with staff; no working while ill or until free of fever for 24 hours, without fever-reducing medication. Remind staff and residents to use respiratory hygiene and cough etiquette. Visual aids such as a “Cover Your Cough” poster can be used as reminders http://www.cdc.gov/flu/protect/covercough.htm Conduct in-services on respiratory hygiene and cough etiquette to help remind and educate employees. Ensure all shifts receive education. Remind staff and residents to increase hand hygiene during an outbreak. Make sure that supplies for hand washing and hand sanitizer are readily available. Environmental Hygiene: Adhere to routine cleaning procedures, especially the cleaning of surfaces that are frequently touched, such as hand rails, elevator buttons, and door knobs. Environmental staff should be made aware of the outbreak so that they can concentrate on cleaning these surfaces, especially if time or resources are limited. If possible, increase frequency of cleaning of frequently touched surfaces. Staff Employees with fever should not work until they have not had fever for 24 hours without the use of fever-reducing medications. Employees with respiratory illness and no fever should be evaluated for appropriateness of patient care duties. Employees with respiratory illness and no fever who remain at work should wear a facemask during resident care activities, perform frequent hand hygiene, and adhere to respiratory hygiene and cough etiquette. Visitors People visiting an ill resident should limit their visits to only that resident and should be instructed on hand hygiene and the use of PPE. Consider posting signage to alert visitors that an outbreak is occurring and that they should refrain from visiting if they have respiratory symptoms or are at high risk of complications if they become ill. Discourage visitors from visiting multiple residents or traveling to more than one area of the facility. Have the following supplies readily available: Soap and paper towels for hand washing Tissues for staff, residents, and visitors PPE- Facemasks, gowns, gloves, and eye protection Hand sanitizer for staff, residents, and visitors No-touch trash receptacles for used tissue disposal Resources: CDC Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Available at http://www.cdc.gov/hicpac/pdf/isolation/isolation2007.pdf CDC Guidelines for the Prevention of Healthcare Associated Pneumonia, 2003. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5303a1.htm 2014 IDPH Guidelines for the Prevention and Control of Influenza Outbreaks in Illinois Long Term Care Facilities, available at http://www.idph.state.il.us/flu/CDCS_Influenza_Outbreak_Guidance_for_Long_Term_Care_Facilities.pdf From: "Shay Drummond" To: Austin "Connie \(Connie.Austin@Illinois.gov\);" CC: "Jon Campos" Date: 8/25/2015 1:51:02 PM Subject: Sputum Testing Attachments: Legionella pneumophila - LabCorps Testing.pdf legionellacollectioninstructions (2).pdf Hi, Attached is the testing protocol from LabCorp – I also attached the guidance sent from Dr. Conover for the Iowa lab. The problem for us was getting specimens to the Iowa facility. LabCorp is going to be quicker with their currier pickup. Thanks, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Arnold, Melaney" To: "Emily Andrews" CC: Date: 8/26/2015 4:39:00 PM Subject: FW: Draft Press Release/Statement on Veterans Home RespirsitorySituation A t t a c h m e n t s : DRAFT 2015-08 -26 5pm Vets Home Medical Situation.docx FYI From: Yantis, Ryan Sent: Wednesday, August 26, 2015 5:34 PM To: steve.felde@blessinghealthsystem.org; Shay Drummond; Arnold, Melaney; HOUSTON, CATHY S; elliot.kuida@blessinghealthsystem.org; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; VACA, BRUCE L; DIEHL, GWEN G; Little, Divya Mohan Cc: McGill, Patricia O; Ray, Jaimee M; SAWYER, HARRY H Subject: Draft Press Release/Statement on Veterans Home Respirsitory Situation Ladies and Gents Attached please find the draft working release/RTQ for the situation at Illinois Veterans' Home - Quincy. It is a collaborative effort of IDVA, IDPH and the Home, with information gleaned from previous calls and emails. The Overall Messages/Themes discussed on the conference call this evening: ​- (There is very low/low risk to the general public, unless they visited the Home during a period of exposure. However, this respiratory illness generally affects those with weaker immune systems - the young, old, those with suppressed immune systems, etc.) - There is a strong team approach to this situation and we are harnessing the talents and capabilities of the Home, Adams County Dept of Health, Blessing Hospital, IDPH, IDVA and others as needed. - We are working well together to identify any possible source of this illness on the Home campus; this is an ongoing effort. - There have been no known/reported fatalities associated with this illness; those identified have responded well to treatment. - There is no cause for alarm; this is a manageable situation and we are focusing talents, efforts, and appropriate resources to meet the needs. Next Steps: - Conf Call on Thurs, Aug 27 at 8 a.m. (0800) to review lab results and discuss release. - Finalize release based on Lab results and new patient info/Home info - Agree to time for release; prep any press event. - Notify Gov's Press Office - Pre-position release information with select elected officials (?) - Plan post-release Conf Call to review any outstanding issues. - Consider additional information-sharing conf. calls for next few days. Early Triggers - We need agreement after a trigger to push the release - A media query asking specific questions about the current medical situation (legionella, Legionnaire's Disease, citing high traffic to Blessing, etc.) - (A death related to Legionnaire's Disease, at Blessing or the Home)[ I realize this was not discussed, but may really be a game-changer as far as outreach] Thanks Ryan Ryan Yantis Communication Manager, IDVA 312-814-0778 (desk) 312-520-6958 (cell) ryan.yantis@illinois.gov From: "Arnold, Melaney" To: Yantis "Ryan ;steve.felde@blessinghealthsystem.org;Shay Drummond" "CATHY S ;;Jeffries>" "Erica L" "LENARD F" "BRUCE L" "GWEN G" "Divya Mohan" Nirav CC: "McGill, Patricia O" "Ray, Jaimee M" "SAWYER, HARRY H" Date: 8/26/2015 4:38:51 PM Subject: RE: Draft Press Release/Statement on Veterans Home RespirsitorySituation Thanks. Please add IDPH Director Shah to this chain. From: Yantis, Ryan Sent: Wednesday, August 26, 2015 5:34 PM To: steve.felde@blessinghealthsystem.org; Shay Drummond; Arnold, Melaney; HOUSTON, CATHY S; elliot.kuida@blessinghealthsystem.org; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; VACA, BRUCE L; DIEHL, GWEN G; Little, Divya Mohan Cc: McGill, Patricia O; Ray, Jaimee M; SAWYER, HARRY H Subject: Draft Press Release/Statement on Veterans Home Respirsitory Situation Ladies and Gents Attached please find the draft working release/RTQ for the situation at Illinois Veterans' Home - Quincy. It is a collaborative effort of IDVA, IDPH and the Home, with information gleaned from previous calls and emails. The Overall Messages/Themes discussed on the conference call this evening: ​- (There is very low/low risk to the general public, unless they visited the Home during a period of exposure. However, this respiratory illness generally affects those with weaker immune systems - the young, old, those with suppressed immune systems, etc.) - There is a strong team approach to this situation and we are harnessing the talents and capabilities of the Home, Adams County Dept of Health, Blessing Hospital, IDPH, IDVA and others as needed. - We are working well together to identify any possible source of this illness on the Home campus; this is an ongoing effort. - There have been no known/reported fatalities associated with this illness; those identified have responded well to treatment. - There is no cause for alarm; this is a manageable situation and we are focusing talents, efforts, and appropriate resources to meet the needs. Next Steps: - Conf Call on Thurs, Aug 27 at 8 a.m. (0800) to review lab results and discuss release. - Finalize release based on Lab results and new patient info/Home info - Agree to time for release; prep any press event. - Notify Gov's Press Office - Pre-position release information with select elected officials (?) - Plan post-release Conf Call to review any outstanding issues. - Consider additional information-sharing conf. calls for next few days. Early Triggers - We need agreement after a trigger to push the release - A media query asking specific questions about the current medical situation (legionella, Legionnaire's Disease, citing high traffic to Blessing, etc.) - (A death related to Legionnaire's Disease, at Blessing or the Home)[ I realize this was not discussed, but may really be a game-changer as far as outreach] Thanks Ryan Ryan Yantis Communication Manager, IDVA 312-814-0778 (desk) 312-520-6958 (cell) ryan.yantis@illinois.gov From: "Arnold, Melaney" To: "Shay Drummond" CC: "Shah, Nirav" Date: 8/26/2015 7:15:22 PM Subject: Re: Draft Press Release/Statement on Veterans Home RespirsitorySituation - RESPONSES FROM BLESSING HOSPITAL Thank you Shay. On Aug 26, 2015, at 8:05 PM, Shay Drummond wrote: Hello, Please see the recommendations from Blessing Hospital. Thanks, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 From: Felde, Steve [mailto:Steve.Felde@blessinghealthsystem.org] Sent: Wednesday, August 26, 2015 8:00 PM To: Yantis, Ryan; Kuida, Elliot; Saalborn, Dr. Richard; Roberts, Vickie; Manley, Linda; Neisen, Lisa (PR); Loyd, David; Bailey, Carolyn; Shay Drummond; Barthel, Mary Cc: Powell, Betsey Subject: FW: Draft Press Release/Statement on Veterans Home Respirsitory Situation - RESPONSES FROM BLESSING HOSPITAL Importance: High The following changes are suggested by Robert Merrick, MPH, Epidemiologist, Blessing Hospital and Carolyn Bailey, administrative director, Risk Management, Blessing Corporate Services (parent company of Blessing Hospital): Dr. Merrick: We had 23 patients in house today so have treated well over the 18 referred to in paragraph 1. The last paragraph sounds like the cleaning is a new activity; did they not clean these before and what did they do as a result of the first cases in July? A smart reporter will eat the spokesperson alive. Carolyn Bailey: We recommend stating “approximately 20 patients” since our records reflect 22 inpatients (residents) and does not count the staff or those treated and discharged from the ED. We hate to be pinned down to a specific number, especially since that could change. Thanks. Steve Felde Senior Communications Specialist Blessing Hospital (217)223-8400, ext. 4191 From: Merrick, Robert Sent: Wednesday, August 26, 2015 6:32 PM To: Felde, Steve Subject: RE: Draft Press Release/Statement on Veterans Home Respirsitory Situation Steve, We had 23 patients in house today so have treated well over the 18 referred to in paragraph 1. The last paragraph sounds like the cleaning is a new activity; did they not clean these before and what did they do as a result of the first cases in July? A smart reporter will eat the spokesperson alive They should have had you write the release. Overall I think it is poorly written, confusing and in my view just a smoke to cover peoples butts. You do not need to share that comment. Regards, REM From: Felde, Steve Sent: Wednesday, August 26, 2015 5:43 PM To: Saalborn, Dr. Richard; Manley, Linda; Bailey, Carolyn; Loyd, David; Barthel, Mary; Merrick, Robert; Roberts, Vickie; Neisen, Lisa (PR) Cc: Kuida, Elliot Subject: FW: Draft Press Release/Statement on Veterans Home Respirsitory Situation Importance: High Attached is a draft working release prepared by the State about the situation at IVH for probable release tomorrow after 8 am. Please review this and let me know if you are OK with the release as it is presented here, or if you feel changes are needed. IF you feel changes are needed, please email me the changes you suggest AND please text my cellphone 257-8641 to let me know that you have emailed me changes. With your text, I will know to come into work early tomorrow to gather up the changes suggested. I thank you for taking the extra step as I do not get hospital email on my cellphone. If you have no changes to suggest, only the email to stating that is needed. No text is required. Thank you. Steve Felde Senior Communications Specialist Blessing Hospital (217)223-8400, ext. 4191 From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Wednesday, August 26, 2015 5:34 PM To: Felde, Steve; Shay Drummond; Arnold, Melaney; HOUSTON, CATHY S; Kuida, Elliot; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; VACA, BRUCE L; DIEHL, GWEN G; Little, Divya Mohan Cc: McGill, Patricia O; Ray, Jaimee M; SAWYER, HARRY H Subject: Draft Press Release/Statement on Veterans Home Respirsitory Situation Ladies and Gents Attached please find the draft working release/RTQ for the situation at Illinois Veterans' Home - Quincy. It is a collaborative effort of IDVA, IDPH and the Home, with information gleaned from previous calls and emails. The Overall Messages/Themes discussed on the conference call this evening: ​- (There is very low/low risk to the general public, unless they visited the Home during a period of exposure. However, this respiratory illness generally affects those with weaker immune systems - the young, old, those with suppressed immune systems, etc.) - There is a strong team approach to this situation and we are harnessing the talents and capabilities of the Home, Adams County Dept of Health, Blessing Hospital, IDPH, IDVA and others as needed. - We are working well together to identify any possible source of this illness on the Home campus; this is an ongoing effort. - There have been no known/reported fatalities associated with this illness; those identified have responded well to treatment. - There is no cause for alarm; this is a manageable situation and we are focusing talents, efforts, and appropriate resources to meet the needs. Next Steps: - Conf Call on Thurs, Aug 27 at 8 a.m. (0800) to review lab results and discuss release. - Finalize release based on Lab results and new patient info/Home info - Agree to time for release; prep any press event. - Notify Gov's Press Office - Pre-position release information with select elected officials (?) - Plan post-release Conf Call to review any outstanding issues. - Consider additional information-sharing conf. calls for next few days. Early Triggers - We need agreement after a trigger to push the release - A media query asking specific questions about the current medical situation (legionella, Legionnaire's Disease, citing high traffic to Blessing, etc.) - (A death related to Legionnaire's Disease, at Blessing or the Home)[ I realize this was not discussed, but may really be a game-changer as far as outreach] Thanks Ryan Ryan Yantis Communication Manager, IDVA 312-814-0778 (desk) 312-520-6958 (cell) ryan.yantis@illinois.gov The information contained in this e-mail message is PRIVILEGED AND CONFIDENTIAL and is intended for the use of the addressee and no one else. If you are not the intended recipient, please do not read, distribute, reproduce or use this e-mail message (or the attachments). Please delete the original and notify the sender of the mistaken transmission. Thank you. From: "Arnold, Melaney" To: "Emily Andrews" CC: Date: 8/26/2015 4:23:52 PM Subject: Vets Home Legionella Hi Emily ~ We just got off a call with Veterans’ Affairs, Blessing Hospital, IDPH and Adams Co. Health Dept. We are finalizing a news release and have plans to issue it tomorrow morning. I believe Shay was on the call and said the news release would go to her for review. I will also send you a copy and loop you in. Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: "Austin, Connie" To: "Jon Campos" CC: "Cox, Robert F." Date: 8/26/2015 8:19:36 AM Subject: FW: Respiratory illness at large Veterans home in Illinois Attachments: CDC RVDP Specimen Submission Guidelines v1.8.pdf Jon, I think this will be very helpful. I think Tom Johnson sent something to Shay about submission form. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: "Jon Campos" CC: Date: 8/26/2015 8:24:55 AM Subject: lab form Attachments: CD_TestRequisition_01062015.pdf For you to share with hospital Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: Cox "Robert F." "Kate D." Jodi Justin Fred Ken Whitney CC: "Shay Drummond" "Jon Campos" Date: 8/26/2015 6:21:32 PM Subject: Outbreak number I quickly entered the very basic information in our ORS system on this outbreak. The lab needed an outbreak number so please feel free to use this for discussions/lab submission purposes as needed. IL2015-0427 Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: "Shay Drummond" CC: "Cox, Robert F." "Charles, Matt" Date: 8/26/2015 1:15:43 PM Subject: RE: labs Shay, CDC has said they would like any isolates of Legionella from the outbreak so if you could advise either LabCorp or Iowa, if they both are doing sputums and culture, to send them to the Springfield lab. We just want isolates, not urine antigens to come in. So they can go to Bob Cox at the Springfield lab. Bob, any other details of where you want them to go. Also filling out the IDPH lab submission form. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: "Shay Drummond" CC: Date: 8/26/2015 1:37:01 PM Subject: RE: labs Lets see what the urine antigen results are, We are having some discussions here, so let me get back to you on when a call. No specific changes to Blessing Hospital right now. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 2:18 PM To: A ustin, Connie Cc: C ox, Robert F.; Charles, Matt Subject: RE: labs Thank you and could you send me the exact address: Want to eliminate any confusion on this end. I will forward the submission form as well. Connie, I am having a conference call at 2:30 with Blessing – I would like any “next steps” from IDPH if you have any you can share. Also at what point do we need to have another conference call similar to the one we did with all entities including IVH? From: A ustin, Connie [mailto:Connie.A ustin@Illinois.gov] Sent: Wednesday, August 26, 2015 2:16 PM To: Shay Drummond Cc: C ox, Robert F.; Charles, Matt Subject: RE: labs Shay, CDC has said they would like any isolates of Legionella from the outbreak so if you could advise either LabCorp or Iowa, if they both are doing sputums and culture, to send them to the Springfield lab. We just want isolates, not urine antigens to come in. So they can go to Bob Cox at the Springfield lab. Bob, any other details of where you want them to go. Also filling out the IDPH lab submission form. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: "Shay Drummond" CC: Date: 8/26/2015 3:16:14 PM Subject: RE: labs I am on call and will probably still be here so feel free to call or email, Direct line is 217-524-5354 Or work mobile 217-725-8059, I’m also on call tonite. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 3:01 PM To: Austin, Connie Subject: RE: labs Off of my call with Blessing. They are nearing capacity and IVH has about 20 they are providing care for on campus. To clarify – we got the two Iowa lab results in – one + and one – NO Lab Corps, results they were sending me a previous positive. We expect the labcorps results back at 8 this evening. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 2:37 PM To: Shay Drummond Subject: RE: labs Lets see what the urine antigen results are, We are having some discussions here, so let me get back to you on when a call. No specific changes to Blessing Hospital right now. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 2:18 PM To: Austin, Connie Cc: Cox, Robert F.; Charles, Matt Subject: RE: labs Thank you and could you send me the exact address: Want to eliminate any confusion on this end. I will forward the submission form as well. Connie, I am having a conference call at 2:30 with Blessing – I would like any “next steps” from IDPH if you have any you can share. Also at what point do we need to have another conference call similar to the one we did with all entities including IVH? From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 2:16 PM To: Shay Drummond Cc: Cox, Robert F.; Charles, Matt Subject: RE: labs Shay, CDC has said they would like any isolates of Legionella from the outbreak so if you could advise either LabCorp or Iowa, if they both are doing sputums and culture, to send them to the Springfield lab. We just want isolates, not urine antigens to come in. So they can go to Bob Cox at the Springfield lab. Bob, any other details of where you want them to go. Also filling out the IDPH lab submission form. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: "Shay Drummond" CC: Date: 8/26/2015 12:23:21 PM Subject: RE: Media We know that feeling, we’ve had CDC and/or FDA announce things without telling us and it is very frustrating. I have asked the PIO about whether this is just in preparation for reporters calling or if they are intending to release it in the near future. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 1:22 PM To: Austin, Connie Subject: RE: Media Good, and I would like to know before they do a press release at that level so we can be ready to roll so anything that they can send my way would be helpful! From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 1:20 PM To: Shay Drummond; Morgan, Jodi; Conover, Craig Subject: RE: Media Let me check. I just sent the talking points to our PIO and have not heard back if they look ok. I think they are preparing a press release with Veterans Affairs but not sure of a proposed release date, have asked will get back to you. It would be much easier to answer questions with a few more lab results ⅛ ! Thanks for checking on that. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 1:15 PM To: Austin, Connie; Morgan, Jodi; Conover, Craig Subject: Media Hi did IDPH get draft guidance for media/talking points out to anyone yet? My sense is that this will break soon and I want to be prepared with Blessing and IVH to make a united statement on the local level that mirrors the IDPH messaging. Lab results still not back,,,they are supposed to be calling me soon. Thanks, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: "Shay Drummond" Jodi Craig CC: Date: 8/26/2015 12:20:25 PM Subject: RE: Media Let me check. I just sent the talking points to our PIO and have not heard back if they look ok. I think they are preparing a press release with Veterans Affairs but not sure of a proposed release date, have asked will get back to you. It would be much easier to answer questions with a few more lab results ⅛ ! Thanks for checking on that. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 1:15 PM To: Austin, Connie; Morgan, Jodi; Conover, Craig Subject: Media Hi did IDPH get draft guidance for media/talking points out to anyone yet? My sense is that this will break soon and I want to be prepared with Blessing and IVH to make a united statement on the local level that mirrors the IDPH messaging. Lab results still not back,,,they are supposed to be calling me soon. Thanks, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: "Shay Drummond" CC: Date: 8/26/2015 6:54:56 PM Subject: RE: Outbreak number Wish I could send it to you, I’m feeling sick, someone brought over reeses, kisses and kitkats Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 7:54 PM To: Austin, Connie Subject: RE: Outbreak number Okay, I am hoping to get a call in about 10 minutes…I could use some chocolate right now! From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 7:53 PM To: Shay Drummond Subject: RE: Outbreak number We found out the Memorial specimens will be run tomorrow. Don’t forget to let us know about LabCorp we are very anxious as well. I have eaten quite a bit of chocolate. From: "Austin, Connie" To: "Shay Drummond" CC: Date: 8/26/2015 6:53:20 PM Subject: RE: Outbreak number We found out the Memorial specimens will be run tomorrow. Don’t forget to let us know about LabCorp we are very anxious as well. I have eaten quite a bit of chocolate. From: "Austin, Connie" To: "Shay Drummond" CC: Date: 8/26/2015 6:30:28 PM Subject: RE: Outbreak number Good question, she said she would let me know and that didn’t happen! I will check with her aga in. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 7:30 PM To: Austin, Connie Subject: RE: Outbreak number Connie, Following up with the labs: CDC had wanted Blessing to hold blood samples and Dr. Merrick had inquired as to whole, plasma etc. Did we get a response on that? Thanks, Shay From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 7:22 PM To: Cox, Robert F.; Kelly-Shannon, Kate D.; Morgan, Jodi; Albertson, Justin; Echols, Fred; McCann, Ken; Clegg, Whitney Cc: Shay Drummond; Jon Campos Subject: Outbreak number I quickly entered the very basic information in our ORS system on this outbreak. The lab needed an outbreak number so please feel free to use this for discussions/lab submission purposes as needed. IL2015-0427 Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: "Shay Drummond" CC: Date: 8/26/2015 6:30:00 PM Subject: RE: Outbreak number Yes, we shall see. On pins and needles, is it Memorial results that will be back or LabCorp. I was also going to mention to you to document carefully everything. Our previous experience with Legionella indicates that many people will FOI information from these outbreaks. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 7:28 PM To: Austin, Connie; Cox, Robert F.; Kelly-Shannon, Kate D.; Morgan, Jodi; Albertson, Justin; Echols, Fred; McCann, Ken; Clegg, Whitney Cc: Jon Campos Subject: RE: Outbreak number Great, thanks! I shared out the CDC/IDPH guidance with Bruce Vaca and David Clifford at IVH and Justin DeWitt did a great job explaining various approaches to the EH side. Our EH staff is ready to assist IVH in implementing. IVH is contacting Hummel Springs their back up water supply for emergencies tonight and starting the plan implementation. I am patiently ( not) awaiting the lab results due. Thanks, Shay From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 7:22 PM To: Cox, Robert F.; Kelly-Shannon, Kate D.; Morgan, Jodi; Albertson, Justin; Echols, Fred; McCann, Ken; Clegg, Whitney Cc: Shay Drummond; Jon Campos Subject: Outbreak number I quickly entered the very basic information in our ORS system on this outbreak. The lab needed an outbreak number so please feel free to use this for discussions/lab submission purposes as needed. IL2015-0427 Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: "Shay Drummond" Jodi Craig CC: "Jon Campos" Date: 8/26/2015 7:22:09 AM Subject: RE: Pateints in house Attachments: cdcs Legionella ppt August252015.pptx We are working on the talking points. CDC has asked that any blood be saved in case H. flu is positive by PCR on OP/NP. At 9 am can you check with the hospital about whether they will be able to get those OP/NP this morning so we can ship to CDC today? Any additional sputums collected? Thanks for all your work. Attached a power point that uses the data you sent yesterday afternoon. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 8:07 AM To: Austin, Connie; Morgan, Jodi; Conover, Craig Cc: Jon Campos Subject: FW: Pateints in house Good morning, This is the current Blessing census and location at Blessing. Currently: 2N-2 2S-2 ICU 3- CPAP, 3S (IMC) 5 3N 6 - BIPAP, - BIPAP removed at 3:24, O2 at 4L Overnight there was 1 employee in ER that was discharged, tests are pending and one admit, I IVH patient with Dx of pneumonia, dehydration, elevated troponin, blood cultures collected, discharged back to IVH (comfort care), not tested for Legionella No test results back as of 5:50 am My question: do we want a legionella test and NP/OP done on the patient that was sent back for comfort care? I am guessing that he is a DNR. I will send over room/building maps as soon as I receive them. I have a conference call at 0900 with Blessing Hospital. Has there been any media messaging from IDPH that is ready for us to have in case we need it – I am sensing that today there may be requests. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: "Shay Drummond" Jodi Craig CC: "Jon Campos" Date: 8/26/2015 7:10:58 AM Subject: RE: Pateints in house Yes. If necessary, and the specimens can get to Springfield, our lab can pay for the legionella urine antigen and CDC does the OP/NP for free. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 8:07 AM To: Austin, Connie; Morgan, Jodi; Conover, Craig Cc: Jon Campos Subject: FW: Pateints in house Good morning, This is the current Blessing census and location at Blessing. Currently: 2N-2 2S-2 ICU 3- Bisby- CPAP, Barton- BIPAP, Smith- BIPAP removed at 3:24, O2 at 4L 3S (IMC) 5 3N 6 Overnight there was 1 employee in ER that was discharged, tests are pending and one admit, I IVH patient with Dx of pneumonia, dehydration, elevated troponin, blood cultures collected, discharged back to IVH (comfort care), not tested for Legionella No test results back as of 5:50 am My question: do we want a legionella test and NP/OP done on the patient that was sent back for comfort care? I am guessing that he is a DNR. I will send over room/building maps as soon as I receive them. I have a conference call at 0900 with Blessing Hospital. Has there been any media messaging from IDPH that is ready for us to have in case we need it – I am sensing that today there may be requests. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: "Shay Drummond" "Bernard T." CC: eric.dix@blessinghealthsystem.org "Cox, Robert F." Date: 8/26/2015 9:04:26 AM Subject: RE: Respiratory illness at large Veterans home in Illinois Bob, Do you think you can assist, I can send you the respiratory specimen collection guidelines from CDC. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 10:02 AM To: Johnson, Bernard T. Cc: eric.dix@blessinghealthsystem.org; Austin, Connie Subject: FW: Respiratory illness at large Veterans home in Illinois Importance: High Hi, I gave Eric Dix you contact info: He is collecting specimens and needs guidance on below:: A variety of specimens are suitable and include nasopharyngeal (NP) swab, oropharyngeal (OP) swab, NP aspirate, NP wash, OP wash, bronchoalveolar lavage, tracheal aspirate, sputum, serum, blood, urine, stool, conjunctival swab, viral isolate, and cerebral spinal fluid. Multiple respiratory specimen types of ample volume are preferred. NP and OP swabs collected from the same patient can be placed together in a single vial. Swab specimens should be collected using only swabs with a synthetic tip (e.g., polyester, Dacron®) and an aluminum or plastic shaft. Swabs with cotton tips and wooden shafts are not recommended. Specimens collected with swabs made of calcium alginate are not acceptable. Cell culture medium from a virus isolate can be sent in a screw-cap vial. From: Johnson, Bernard T. [mailto:Bernard.Johnson@Illinois.gov] Sent: Tuesday, August 25, 2015 3:10 PM To: Austin, Connie; Shay Drummond; Jon Campos Cc: Morgan, Jodi; Conover, Craig; Kelly-Shannon, Kate D.; Holmes, Tal Subject: RE: Respiratory illness at large Veterans home in Illinois Connie: They can fill out the standard Communicable Disease form information completely. If they have someone available by phone for follow up questions if the CD form is not complete it would be helpful. Tom Bernard (Tom) Johnson Chief, Division of Laboratories Illinois Department of Public Health 825 N. Rutledge St. Springfield, IL 62702 Phone: 217-782-6562 Cell: 309-222-1312 Fax: 217-524-7924 Email: Bernard.Johnson@Illinois.gov From: Austin, Connie Sent: Tuesday, August 25, 2015 2:59 PM To: Shay Drummond; Jon Campos Cc: Morgan, Jodi; Conover, Craig; Johnson, Bernard T.; Kelly-Shannon, Kate D.; Holmes, Tal Subject: FW: Respiratory illness at large Veterans home in Illinois Shay/Jon, Had a conversation and some email with CDC about the respiratory panel. There is a viral respiratory group and a bacterial so they would work together to get the testing done. My suggestion is that specimens be collected on hospitalized patients that the physicians think would be the best candidates. if specimens as listed in the email below can be collected, if they could be transported (hopefully by car for rapid transit) to the IDPH lab in Springfield for shipping to CDC that works the best because they are very particular about shipping requirements/forms. CDC requests that specimens arrive prior to the weekend, not to arrive on the weekend. Tom, What form would they be able to fill out that will give you enough information to do the DASH form? Or do you want them to attempt the DASH form? From CDC… We prefer to have an NP/OP collected on each patient. For those with pneumonia or lower resp findings please also collect a lower resp specimen. The link to the instructions is attached. If you have previously collected stored specimens we could test those as long as they have been refrigerated. Keep the specimens refrigerated. If you cannot send until next week you will need to freeze the specimens that were collected 72hrs earlier. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Cox, Robert F." To: "Shay Drummond" CC: Date: 8/26/2015 8:30:17 AM Subject: FW: Respiratory illness at large Veterans home in Illinois Attachments: CDC RVDP Specimen Submission Guidelines v1.8.pdf fyi From: Austin, Connie Sent: Wednesday, August 26, 2015 9:20 AM To: Jon Campos Cc: Cox, Robert F. Subject: FW: Respiratory illness at large Veterans home in Illinois Jon, I think this will be very helpful. I think Tom Johnson sent something to Shay about submission form. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Cox, Robert F." To: "Shay Drummond" Connie CC: "Charles, Matt" "Johnson, Bernard T." Date: 8/26/2015 1:21:14 PM Subject: RE: labs Attachments: CD_TestRequisition_01062015.pdf Shay, Please send with our CD form. Our address is listed on page 2. Thanks, Bob From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 2:18 PM To: Austin, Connie Cc: Cox, Robert F.; Charles, Matt Subject: RE: labs Thank you and could you send me the exact address: Want to eliminate any confusion on this end. I will forward the submission form as well. Connie, I am having a conference call at 2:30 with Blessing – I would like any “next steps” from IDPH if you have any you can share. Also at what point do we need to have another conference call similar to the one we did with all entities including IVH? From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 2:16 PM To: Shay Drummond Cc: Cox, Robert F.; Charles, Matt Subject: RE: labs Shay, CDC has said they would like any isolates of Legionella from the outbreak so if you could advise either LabCorp or Iowa, if they both are doing sputums and culture, to send them to the Springfield lab. We just want isolates, not urine antigens to come in. So they can go to Bob Cox at the Springfield lab. Bob, any other details of where you want them to go. Also filling out the IDPH lab submission form. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Cox, Robert F." To: Austin Connie CC: "Shay Drummond" "Morgan, Jodi" Date: 8/26/2015 8:17:51 AM Subject: RE: Pateints in house Attachments: CD_TestRequisition_01062015.pdf Please see attached form. Bob From: Austin, Connie Sent: Wednesday, August 26, 2015 9:08 AM To: Cox, Robert F. Cc: Shay Drummond; Morgan, Jodi Subject: FW: Pateints in house Bob, Do you want them just to complete the IDPH form for the specimens, I think the CDC DASH form is what you guys at IDPH lab fill out? If yes to IDPH form can you email the form to Shay? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 8:56 AM To: Austin, Connie Subject: RE: Pateints in house Just got two requests from Blessing: Need CDC submission form Also need swabs- I am calling out to other area agenciesWe do not have any in house Dr. Merrick is available at 223-8400 x 6802 From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 8:53 AM To: Shay Drummond Cc: Morgan, Jodi Subject: RE: Pateints in house Dr. Craig Conover is out of the office today, I’m trying to reach him so we can connect the two physicians. Do you have the contact information for the Blessing physician so I can give to Craig? At this point CDC would not have any better clue what the pathogen is, unfortunately the lab results will be very helpful. Jodi, Do you have any interim thoughts for the hospital while we wait for a call back from Dr. Conover? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 8:43 AM To: Austin, Connie Subject: RE: Pateints in house Thanks and if you could send me specific driving instructions, address and phone contacts for our driver/staff. Did you want me to get Dr. Merrick in touch with Dr. Conover? He was asking about CDC contact in light of the sampling requested by CDC. Also did you see his questions on the blood? From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 8:40 AM To: Shay Drummond Cc: Cox, Robert F. Subject: RE: Pateints in house Thanks, Shay when you know what is coming and when they will be arriving let us know so we can alert our lab. Were you able to provide Craig with the phone number for the physician at the hospital? That would probably be a good contact for them to talk thru infection control issues. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 8:34 AM To: Austin, Connie Subject: RE: Pateints in house Thanks! Labs are getting collected. Do you have a contact at CDC that Dr. Merrick (Blessing Hospital Epi/QI) can speak to? See his message to me Also they are getting all of the labs collected this am for us to bring over. Thanks, Shay From: "DeWitt, Justin" To: "Shay Drummond" CC: Date: 8/26/2015 1:33:38 PM Subject: Re: Quincy facility Thanks we might expect the others to follow suit. I expect an exit meeting today w DVA on next steps. Will you want a heads up on that? Justin DeWitt, P.E., LEED AP Chief of General Engineering Division of Environmental Health justin.dewitt@illinois.gov Illinois Department of Public Health 525 West Jefferson Street Springfield, Illinois 62761 (217)782-5830, Fax (217)785-5897 Visit our website at: http://www.idph.state.il.us/envhealth/ehhome.htm CONFIDENTIALITY NOTE: This e-mail and any attachments are confidential and may be protected by legal privilege. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of this e-mail or any attachment is prohibited. If you have received this e-mail in error, please notify me immediately and delete this copy from your system. Thank you for your cooperation. On Aug 26, 2015, at 2:31 PM, Shay Drummond wrote: He is on his way, thanks, we did just get two labs back as positive – FYI….. From: DeWitt, Justin [mailto:Justin.Dewitt@Illinois.gov] Sent: Wednesday, August 26, 2015 2:31 PM To: Shay Drummond Cc: McCann, Ken Subject: Re: Quincy facility Shay can Tony come now to meet us? Justin DeWitt, P.E., LEED AP Chief of General Engineering Division of Environmental Health justin.dewitt@illinois.gov Illinois Department of Public Health 525 West Jefferson Street Springfield, Illinois 62761 (217)782-5830, Fax (217)785-5897 Visit our website at: http://www.idph.state.il.us/envhealth/ehhome.htm CONFIDENTIALITY NOTE: This e-mail and any attachments are confidential and may be protected by legal privilege. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of this e-mail or any attachment is prohibited. If you have received this e-mail in error, please notify me immediately and delete this copy from your system. Thank you for your cooperation. On Aug 25, 2015, at 4:21 PM, Shay Drummond wrote: Thank you Ken, we will review and convey to IVHQ. From: McCann, Ken [mailto:Ken.McCann@Illinois.gov] Sent: Tuesday, August 25, 2015 4:20 PM To: Shay Drummond; Jon Campos; Jerrod Welch Cc: Culp, David; Conover, Craig; Austin, Connie; Morgan, Jodi; Mitchell, Joe; DeWitt, Justin; Martin, Aaron; Bell, Scott S. Subject: Quincy facility Jerrod/Shay – below are recommendations from us for your review and forwarding the facility. We recognize that these don’t answer all the questions and additional conversations will be necessary. We thought this would be a good start and we’ll see how things develop in the coming days. Let us know of thoughts/concerns. We’ll assume you will take care of communicating with the facility unless you tell us otherwise. Thanks ken +++++++++++++++++ The following recommendations are based upon 2 currently confirmed cases which were the focus of the environmental investigation at the facility Monday, August 24. These recommendations may change with additional epidemiologic information on current or additional cases. Additional environmental samples will be necessary if additional cases are confirmed. Consideration should be given to retaining the services of an environmental consultant with experience and expertise regarding legionella investigation and mitigation to assist with additional investigation and possible mitigation efforts. Elmore Infirmary · Tub rooms located in Elmore East and Elmore West: o Replace tub spray heads with point-of-use filtration heads capable of filtering legionella bacteria. o Contact the Apollo tub manufacturer to discuss possible methods to increase levels of sanitization of the tubs. The manufacturer should be able to recommend additional sanitization methods that won’t adversely affect the tubs. Tubs should be sanitized prior to use. o Documentation of tub sanitization should maintained. o Tubs can be used once these steps are completed and documented. · Routine maintenance of the water system should include monitoring residual chlorine levels and temperatures in representative end-use plumbing fixtures. All monitoring should be adequately documented. · We recommend the implementation of a water system management plan consistent with the American Society of Heating, Refrigeration and AirConditioning Engineer’s (ASHRAE) Standard 188. A draft version for public comment is attached. However, a read only version of the final standard is available from: https://www.ashrae.org/standards-research--technology/standards--guidelines/other-ashrae-standards-referenced-in-code. Elements of such a plan would include water quality monitoring at site specific intervals as well as contingency plans for responding to positive test results. A plan should also include a system flushing program to ensure all plumbing fixtures in the Elmore Infirmary are flushed on a regular basis to eliminate potential stagnant potable water in the plumbing system. Other Recommendations · Drain and discontinue use of outdoor fountains. Ken McCann, MA, LEHP Chief, Division of Environmental Health Illinois Department of Public Health 525 West Jefferson Str. Springfield, Il 62761 phone: 217-785-2043 fax: 217-785-0253 Ken.McCann@illinois.gov IMPORTANT: This e-mail, including all attachments, constitute State Government records and property that is intended only for the use of the individual or entity to w hich it is addressed. It also may contain information that is privileged, confidential, or otherw ise protected from disclosure under applicable law . If the reader of this transmission is not the intended recipient or the employee or agent responsible for delivering the transmission to the intended recipient, you are hereby notified that any dissemination, distribution, copying or use of this e-mail or its contents is strictly prohibited. If you have received this in error, please notify the sender. From: "DeWitt, Justin" To: "Shay Drummond" CC: "McCann, Ken" Date: 8/26/2015 1:30:34 PM Subject: Re: Quincy facility Shay can Tony come now to meet us? Justin DeWitt, P.E., LEED AP Chief of General Engineering Division of Environmental Health justin.dewitt@illinois.gov Illinois Department of Public Health 525 West Jefferson Street Springfield, Illinois 62761 (217)782-5830, Fax (217)785-5897 Visit our website at: http://www.idph.state.il.us/envhealth/ehhome.htm CONFIDENTIALITY NOTE: This e-mail and any attachments are confidential and may be protected by legal privilege. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of this e-mail or any attachment is prohibited. If you have received this e-mail in error, please notify me immediately and delete this copy from your system. Thank you for your cooperation. On Aug 25, 2015, at 4:21 PM, Shay Drummond wrote: Thank you Ken, we will review and convey to IVHQ. From: McCann, Ken [mailto:Ken.McCann@Illinois.gov] Sent: Tuesday, August 25, 2015 4:20 PM To: Shay Drummond; Jon Campos; Jerrod Welch Cc: Culp, David; Conover, Craig; Austin, Connie; Morgan, Jodi; Mitchell, Joe; DeWitt, Justin; Martin, Aaron; Bell, Scott S. Subject: Quincy facility Jerrod/Shay – below are recommendations from us for your review and forwarding the facility. We recognize that these don’t answer all the questions and additional conversations will be necessary. We thought this would be a good start and we’ll see how things develop in the coming days. Let us know of thoughts/concerns. We’ll assume you will take care of communicating with the facility unless you tell us otherwise. Thanks ken +++++++++++++++++ The following recommendations are based upon 2 currently confirmed cases which were the focus of the environmental investigation at the facility Monday, August 24. These recommendations may change with additional epidemiologic information on current or additional cases. Additional environmental samples will be necessary if additional cases are confirmed. Consideration should be given to retaining the services of an environmental consultant with experience and expertise regarding legionella investigation and mitigation to assist with additional investigation and possible mitigation efforts. Elmore Infirmary · Tub rooms located in Elmore East and Elmore West: o Replace tub spray heads with point-of-use filtration heads capable of filtering legionella bacteria. o Contact the Apollo tub manufacturer to discuss possible methods to increase levels of sanitization of the tubs. The manufacturer should be able to recommend additional sanitization methods that won’t adversely affect the tubs. Tubs should be sanitized prior to use. o Documentation of tub sanitization should maintained. o Tubs can be used once these steps are completed and documented. · Routine maintenance of the water system should include monitoring residual chlorine levels and temperatures in representative end-use plumbing fixtures. All monitoring should be adequately documented. · We recommend the implementation of a water system management plan consistent with the American Society of Heating, Refrigeration and AirConditioning Engineer’s (ASHRAE) Standard 188. A draft version for public comment is attached. However, a read only version of the final standard is available from: https://www.ashrae.org/standards-research--technology/standards--guidelines/other-ashrae-standards-referenced-in-code. Elements of such a plan would include water quality monitoring at site specific intervals as well as contingency plans for responding to positive test results. A plan should also include a system flushing program to ensure all plumbing fixtures in the Elmore Infirmary are flushed on a regular basis to eliminate potential stagnant potable water in the plumbing system. Other Recommendations · Drain and discontinue use of outdoor fountains. Ken McCann, MA, LEHP Chief, Division of Environmental Health Illinois Department of Public Health 525 West Jefferson Str. Springfield, Il 62761 phone: 217-785-2043 fax: 217-785-0253 Ken.McCann@illinois.gov IMPORTANT: This e-mail, including all attachments, constitute State Government records and property that is intended only for the use of the individual or entity to w hich it is addressed. It also may contain information that is privileged, confidential, or otherw ise protected from disclosure under applicable law . If the reader of this transmission is not the intended recipient or the employee or agent responsible for delivering the transmission to the intended recipient, you are hereby notified that any dissemination, distribution, copying or use of this e-mail or its contents is strictly prohibited. If you have received this in error, please notify the sender. From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/26/2015 12:15:18 PM Subject: Legionella Tracking Log.xlsx Attachments: Legionella Tracking Log.xlsx From: "HOUSTON, CATHY" To: "Shay Drummond" CC: "VACA, BRUCE" "WINNICKI, LENARD F." "PERRINE, HOLLY" "KELLEY, LINDSEY" Date: 8/26/2015 4:34:14 PM Subject: Legionella Tracking Log.xlsx Attachments: Legionella Tracking Log.xlsx UPDATED. From: "HOUSTON, CATHY" To: Jeffries "Erica L" GWEN Ryan "LENARD F." CC: "VACA, BRUCE" "HOUSTON, CATHY" "Shay Drummond" Date: 8/26/2015 2:30:17 PM Subject: PRESS RELEASE--IMPORTANT Shay Drummond has just informed me that one of the residents in the hospital does now in fact have a positive Sputum Culture for Legionella. This was a different resident than the 2 confirmed cases. There are several urine tests that should be back by 8 PM tonight and to be quite honest they are expecting them to come back positive. IF these do in fact come back positive, Shay has spoken with Blessing Hospital who would like to have a united Press Release from IVH, ACHD and Blessing Hospital. Len, Are You able to set up a 4:30 conference call in which we can all be on this. I cc’d Shay on this email so it you will please include her for the meeting, she will forward on to the other people at ACHD and Blessing Hospital to be on the call also. Thanks. Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 CATHY.S.HOUSTON@illinois.gov From: "HOUSTON, CATHY" To: "Shay Drummond" CC: "VACA, BRUCE" Date: 8/26/2015 12:24:45 PM Subject: RE: Legionella Tracking Log.xlsx You will let me know then which ones of these you want urines and NP/OP swabs? When do you want us to collect them? We were only able to get the urine on to send with your staff to Springfield. She said she would bring us back the appropriate swabs upon her return. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 1:21 PM To: HOUSTON, CATHY Subject: RE: Legionella Tracking Log.xlsx This is great, thanks so much! From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Wednesday, August 26, 2015 1:15 PM To: Shay Drummond Subject: Legionella Tracking Log.xlsx From: "Jeffries, Erica L" To: WINNICKI "LENARD F." CC: "HOUSTON, CATHY" "DIEHL, GWEN" "Yantis, Ryan" "McGill, Trish" "Ray, Jaimee M." "VACA, BRUCE" "Shay Drummond" Date: 8/26/2015 4:05:05 PM S u b j e c t : Re: PRESS RELEASE--IMPORTANT FYI - my cell phone: 312-636-6054 Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 26, 2015, at 15:45, WINNICKI, LENARD F. wrote: Set up for 4:30 on Main Line: Main: 1-888-494-4032 Pass code: 8878280078# From: HOUSTON, CATHY Sent: Wednesday, August 26, 2015 3:30 PM To: Jeffries, Erica L; DIEHL, GWEN; Yantis, Ryan; WINNICKI, LENARD F. Cc: VACA, BRUCE; HOUSTON, CATHY; Shay Drummond Subject: PRESS RELEASE--IMPORTANT Importance: High Shay Drummond has just informed me that one of the residents in the hospital does now in fact have a positive Sputum Culture for Legionella. This was a different resident than the 2 confirmed cases. There are several urine tests that should be back by 8 PM tonight and to be quite honest they are expecting them to come back positive. IF these do in fact come back positive, Shay has spoken with Blessing Hospital who would like to have a united Press Release from IVH, ACHD and Blessing Hospital. Len, Are You able to set up a 4:30 conference call in which we can all be on this. I cc’d Shay on this email so it you will please include her for the meeting, she will forward on to the other people at ACHD and Blessing Hospital to be on the call also. Thanks. Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 CATHY.S.HOUSTON@illinois.gov From: "Johnson, Bernard T." To: "Shay Drummond" CC: eric.dix@blessinghealthsystem.org "Austin, Connie" "Cox, Robert F." Date: 8/26/2015 9:27:03 AM Subject: RE: Respiratory illness at large Veterans home in Illinois Thank you, Shay. Bob Cox, Supervisor of Clinical Microbiology in the IDPH Springfield lab, has contacted Eric Dix. Bob is confirming the tests being ordered so he can provide information on the correct collection and transport. Tom Bernard (Tom) Johnson Chief, Division of Laboratories Illinois Department of Public Health 825 N. Rutledge St. Springfield, IL 62702 Phone: 217-782-6562 Cell: 309-222-1312 Fax: 217-524-7924 Email: Bernard.Johnson@Illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 10:02 AM To: Johnson, Bernard T. Cc: eric.dix@blessinghealthsystem.org; Austin, Connie Subject: FW: Respiratory illness at large Veterans home in Illinois Importance: High Hi, I gave Eric Dix you contact info: He is collecting specimens and needs guidance on below:: A variety of specimens are suitable and include nasopharyngeal (NP) swab, oropharyngeal (OP) swab, NP aspirate, NP wash, OP wash, bronchoalveolar lavage, tracheal aspirate, sputum, serum, blood, urine, stool, conjunctival swab, viral isolate, and cerebral spinal fluid. Multiple respiratory specimen types of ample volume are preferred. NP and OP swabs collected from the same patient can be placed together in a single vial. Swab specimens should be collected using only swabs with a synthetic tip (e.g., polyester, Dacron®) and an aluminum or plastic shaft. Swabs with cotton tips and wooden shafts are not recommended. Specimens collected with swabs made of calcium alginate are not acceptable. Cell culture medium from a virus isolate can be sent in a screw-cap vial. From: Johnson, Bernard T. [mailto:Bernard.Johnson@Illinois.gov] Sent: Tuesday, August 25, 2015 3:10 PM To: Austin, Connie; Shay Drummond; Jon Campos Cc: Morgan, Jodi; Conover, Craig; Kelly-Shannon, Kate D.; Holmes, Tal Subject: RE: Respiratory illness at large Veterans home in Illinois Connie: They can fill out the standard Communicable Disease form information completely. If they have someone available by phone for follow up questions if the CD form is not complete it would be helpful. Tom Bernard (Tom) Johnson Chief, Division of Laboratories Illinois Department of Public Health 825 N. Rutledge St. Springfield, IL 62702 Phone: 217-782-6562 Cell: 309-222-1312 Fax: 217-524-7924 Email: Bernard.Johnson@Illinois.gov From: Austin, Connie Sent: Tuesday, August 25, 2015 2:59 PM To: Shay Drummond; Jon Campos Cc: Morgan, Jodi; Conover, Craig; Johnson, Bernard T.; Kelly-Shannon, Kate D.; Holmes, Tal Subject: FW: Respiratory illness at large Veterans home in Illinois Shay/Jon, Had a conversation and some email with CDC about the respiratory panel. There is a viral respiratory group and a bacterial so they would work together to get the testing done. My suggestion is that specimens be collected on hospitalized patients that the physicians think would be the best candidates. if specimens as listed in the email below can be collected, if they could be transported (hopefully by car for rapid transit) to the IDPH lab in Springfield for shipping to CDC that works the best because they are very particular about shipping requirements/forms. CDC requests that specimens arrive prior to the weekend, not to arrive on the weekend. Tom, What form would they be able to fill out that will give you enough information to do the DASH form? Or do you want them to attempt the DASH form? From CDC… We prefer to have an NP/OP collected on each patient. For those with pneumonia or lower resp findings please also collect a lower resp specimen. The link to the instructions is attached. If you have previously collected stored specimens we could test those as long as they have been refrigerated. Keep the specimens refrigerated. If you cannot send until next week you will need to freeze the specimens that were collected 72hrs earlier. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Morgan, Jodi" To: "Shay Drummond" Connie CC: "Echols, Fred" Date: 8/26/2015 5:17:52 PM Subject: RE: Updates A t t a c h m ents: Interim Guidelines for PotableWater Restrictions in Long Term Care Facility DRAFT2.docx This was based on CDC information and recommendations and reviewed with IDPH Environmental Health also. Subject to change as more info becomes available. -----Original Message----From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 5:56 PM To: Austin, Connie Cc: Morgan, Jodi Subject: Re: Updates Great i am meeting - with IVH now. Sent from my iPhone > On Aug 26, 2015, at 5:55 PM, Austin, Connie wrote: > > Yes, Jodi is almost finished with the guidance on water restrictions. > > Connie Austin > State public health veterinarian > Division of Infectious Disease > Illinois Department of Public Health > 525 W Jefferson St > WorK: 217-785-7165 > Fax: 217-557-4049 > Connie.austin@illinois.gov > > -----Original Message----> From: Shay Drummond [mailto:sdrummond@co.adams.il.us] > Sent: Wednesday, August 26, 2015 5:52 PM > To: Austin, Connie > Subject: Updates > > Hi, > I understand there was a call with CDC earlier, any updates? > > Sent from my iPhone From: "Shay Drummond" To: HOUSTON "CATHY <" "\(CATHY.S.HOUSTON@illinois.gov\);>" CC: Date: 8/26/2015 10:34:53 AM Subject: Emailing - CD_TestRequisition_01062015.pdf Attachments: CD_TestRequisition_01062015.pdf From: "Shay Drummond" To: HOUSTON "CATHY <" "\(CATHY.S.HOUSTON@illinois.gov\);>" CC: Date: 8/26/2015 10:34:31 AM Subject: Emailing - CDC RVDP Specimen Submission Guidelines v1.8.pdf Attachments: CDC RVDP Specimen Submission Guidelines v1.8.pdf Here is the guidance for collection of NPOP. Do you need swabs? From: "Shay Drummond" To: Arnold Melaney Nirav CC: Date: 8/26/2015 7:05:33 PM Subject: FW: Draft Press Release/Statement on Veterans Home RespirsitorySituation - RESPONSES FROM BLESSING HOSPITAL Hello, Please see the recommendations from Blessing Hospital. Thanks, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 From: Felde, Steve [mailto:Steve.Felde@blessinghealthsystem.org] Sent: Wednesday, August 26, 2015 8:00 PM To: Yantis, Ryan; Kuida, Elliot; Saalborn, Dr. Richard; Roberts, Vickie; Manley, Linda; Neisen, Lisa (PR); Loyd, David; Bailey, Carolyn; Shay Drummond; Barthel, Mary Cc: Powell, Betsey Subject: FW: Draft Press Release/Statement on Veterans Home Respirsitory Situation - RESPONSES FROM BLESSING HOSPITAL Importance: High The following changes are suggested by Robert Merrick, MPH, Epidemiologist, Blessing Hospital and Carolyn Bailey, administrative director, Risk Management, Blessing Corporate Services (parent company of Blessing Hospital): Dr. Merrick: We had 23 patients in house today so have treated well over the 18 referred to in paragraph 1. The last paragraph sounds like the cleaning is a new activity; did they not clean these before and what did they do as a result of the first cases in July? A smart reporter will eat the spokesperson alive. Carolyn Bailey: We recommend stating “approximately 20 patients” since our records reflect 22 inpatients (residents) and does not count the staff or those treated and discharged from the ED. We hate to be pinned down to a specific number, especially since that could change. Thanks. Steve Felde Senior Communications Specialist Blessing Hospital (217)223-8400, ext. 4191 From: Merrick, Robert Sent: Wednesday, August 26, 2015 6:32 PM To: Felde, Steve Subject: RE: Draft Press Release/Statement on Veterans Home Respirsitory Situation Steve, We had 23 patients in house today so have treated well over the 18 referred to in paragraph 1. The last paragraph sounds like the cleaning is a new activity; did they not clean these before and what did they do as a result of the first cases in July? A smart reporter will eat the spokesperson alive They should have had you write the release. Overall I think it is poorly written, confusing and in my view just a smoke to cover peoples butts. You do not need to share that comment. Regards, REM From: Felde, Steve Sent: Wednesday, August 26, 2015 5:43 PM To: Saalborn, Dr. Richard; Manley, Linda; Bailey, Carolyn; Loyd, David; Barthel, Mary; Merrick, Robert; Roberts, Vickie; Neisen, Lisa (PR) Cc: Kuida, Elliot Subject: FW: Draft Press Release/Statement on Veterans Home Respirsitory Situation Importance: High Attached is a draft working release prepared by the State about the situation at IVH for probable release tomorrow after 8 am. Please review this and let me know if you are OK with the release as it is presented here, or if you feel changes are needed. IF you feel changes are needed, please email me the changes you suggest AND please text my cellphone 257-8641 to let me know that you have emailed me changes. With your text, I will know to come into work early tomorrow to gather up the changes suggested. I thank you for taking the extra step as I do not get hospital email on my cellphone. If you have no changes to suggest, only the email to stating that is needed. No text is required. Thank you. Steve Felde Senior Communications Specialist Blessing Hospital (217)223-8400, ext. 4191 From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Wednesday, August 26, 2015 5:34 PM To: Felde, Steve; Shay Drummond; Arnold, Melaney; HOUSTON, CATHY S; Kuida, Elliot; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; VACA, BRUCE L; DIEHL, GWEN G; Little, Divya Mohan Cc: McGill, Patricia O; Ray, Jaimee M; SAWYER, HARRY H Subject: Draft Press Release/Statement on Veterans Home Respirsitory Situation Ladies and Gents Attached please find the draft working release/RTQ for the situation at Illinois Veterans' Home - Quincy. It is a collaborative effort of IDVA, IDPH and the Home, with information gleaned from previous calls and emails. The Overall Messages/Themes discussed on the conference call this evening: ​- (There is very low/low risk to the general public, unless they visited the Home during a period of exposure. However, this respiratory illness generally affects those with weaker immune systems - the young, old, those with suppressed immune systems, etc.) - There is a strong team approach to this situation and we are harnessing the talents and capabilities of the Home, Adams County Dept of Health, Blessing Hospital, IDPH, IDVA and others as needed. - We are working well together to identify any possible source of this illness on the Home campus; this is an ongoing effort. - There have been no known/reported fatalities associated with this illness; those identified have responded well to treatment. - There is no cause for alarm; this is a manageable situation and we are focusing talents, efforts, and appropriate resources to meet the needs. Next Steps: - Conf Call on Thurs, Aug 27 at 8 a.m. (0800) to review lab results and discuss release. - Finalize release based on Lab results and new patient info/Home info - Agree to time for release; prep any press event. - Notify Gov's Press Office - Pre-position release information with select elected officials (?) - Plan post-release Conf Call to review any outstanding issues. - Consider additional information-sharing conf. calls for next few days. Early Triggers - We need agreement after a trigger to push the release - A media query asking specific questions about the current medical situation (legionella, Legionnaire's Disease, citing high traffic to Blessing, etc.) - (A death related to Legionnaire's Disease, at Blessing or the Home)[ I realize this was not discussed, but may really be a game-changer as far as outreach] Thanks Ryan Ryan Yantis Communication Manager, IDVA 312-814-0778 (desk) 312-520-6958 (cell) ryan.yantis@illinois.gov The information contained in this e-mail message is PRIVILEGED AND CONFIDENTIAL and is intended for the use of the addressee and no one else. If you are not the intended recipient, please do not read, distribute, reproduce or use this e-mail message (or the attachments). Please delete the original and notify the sender of the mistaken transmission. Thank you. From: "Shay Drummond" To: Austin "Connie \(Connie.Austin@Illinois.gov\); jodi.Morgan@illinois.gov;" CC: "Jon Campos" Date: 8/26/2015 7:06:52 AM S u b j e c t : FW: Pateints in house Good morning, This is the current Blessing census and location at Blessing. Currently: 2N-2 2S-2 ICU 33S (IMC) 5 3N 6 CPAP, BIPAP, BIPAP removed at 3:24, O2 at 4L Overnight there was 1 employee in ER that was discharged, tests are pending and one admit, I IVH patient with Dx of pneumonia, dehydration, elevated troponin, blood cultures collected, discharged back to IVH (comfort care), not tested for Legionella No test results back as of 5:50 am My question: do we want a legionella test and NP/OP done on the patient that was sent back for comfort care? I am guessing that he is a DNR. I will send over room/building maps as soon as I receive them. I have a conference call at 0900 with Blessing Hospital. Has there been any media messaging from IDPH that is ready for us to have in case we need it – I am sensing that today there may be requests. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: bernard.johnson@illinois.gov CC: eric.dix@blessinghealthsystem.org "Austin, Connie \(Connie.Austin@Illinois.gov\)" Date: 8/26/2015 9:02:11 AM Subject: FW: Respiratory illness at large Veterans home in Illinois Hi, I gave Eric Dix you contact info: He is collecting specimens and needs guidance on below:: A variety of specimens are suitable and include nasopharyngeal (NP) swab, oropharyngeal (OP) swab, NP aspirate, NP wash, OP wash, bronchoalveolar lavage, tracheal aspirate, sputum, serum, blood, urine, stool, conjunctival swab, viral isolate, and cerebral spinal fluid. Multiple respiratory specimen types of ample volume are preferred. NP and OP swabs collected from the same patient can be placed together in a single vial. Swab specimens should be collected using only swabs with a synthetic tip (e.g., polyester, Dacron®) and an aluminum or plastic shaft. Swabs with cotton tips and wooden shafts are not recommended. Specimens collected with swabs made of calcium alginate are not acceptable. Cell culture medium from a virus isolate can be sent in a screw-cap vial. From: Johnson, Bernard T. [mailto:Bernard.Johnson@Illinois.gov] Sent: Tuesday, August 25, 2015 3:10 PM To: Austin, Connie; Shay Drummond; Jon Campos Cc: Morgan, Jodi; Conover, Craig; Kelly-Shannon, Kate D.; Holmes, Tal Subject: RE: Respiratory illness at large Veterans home in Illinois Connie: They can fill out the standard Communicable Disease form information completely. If they have someone available by phone for follow up questions if the CD form is not complete it would be helpful. Tom Bernard (Tom) Johnson Chief, Division of Laboratories Illinois Department of Public Health 825 N. Rutledge St. Springfield, IL 62702 Phone: 217-782-6562 Cell: 309-222-1312 Fax: 217-524-7924 Email: Bernard.Johnson@Illinois.gov From: Austin, Connie Sent: Tuesday, August 25, 2015 2:59 PM To: Shay Drummond; Jon Campos Cc: Morgan, Jodi; Conover, Craig; Johnson, Bernard T.; Kelly-Shannon, Kate D.; Holmes, Tal Subject: FW: Respiratory illness at large Veterans home in Illinois Shay/Jon, Had a conversation and some email with CDC about the respiratory panel. There is a viral respiratory group and a bacterial so they would work together to get the testing done. My suggestion is that specimens be collected on hospitalized patients that the physicians think would be the best candidates. if specimens as listed in the email below can be collected, if they could be transported (hopefully by car for rapid transit) to the IDPH lab in Springfield for shipping to CDC that works the best because they are very particular about shipping requirements/forms. CDC requests that specimens arrive prior to the weekend, not to arrive on the weekend. Tom, What form would they be able to fill out that will give you enough information to do the DASH form? Or do you want them to attempt the DASH form? From CDC… We prefer to have an NP/OP collected on each patient. For those with pneumonia or lower resp findings please also collect a lower resp specimen. The link to the instructions is attached. If you have previously collected stored specimens we could test those as long as they have been refrigerated. Keep the specimens refrigerated. If you cannot send until next week you will need to freeze the specimens that were collected 72hrs earlier. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Shay Drummond" To: "DAVE CLIFFORD" CC: Date: 8/26/2015 5:23:44 PM Subject: Fwd: Updates Attachments: Interim Guidelines for PotableWater Restrictions in Long Term Care Facility DRAFT2.docx ATT00001.htm Sent from my iPhone Begin forwarded message: From: "Morgan, Jodi" Date: August 26, 2015 at 6:17:52 PM CDT To: Shay Drummond , "Austin, Connie" Cc: "Echols, Fred" Subject: RE: Updates This was based on CDC information and recommendations and reviewed with IDPH Environmental Health also. Subject to change as more info becomes available. -----Original Message----From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 5:56 PM To: Austin, Connie Cc: Morgan, Jodi Subject: Re: Updates Great i am meeting - with IVH now. Sent from my iPhone On Aug 26, 2015, at 5:55 PM, Austin, Connie wrote: Yes, Jodi is almost finished with the guidance on water restrictions. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov -----Original Message----From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 5:52 PM To: Austin, Connie Subject: Updates Hi, I understand there was a call with CDC earlier, any updates? Sent from my iPhone From: "Shay Drummond" To: "BRUCE VACA" "CATHY HOUSTON" "Jerrod Welch" TonyDede CC: Date: 8/26/2015 5:23:01 PM Subject: Fwd: Updates Attachments: Interim Guidelines for PotableWater Restrictions in Long Term Care Facility DRAFT2.docx ATT00001.htm See guidance below: Sent from my iPhone Begin forwarded message: From: "Morgan, Jodi" Date: August 26, 2015 at 6:17:52 PM CDT To: Shay Drummond , "Austin, Connie" Cc: "Echols, Fred" Subject: RE: Updates This was based on CDC information and recommendations and reviewed with IDPH Environmental Health also. Subject to change as more info becomes available. -----Original Message----From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 5:56 PM To: Austin, Connie Cc: Morgan, Jodi Subject: Re: Updates Great i am meeting - with IVH now. Sent from my iPhone On Aug 26, 2015, at 5:55 PM, Austin, Connie wrote: Yes, Jodi is almost finished with the guidance on water restrictions. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov -----Original Message----From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 5:52 PM To: Austin, Connie Subject: Updates Hi, I understand there was a call with CDC earlier, any updates? Sent from my iPhone From: "Shay Drummond" To: Austin "Connie \(Connie.Austin@Illinois.gov\); jodi.Morgan@illinois.gov;" CC: "Jon Campos" Date: 8/26/2015 12:17:05 PM Subject: Legionella Tracking Log.xlsx Attachments: Legionella Tracking Log.xlsx Hi, This is the IVH tracking from Cathy Houston. Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Yantis Ryan CC: Date: 8/26/2015 7:26:35 PM Subject: RE: Draft Press Release/Statement on Veterans Home RespirsitorySituation Ryan, The person from IVHQ who is quoted was Cathy Houston DON. Thanks! From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Wednesday, August 26, 2015 5:34 PM To: steve.felde@blessinghealthsystem.org; Shay Drummond; Arnold, Melaney; HOUSTON, CATHY S; elliot.kuida@blessinghealthsystem.org; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; VACA, BRUCE L; DIEHL, GWEN G; Little, Divya Mohan Cc: McGill, Patricia O; Ray, Jaimee M; SAWYER, HARRY H Subject: Draft Press Release/Statement on Veterans Home Respirsitory Situation Ladies and Gents Attached please find the draft working release/RTQ for the situation at Illinois Veterans' Home - Quincy. It is a collaborative effort of IDVA, IDPH and the Home, with information gleaned from previous calls and emails. The Overall Messages/Themes discussed on the conference call this evening: ​- (There is very low/low risk to the general public, unless they visited the Home during a period of exposure. However, this respiratory illness generally affects those with weaker immune systems - the young, old, those with suppressed immune systems, etc.) - There is a strong team approach to this situation and we are harnessing the talents and capabilities of the Home, Adams County Dept of Health, Blessing Hospital, IDPH, IDVA and others as needed. - We are working well together to identify any possible source of this illness on the Home campus; this is an ongoing effort. - There have been no known/reported fatalities associated with this illness; those identified have responded well to treatment. - There is no cause for alarm; this is a manageable situation and we are focusing talents, efforts, and appropriate resources to meet the needs. Next Steps: - Conf Call on Thurs, Aug 27 at 8 a.m. (0800) to review lab results and discuss release. - Finalize release based on Lab results and new patient info/Home info - Agree to time for release; prep any press event. - Notify Gov's Press Office - Pre-position release information with select elected officials (?) - Plan post-release Conf Call to review any outstanding issues. - Consider additional information-sharing conf. calls for next few days. Early Triggers - We need agreement after a trigger to push the release - A media query asking specific questions about the current medical situation (legionella, Legionnaire's Disease, citing high traffic to Blessing, etc.) - (A death related to Legionnaire's Disease, at Blessing or the Home)[ I realize this was not discussed, but may really be a game-changer as far as outreach] Thanks Ryan Ryan Yantis Communication Manager, IDVA 312-814-0778 (desk) 312-520-6958 (cell) ryan.yantis@illinois.gov From: "Shay Drummond" To: Felde Steve Ryan Elliot "Dr. Richard" Vickie Linda "Lisa \(PR\)" David Carolyn Mary CC: "Powell, Betsey" Date: 8/26/2015 7:06:44 PM Subject: RE: Draft Press Release/Statement on Veterans Home RespirsitorySituation - RESPONSES FROM BLESSING HOSPITAL Thanks I have forwarded this up to IDPH as they are crafting this message at the state level. Shay From: Felde, Steve [mailto:Steve.Felde@blessinghealthsystem.org] Sent: Wednesday, August 26, 2015 8:00 PM To: Yantis, Ryan; Kuida, Elliot; Saalborn, Dr. Richard; Roberts, Vickie; Manley, Linda; Neisen, Lisa (PR); Loyd, David; Bailey, Carolyn; Shay Drummond; Barthel, Mary Cc: Powell, Betsey Subject: FW: Draft Press Release/Statement on Veterans Home Respirsitory Situation - RESPONSES FROM BLESSING HOSPITAL Importance: High The following changes are suggested by Robert Merrick, MPH, Epidemiologist, Blessing Hospital and Carolyn Bailey, administrative director, Risk Management, Blessing Corporate Services (parent company of Blessing Hospital): Dr. Merrick: We had 23 patients in house today so have treated well over the 18 referred to in paragraph 1. The last paragraph sounds like the cleaning is a new activity; did they not clean these before and what did they do as a result of the first cases in July? A smart reporter will eat the spokesperson alive. Carolyn Bailey: We recommend stating “approximately 20 patients” since our records reflect 22 inpatients (residents) and does not count the staff or those treated and discharged from the ED. We hate to be pinned down to a specific number, especially since that could change. Thanks. Steve Felde Senior Communications Specialist Blessing Hospital (217)223-8400, ext. 4191 From: Merrick, Robert Sent: Wednesday, August 26, 2015 6:32 PM To: Felde, Steve Subject: RE: Draft Press Release/Statement on Veterans Home Respirsitory Situation Steve, We had 23 patients in house today so have treated well over the 18 referred to in paragraph 1. The last paragraph sounds like the cleaning is a new activity; did they not clean these before and what did they do as a result of the first cases in July? A smart reporter will eat the spokesperson alive They should have had you write the release. Overall I think it is poorly written, confusing and in my view just a smoke to cover peoples butts. You do not need to share that comment. Regards, REM From: Felde, Steve Sent: Wednesday, August 26, 2015 5:43 PM To: Saalborn, Dr. Richard; Manley, Linda; Bailey, Carolyn; Loyd, David; Barthel, Mary; Merrick, Robert; Roberts, Vickie; Neisen, Lisa (PR) Cc: Kuida, Elliot Subject: FW: Draft Press Release/Statement on Veterans Home Respirsitory Situation Importance: High Attached is a draft working release prepared by the State about the situation at IVH for probable release tomorrow after 8 am. Please review this and let me know if you are OK with the release as it is presented here, or if you feel changes are needed. IF you feel changes are needed, please email me the changes you suggest AND please text my cellphone 257-8641 to let me know that you have emailed me changes. With your text, I will know to come into work early tomorrow to gather up the changes suggested. I thank you for taking the extra step as I do not get hospital email on my cellphone. If you have no changes to suggest, only the email to stating that is needed. No text is required. Thank you. Steve Felde Senior Communications Specialist Blessing Hospital (217)223-8400, ext. 4191 From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Wednesday, August 26, 2015 5:34 PM To: Felde, Steve; Shay Drummond; Arnold, Melaney; HOUSTON, CATHY S; Kuida, Elliot; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; VACA, BRUCE L; DIEHL, GWEN G; Little, Divya Mohan Cc: McGill, Patricia O; Ray, Jaimee M; SAWYER, HARRY H Subject: Draft Press Release/Statement on Veterans Home Respirsitory Situation Ladies and Gents Attached please find the draft working release/RTQ for the situation at Illinois Veterans' Home - Quincy. It is a collaborative effort of IDVA, IDPH and the Home, with information gleaned from previous calls and emails. The Overall Messages/Themes discussed on the conference call this evening: ​- (There is very low/low risk to the general public, unless they visited the Home during a period of exposure. However, this respiratory illness generally affects those with weaker immune systems - the young, old, those with suppressed immune systems, etc.) - There is a strong team approach to this situation and we are harnessing the talents and capabilities of the Home, Adams County Dept of Health, Blessing Hospital, IDPH, IDVA and others as needed. - We are working well together to identify any possible source of this illness on the Home campus; this is an ongoing effort. - There have been no known/reported fatalities associated with this illness; those identified have responded well to treatment. - There is no cause for alarm; this is a manageable situation and we are focusing talents, efforts, and appropriate resources to meet the needs. Next Steps: - Conf Call on Thurs, Aug 27 at 8 a.m. (0800) to review lab results and discuss release. - Finalize release based on Lab results and new patient info/Home info - Agree to time for release; prep any press event. - Notify Gov's Press Office - Pre-position release information with select elected officials (?) - Plan post-release Conf Call to review any outstanding issues. - Consider additional information-sharing conf. calls for next few days. Early Triggers - We need agreement after a trigger to push the release - A media query asking specific questions about the current medical situation (legionella, Legionnaire's Disease, citing high traffic to Blessing, etc.) - (A death related to Legionnaire's Disease, at Blessing or the Home)[ I realize this was not discussed, but may really be a game-changer as far as outreach] Thanks Ryan Ryan Yantis Communication Manager, IDVA 312-814-0778 (desk) 312-520-6958 (cell) ryan.yantis@illinois.gov The information contained in this e-mail message is PRIVILEGED AND CONFIDENTIAL and is intended for the use of the addressee and no one else. If you are not the intended recipient, please do not read, distribute, reproduce or use this e-mail message (or the attachments). Please delete the original and notify the sender of the mistaken transmission. Thank you. From: "Shay Drummond" To: Austin Connie CC: Date: 8/26/2015 2:01:27 PM Subject: RE: labs Off of my call with Blessing. They are nearing capacity and IVH has about 20 they are providing care for on campus. To clarify – we got the two Iowa lab results in – one + and one – NO Lab Corps, results they were sending me a previous positive. We expect the labcorps results back at 8 this evening. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 2:37 PM To: Shay Drummond Subject: RE: labs Lets see what the urine antigen results are, We are having some discussions here, so let me get back to you on when a call. No specific changes to Blessing Hospital right now. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 2:18 PM To: Austin, Connie Cc: Cox, Robert F.; Charles, Matt Subject: RE: labs Thank you and could you send me the exact address: Want to eliminate any confusion on this end. I will forward the submission form as well. Connie, I am having a conference call at 2:30 with Blessing – I would like any “next steps” from IDPH if you have any you can share. Also at what point do we need to have another conference call similar to the one we did with all entities including IVH? From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 2:16 PM To: Shay Drummond Cc: Cox, Robert F.; Charles, Matt Subject: RE: labs Shay, CDC has said they would like any isolates of Legionella from the outbreak so if you could advise either LabCorp or Iowa, if they both are doing sputums and culture, to send them to the Springfield lab. We just want isolates, not urine antigens to come in. So they can go to Bob Cox at the Springfield lab. Bob, any other details of where you want them to go. Also filling out the IDPH lab submission form. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Shay Drummond" To: Cox "Robert F." CC: Date: 8/26/2015 1:22:15 PM S u b j ect: RE: labs Thanks am forwarding. From: Cox, Robert F. [mailto:Robert.F.Cox@Illinois.gov] Sent: Wednesday, August 26, 2015 2:21 PM To: Shay Drummond; Austin, Connie Cc: Charles, Matt; Johnson, Bernard T. Subject: RE: labs Shay, Please send with our CD form. Our address is listed on page 2. Thanks, Bob From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 2:18 PM To: Austin, Connie Cc: Cox, Robert F.; Charles, Matt Subject: RE: labs Thank you and could you send me the exact address: Want to eliminate any confusion on this end. I will forward the submission form as well. Connie, I am having a conference call at 2:30 with Blessing – I would like any “next steps” from IDPH if you have any you can share. Also at what point do we need to have another conference call similar to the one we did with all entities including IVH? From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 2:16 PM To: Shay Drummond Cc: Cox, Robert F.; Charles, Matt Subject: RE: labs Shay, CDC has said they would like any isolates of Legionella from the outbreak so if you could advise either LabCorp or Iowa, if they both are doing sputums and culture, to send them to the Springfield lab. We just want isolates, not urine antigens to come in. So they can go to Bob Cox at the Springfield lab. Bob, any other details of where you want them to go. Also filling out the IDPH lab submission form. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Shay Drummond" To: Austin Connie CC: Date: 8/26/2015 3:23:38 PM Subject: Re: labs Will do! Sent from my iPhone On Aug 26, 2015, at 4:16 PM, Austin, Connie wrote: I am on call and will probably still be here so feel free to call or email, Direct line is 217-524-5354 Or work mobile 217-725-8059, I’m also on call tonite. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 3:01 PM To: Austin, Connie Subject: RE: labs Off of my call with Blessing. They are nearing capacity and IVH has about 20 they are providing care for on campus. To clarify – we got the two Iowa lab results in – one + and one – NO Lab Corps, results they were sending me a previous positive. We expect the labcorps results back at 8 this evening. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 2:37 PM To: Shay Drummond Subject: RE: labs Lets see what the urine antigen results are, We are having some discussions here, so let me get back to you on when a call. No specific changes to Blessing Hospital right now. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 2:18 PM To: Austin, Connie Cc: Cox, Robert F.; Charles, Matt Subject: RE: labs Thank you and could you send me the exact address: Want to eliminate any confusion on this end. I will forward the submission form as well. Connie, I am having a conference call at 2:30 with Blessing – I would like any “next steps” from IDPH if you have any you can share. Also at what point do we need to have another conference call similar to the one we did with all entities including IVH? From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 2:16 PM To: Shay Drummond Cc: Cox, Robert F.; Charles, Matt Subject: RE: labs Shay, CDC has said they would like any isolates of Legionella from the outbreak so if you could advise either LabCorp or Iowa, if they both are doing sputums and culture, to send them to the Springfield lab. We just want isolates, not urine antigens to come in. So they can go to Bob Cox at the Springfield lab. Bob, any other details of where you want them to go. Also filling out the IDPH lab submission form. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Shay Drummond" To: Austin Connie CC: "Cox, Robert F." "Charles, Matt" Date: 8/26/2015 1:17:54 PM Subject: RE: labs Thank you and could you send me the exact address: Want to eliminate any confusion on this end. I will forward the submission form as well. Connie, I am having a conference call at 2:30 with Blessing – I would like any “next steps” from IDPH if you have any you can share. Also at what point do we need to have another conference call similar to the one we did with all entities including IVH? From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 2:16 PM To: Shay Drummond Cc: Cox, Robert F.; Charles, Matt Subject: RE: labs Shay, CDC has said they would like any isolates of Legionella from the outbreak so if you could advise either LabCorp or Iowa, if they both are doing sputums and culture, to send them to the Springfield lab. We just want isolates, not urine antigens to come in. So they can go to Bob Cox at the Springfield lab. Bob, any other details of where you want them to go. Also filling out the IDPH lab submission form. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinoiSJzov From: "Shay Drummond" To: HOUSTON CATHY CC: Date: 8/26/2015 12:20:54 PM Subject: RE: Legionella Tracking Log.xlsx This is great, thanks so much! From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Wednesday, August 26, 2015 1:15 PM To: Shay Drummond Subject: Legionella Tracking Log.xlsx From: "Shay Drummond" To: HOUSTON CATHY CC: "VACA, BRUCE" Date: 8/26/2015 12:37:07 PM Subject: RE: Legionella Tracking Log.xlsx Cathy, Yes, once I get the swabs back we will deliver and review the next steps. I am waiting for lab results – and that is going to guide the next few steps. If we were to get back several + for Legionella we can start more EH steps to remediate. IVH is sending their staff to take additional samples this afternoon based on Dave’s thoughts. It was very good that he brought that up as that is a more plausible explanation to the various buildings being affected. Talk to you both very soon, Thanks, Shay From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Wednesday, August 26, 2015 1:25 PM To: Shay Drummond Cc: VACA, BRUCE Subject: RE: Legionella Tracking Log.xlsx You will let me know then which ones of these you want urines and NP/OP swabs? When do you want us to collect them? We were only able to get the urine on to send with your staff to Springfield. She said she would bring us back the appropriate swabs upon her return. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 1:21 PM To: HOUSTON, CATHY Subject: RE: Legionella Tracking Log.xlsx This is great, thanks so much! From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Wednesday, August 26, 2015 1:15 PM To: Shay Drummond Subject: Legionella Tracking Log.x sx From: "Shay Drummond" To: Austin Connie CC: Date: 8/26/2015 12:21:51 PM Subject: RE: Media Good, and I would like to know before they do a press release at that level so we can be ready to roll so anything that they can send my way would be helpful! From: A ustin, Connie [mailto:Connie.A ustin@Illinois.gov] Sent: Wednesday, A ugust 26, 2015 1:20 PM To: Shay Drummond; Morgan, Jodi; Conover, Craig Subject: RE: Media Let me check. I just sent the talking points to our PIO and have not heard back if they look ok. I think they are preparing a press release with Veterans Affairs but not sure of a proposed release date, have asked will get back to you. It would be much easier to answer questions with a few more lab results ⅛ ! Thanks for checking on that. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, A ugust 26, 2015 1:15 PM To: A ustin, Connie; Morgan, Jodi; Conover, Craig Subject: Media Hi did IDPH get draft guidance for media/talking points out to anyone yet? My sense is that this will break soon and I want to be prepared with Blessing and IVH to make a united statement on the local level that mirrors the IDPH messaging. Lab results still not back,,,they are supposed to be calling me soon. Thanks, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Austin Connie "Robert F." "Kate D." Jodi Justin Fred Ken Whitney CC: "Jon Campos" Date: 8/26/2015 6:28:29 PM Subject: RE: Outbreak number Great, thanks! I shared out the CDC/IDPH guidance with Bruce Vaca and David Clifford at IVH and Justin DeWitt did a great job explaining various approaches to the EH side. Our EH staff is ready to assist IVH in implementing. IVH is contacting Hummel Springs their back up water supply for emergencies tonight and starting the plan implementation. I am patiently ( not) awaiting the lab results due. Thanks, Shay From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 7:22 PM To: Cox, Robert F.; Kelly-Shannon, Kate D.; Morgan, Jodi; Albertson, Justin; Echols, Fred; McCann, Ken; Clegg, Whitney Cc: Shay Drummond; Jon Campos Subject: Outbreak number I quickly entered the very basic information in our ORS system on this outbreak. The lab needed an outbreak number so please feel free to use this for discussions/lab submission purposes as needed. IL2015-0427 Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Shay Drummond" To: Austin Connie CC: Date: 8/26/2015 6:29:47 PM Subject: RE: Outbreak number Connie, Following up with the labs: CDC had wanted Blessing to hold blood samples and Dr. Merrick had inquired as to whole, plasma etc. Did we get a response on that? Thanks, Shay From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 7:22 PM To: Cox, Robert F.; Kelly-Shannon, Kate D.; Morgan, Jodi; Albertson, Justin; Echols, Fred; McCann, Ken; Clegg, Whitney Cc: Shay Drummond; Jon Campos Subject: Outbreak number I quickly entered the very basic information in our ORS system on this outbreak. The lab needed an outbreak number so please feel free to use this for discussions/lab submission purposes as needed. IL2015-0427 Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Shay Drummond" To: Austin Connie CC: Date: 8/26/2015 6:32:08 PM Subject: Re: Outbreak number Lab Corps Good point on FOIA! Sent from my iPhone On Aug 26, 2015, at 7:30 PM, Austin, Connie wrote: Yes, we shall see. On pins and needles, is it Memorial results that will be back or LabCorp. I was also going to mention to you to document carefully everything. Our previous experience with Legionella indicates that many people will FOI information from these outbreaks. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 7:28 PM To: Austin, Connie; Cox, Robert F.; Kelly-Shannon, Kate D.; Morgan, Jodi; Albertson, Justin; Echols, Fred; McCann, Ken; Clegg, Whitney Cc: Jon Campos Subject: RE: Outbreak number Great, thanks! I shared out the CDC/IDPH guidance with Bruce Vaca and David Clifford at IVH and Justin DeWitt did a great job explaining various approaches to the EH side. Our EH staff is ready to assist IVH in implementing. IVH is contacting Hummel Springs their back up water supply for emergencies tonight and starting the plan implementation. I am patiently ( not) awaiting the lab results due. Thanks, Shay From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 7:22 PM To: Cox, Robert F.; Kelly-Shannon, Kate D.; Morgan, Jodi; Albertson, Justin; Echols, Fred; McCann, Ken; Clegg, Whitney Cc: Shay Drummond; Jon Campos Subject: Outbreak number I quickly entered the very basic information in our ORS system on this outbreak. The lab needed an outbreak number so please feel free to use this for discussions/lab submission purposes as needed. IL2015-0427 Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Shay Drummond" To: Austin Connie CC: Date: 8/26/2015 6:54:08 PM Subject: RE: Outbreak number Okay, I am hoping to get a call in about 10 minutes…I could use some chocolate right now! From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 7:53 PM To: Shay Drummond Subject: RE: Outbreak number We found out the Memorial specimens will be run tomorrow. Don’t forget to let us know about LabCorp we are very anxious as well. I have eaten quite a bit of chocolate. From: "Shay Drummond" To: Austin Connie CC: Date: 8/26/2015 7:33:43 AM Subject: RE: Pateints in house Thanks! Labs are getting collected. Do you have a contact at CDC that Dr. Merrick (Blessing Hospital Epi/QI) can speak to? See his message to me Do you have a contact with CDC who I may speak with regarding the level of their suspicion regarding other possible causative agents? We are not currently isolating these patients and want to make sure that we are not putting our staff at risk. Also they are getting all of the labs collected this am for us to bring over. Thanks, Shay From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 8:22 AM To: Shay Drummond; Morgan, Jodi; Conover, Craig Cc: Jon Campos Subject: RE: Pateints in house We are working on the talking points. CDC has asked that any blood be saved in case H. flu is positive by PCR on OP/NP. At 9 am can you check with the hospital about whether they will be able to get those OP/NP this morning so we can ship to CDC today? Any additional sputums collected? Thanks for all your work. Attached a power point that uses the data you sent yesterday afternoon. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 8:07 AM To: Austin, Connie; Morgan, Jodi; Conover, Craig Cc: Jon Campos Subject: FW: Pateints in house Good morning, This is the current Blessing census and location at Blessing. Currently: 2N-2 2S-2 ICU 33S (IMC) 5 3N 6 CPAP, BIPAP, BIPAP removed at 3:24, O2 at 4L Overnight there was 1 employee in ER that was discharged, tests are pending and one admit, I IVH patient with Dx of pneumonia, dehydration, elevated troponin, blood cultures collected, discharged back to IVH (comfort care), not tested for Legionella No test results back as of 5:50 am My question: do we want a legionella test and NP/OP done on the patient that was sent back for comfort care? I am guessing that he is a DNR. I will send over room/building maps as soon as I receive them. I have a conference call at 0900 with Blessing Hospital. Has there been any media messaging from IDPH that is ready for us to have in case we need it – I am sensing that today there may be requests. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: DeWitt Justin CC: Date: 8/26/2015 1:31:20 PM Subject: RE: Quincy facility He is on his way, thanks, we did just get two labs back as positive – FYI….. From: DeWitt, Justin [mailto:Justin.Dewitt@Illinois.gov] Sent: Wednesday, August 26, 2015 2:31 PM To: Shay Drummond Cc: McCann, Ken Subject: Re: Quincy facility Shay can Tony come now to meet us? Justin DeWitt, P.E., LEED AP Chief of General Engineering Division of Environmental Health justin.dewitt@illinois.gov Illinois Department of Public Health 525 West Jefferson Street Springfield, Illinois 62761 (217)782-5830, Fax (217)785-5897 Visit our website at: http://www.idph.state.il.us/envhealth/ehhome.htm CONFIDENTIALITY NOTE: This e-mail and any attachments are confidential and may be protected by legal privilege. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of this e-mail or any attachment is prohibited. If you have received this e-mail in error, please notify me immediately and delete this copy from your system. Thank you for your cooperation. On Aug 25, 2015, at 4:21 PM, Shay Drummond wrote: Thank you Ken, we will review and convey to IVHQ. From: McCann, Ken [mailto:Ken.McCann@Illinois.gov] Sent: Tuesday, August 25, 2015 4:20 PM To: Shay Drummond; Jon Campos; Jerrod Welch Cc: Culp, David; Conover, Craig; Austin, Connie; Morgan, Jodi; Mitchell, Joe; DeWitt, Justin; Martin, Aaron; Bell, Scott S. Subject: Quincy facility Jerrod/Shay – below are recommendations from us for your review and forwarding the facility. We recognize that these don’t answer all the questions and additional conversations will be necessary. We thought this would be a good start and we’ll see how things develop in the coming days. Let us know of thoughts/concerns. We’ll assume you will take care of communicating with the facility unless you tell us otherwise. Thanks ken +++++++++++++++++ The following recommendations are based upon 2 currently confirmed cases which were the focus of the environmental investigation at the facility Monday, August 24. These recommendations may change with additional epidemiologic information on current or additional cases. Additional environmental samples will be necessary if additional cases are confirmed. Consideration should be given to retaining the services of an environmental consultant with experience and expertise regarding legionella investigation and mitigation to assist with additional investigation and possible mitigation efforts. Elmore Infirmary · Tub rooms located in Elmore East and Elmore West: o Replace tub spray heads with point-of-use filtration heads capable of filtering legionella bacteria. o Contact the Apollo tub manufacturer to discuss possible methods to increase levels of sanitization of the tubs. The manufacturer should be able to recommend additional sanitization methods that won’t adversely affect the tubs. Tubs should be sanitized prior to use. o Documentation of tub sanitization should maintained. o Tubs can be used once these steps are completed and documented. · Routine maintenance of the water system should include monitoring residual chlorine levels and temperatures in representative end-use plumbing fixtures. All monitoring should be adequately documented. · We recommend the implementation of a water system management plan consistent with the American Society of Heating, Refrigeration and AirConditioning Engineer’s (ASHRAE) Standard 188. A draft version for public comment is attached. However, a read only version of the final standard is available from: https://www.ashrae.org/standards-research--technology/standards--guidelines/other-ashrae-standards-referenced-in-code. Elements of such a plan would include water quality monitoring at site specific intervals as well as contingency plans for responding to positive test results. A plan should also include a system flushing program to ensure all plumbing fixtures in the Elmore Infirmary are flushed on a regular basis to eliminate potential stagnant potable water in the plumbing system. Other Recommendations · Drain and discontinue use of outdoor fountains. Ken McCann, MA, LEHP Chief, Division of Environmental Health Illinois Department of Public Health 525 West Jefferson Str. Springfield, Il 62761 phone: 217-785-2043 fax: 217-785-0253 Ken.McCann@illinois.gov IMPORTANT: This e-mail, including all attachments, constitute State Government records and property that is intended only for the use of the individual or entity to w hich it is addressed. It also may contain information that is privileged, confidential, or otherw ise protected from disclosure under applicable law . If the reader of this transmission is not the intended recipient or the employee or agent responsible for delivering the transmission to the intended recipient, you are hereby notified that any dissemination, distribution, copying or use of this e-mail or its contents is strictly prohibited. If you have received this in error, please notify the sender. From: "Shay Drummond" To: DeWitt Justin CC: Date: 8/26/2015 1:34:11 PM Subject: RE: Quincy facility Yes – Please. From: DeWitt, Justin [mailto:Justin.Dewitt@Illinois.gov] Sent: Wednesday, August 26, 2015 2:34 PM To: Shay Drummond Subject: Re: Quincy facility Thanks we might expect the others to follow suit. I expect an exit meeting today w DVA on next steps. Will you want a heads up on that? Justin DeWitt, P.E., LEED AP Chief of General Engineering Division of Environmental Health justin.dewitt@illinois.gov Illinois Department of Public Health 525 West Jefferson Street Springfield, Illinois 62761 (217)782-5830, Fax (217)785-5897 Visit our website at: http://www.idph.state.il.us/envhealth/ehhome.htm CONFIDENTIALITY NOTE: This e-mail and any attachments are confidential and may be protected by legal privilege. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of this e-mail or any attachment is prohibited. If you have received this e-mail in error, please notify me immediately and delete this copy from your system. Thank you for your cooperation. On Aug 26, 2015, at 2:31 PM, Shay Drummond wrote: He is on his way, thanks, we did just get two labs back as positive – FYI….. From: DeWitt, Justin [mailto:Justin.Dewitt@Illinois.gov] Sent: Wednesday, August 26, 2015 2:31 PM To: Shay Drummond Cc: McCann, Ken Subject: Re: Quincy facility Shay can Tony come now to meet us? Justin DeWitt, P.E., LEED AP Chief of General Engineering Division of Environmental Health justin.dewitt@illinois.gov Illinois Department of Public Health 525 West Jefferson Street Springfield, Illinois 62761 (217)782-5830, Fax (217)785-5897 Visit our website at: http://www.idph.state.il.us/envhealth/ehhome.htm CONFIDENTIALITY NOTE: This e-mail and any attachments are confidential and may be protected by legal privilege. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of this e-mail or any attachment is prohibited. If you have received this e-mail in error, please notify me immediately and delete this copy from your system. Thank you for your cooperation. On Aug 25, 2015, at 4:21 PM, Shay Drummond wrote: Thank you Ken, we will review and convey to IVHQ. From: McCann, Ken [mailto:Ken.McCann@Illinois.gov] Sent: Tuesday, August 25, 2015 4:20 PM To: Shay Drummond; Jon Campos; Jerrod Welch Cc: Culp, David; Conover, Craig; Austin, Connie; Morgan, Jodi; Mitchell, Joe; DeWitt, Justin; Martin, Aaron; Bell, Scott S. Subject: Quincy facility Jerrod/Shay – below are recommendations from us for your review and forwarding the facility. We recognize that these don’t answer all the questions and additional conversations will be necessary. We thought this would be a good start and we’ll see how things develop in the coming days. Let us know of thoughts/concerns. We’ll assume you will take care of communicating with the facility unless you tell us otherwise. Thanks ken +++++++++++++++++ The following recommendations are based upon 2 currently confirmed cases which were the focus of the environmental investigation at the facility Monday, August 24. These recommendations may change with additional epidemiologic information on current or additional cases. Additional environmental samples will be necessary if additional cases are confirmed. Consideration should be given to retaining the services of an environmental consultant with experience and expertise regarding legionella investigation and mitigation to assist with additional investigation and possible mitigation efforts. Elmore Infirmary · Tub rooms located in Elmore East and Elmore West: o Replace tub spray heads with point-of-use filtration heads capable of filtering legionella bacteria. o Contact the Apollo tub manufacturer to discuss possible methods to increase levels of sanitization of the tubs. The manufacturer should be able to recommend additional sanitization methods that won’t adversely affect the tubs. Tubs should be sanitized prior to use. o Documentation of tub sanitization should maintained. o Tubs can be used once these steps are completed and documented. · Routine maintenance of the water system should include monitoring residual chlorine levels and temperatures in representative end-use plumbing fixtures. All monitoring should be adequately documented. · We recommend the implementation of a water system management plan consistent with the American Society of Heating, Refrigeration and AirConditioning Engineer’s (ASHRAE) Standard 188. A draft version for public comment is attached. However, a read only version of the final standard is available from: https://www.ashrae.org/standards-research--technology/standards--guidelines/other-ashrae-standards-referenced-in-code. Elements of such a plan would include water quality monitoring at site specific intervals as well as contingency plans for responding to positive test results. A plan should also include a system flushing program to ensure all plumbing fixtures in the Elmore Infirmary are flushed on a regular basis to eliminate potential stagnant potable water in the plumbing system. Other Recommendations · Drain and discontinue use of outdoor fountains. Ken McCann, MA, LEHP Chief, Division of Environmental Health Illinois Department of Public Health 525 West Jefferson Str. Springfield, Il 62761 phone: 217-785-2043 fax: 217-785-0253 Ken.McCann@illinois.gov IMPORTANT: This e-mail, including all attachments, constitute State Government records and property that is intended only for the use of the individual or entity to w hich it is addressed. It also may contain information that is privileged, confidential, or otherw ise protected from disclosure under applicable law . If the reader of this transmission is not the intended recipient or the employee or agent responsible for delivering the transmission to the intended recipient, you are hereby notified that any dissemination, distribution, copying or use of this e-mail or its contents is strictly prohibited. If you have received this in error, please notify the sender. From: "Shay Drummond" To: Austin Connie "Bernard T." CC: eric.dix@blessinghealthsystem.org "Cox, Robert F." Date: 8/26/2015 9:05:39 AM Subject: RE: Respiratory illness at large Veterans home in Illinois Connie we are looking at the CDC guidance and Eric had specific questions on cell cultures in medium vs. sending swabs. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 10:04 AM To: Shay Drummond; Johnson, Bernard T. Cc: eric.dix@blessinghealthsystem.org; Cox, Robert F. Subject: RE: Respiratory illness at large Veterans home in Illinois Bob, Do you think you can assist, I can send you the respiratory specimen collection guidelines from CDC. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, August 26, 2015 10:02 AM To: Johnson, Bernard T. Cc: eric.dix@blessinghealthsystem.org; Austin, Connie Subject: FW: Respiratory illness at large Veterans home in Illinois Importance: High Hi, I gave Eric Dix you contact info: He is collecting specimens and needs guidance on below:: A variety of specimens are suitable and include nasopharyngeal (NP) swab, oropharyngeal (OP) swab, NP aspirate, NP wash, OP wash, bronchoalveolar lavage, tracheal aspirate, sputum, serum, blood, urine, stool, conjunctival swab, viral isolate, and cerebral spinal fluid. Multiple respiratory specimen types of ample volume are preferred. NP and OP swabs collected from the same patient can be placed together in a single vial. Swab specimens should be collected using only swabs with a synthetic tip (e.g., polyester, Dacron®) and an aluminum or plastic shaft. Swabs with cotton tips and wooden shafts are not recommended. Specimens collected with swabs made of calcium alginate are not acceptable. Cell culture medium from a virus isolate can be sent in a screw-cap vial. From: Johnson, Bernard T. [mailto:Bernard.Johnson@Illinois.gov] Sent: Tuesday, August 25, 2015 3:10 PM To: Austin, Connie; Shay Drummond; Jon Campos Cc: Morgan, Jodi; Conover, Craig; Kelly-Shannon, Kate D.; Holmes, Tal Subject: RE: Respiratory illness at large Veterans home in Illinois Connie: They can fill out the standard Communicable Disease form information completely. If they have someone available by phone for follow up questions if the CD form is not complete it would be helpful. Tom Bernard (Tom) Johnson Chief, Division of Laboratories Illinois Department of Public Health 825 N. Rutledge St. Springfield, IL 62702 Phone: 217-782-6562 Cell: 309-222-1312 Fax: 217-524-7924 Email: Bernard.Johnson@Illinois.gov From: Austin, Connie Sent: Tuesday, August 25, 2015 2:59 PM To: Shay Drummond; Jon Campos Cc: Morgan, Jodi; Conover, Craig; Johnson, Bernard T.; Kelly-Shannon, Kate D.; Holmes, Tal Subject: FW: Respiratory illness at large Veterans home in Illinois Shay/Jon, Had a conversation and some email with CDC about the respiratory panel. There is a viral respiratory group and a bacterial so they would work together to get the testing done. My suggestion is that specimens be collected on hospitalized patients that the physicians think would be the best candidates. if specimens as listed in the email below can be collected, if they could be transported (hopefully by car for rapid transit) to the IDPH lab in Springfield for shipping to CDC that works the best because they are very particular about shipping requirements/forms. CDC requests that specimens arrive prior to the weekend, not to arrive on the weekend. Tom, What form would they be able to fill out that will give you enough information to do the DASH form? Or do you want them to attempt the DASH form? From CDC… We prefer to have an NP/OP collected on each patient. For those with pneumonia or lower resp findings please also collect a lower resp specimen. The link to the instructions is attached. If you have previously collected stored specimens we could test those as long as they have been refrigerated. Keep the specimens refrigerated. If you cannot send until next week you will need to freeze the specimens that were collected 72hrs earlier. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "WINNICKI, LENARD F." To: HOUSTON CATHY "Erica L" GWEN Ryan Trish "Jaimee M." CC: "VACA, BRUCE" "Shay Drummond" Date: 8/26/2015 2:45:39 PM Subject: RE: PRESS RELEASE--IMPORTANT Set up for 4:30 on Main Line: Main: 1-888-494-4032 Pass code: 8878280078# From: HOUSTON, CATHY Sent: Wednesday, August 26, 2015 3:30 PM To: Jeffries, Erica L; DIEHL, GWEN; Yantis, Ryan; WINNICKI, LENARD F. Cc: VACA, BRUCE; HOUSTON, CATHY; Shay Drummond Subject: PRESS RELEASE--IMPORTANT Importance: High Shay Drummond has just informed me that one of the residents in the hospital does now in fact have a positive Sputum Culture for Legionella. This was a different resident than the 2 confirmed cases. There are several urine tests that should be back by 8 PM tonight and to be quite honest they are expecting them to come back positive. IF these do in fact come back positive, Shay has spoken with Blessing Hospital who would like to have a united Press Release from IVH, ACHD and Blessing Hospital. Len, Are You able to set up a 4:30 conference call in which we can all be on this. I cc’d Shay on this email so it you will please include her for the meeting, she will forward on to the other people at ACHD and Blessing Hospital to be on the call also. Thanks. Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12 th Street Quincy, IL 62301 217-222-8641 Extension 358 CATHY.S.HOUSTON@illinois.gov From: "Yantis, Ryan" To: "steve.felde@blessinghealthsystem.org;Shay Drummond" Melaney "CATHY S ;;Arnold>" "Erica L" "LENARD F" "BRUCE L" "GWEN G" "Divya Mohan" CC: "McGill, Patricia O" "Ray, Jaimee M" "SAWYER, HARRY H" Date: 8/26/2015 4:34:27 PM Subject: Draft Press Release/Statement on Veterans Home Respirsitory Situation Attachments: DRAFT 2015-08 -26 5pm Vets Home Medical Situation.docx Ladies and Gents Attached please find the draft working release/RTQ for the situation at Illinois Veterans' Home - Quincy. It is a collaborative effort of IDVA, IDPH and the Home, with information gleaned from previous calls and emails. The Overall Messages/Themes discussed on the conference call this evening: ​- (There is very low/low risk to the general public, unless they visited the Home during a period of exposure. However, this respiratory illness generally affects those with weaker immune systems - the young, old, those with suppressed immune systems, etc.) - There is a strong team approach to this situation and we are harnessing the talents and capabilities of the Home, Adams County Dept of Health, Blessing Hospital, IDPH, IDVA and others as needed. - We are working well together to identify any possible source of this illness on the Home campus; this is an ongoing effort. - There have been no known/reported fatalities associated with this illness; those identified have responded well to treatment. - There is no cause for alarm; this is a manageable situation and we are focusing talents, efforts, and appropriate resources to meet the needs. Next Steps: - Conf Call on Thurs, Aug 27 at 8 a.m. (0800) to review lab results and discuss release. - Finalize release based on Lab results and new patient info/Home info - Agree to time for release; prep any press event. - Notify Gov's Press Office - Pre-position release information with select elected officials (?) - Plan post-release Conf Call to review any outstanding issues. - Consider additional information-sharing conf. calls for next few days. Early Triggers - We need agreement after a trigger to push the release - A media query asking specific questions about the current medical situation (legionella, Legionnaire's Disease, citing high traffic to Blessing, etc.) - (A death related to Legionnaire's Disease, at Blessing or the Home)[ I realize this was not discussed, but may really be a game-changer as far as outreach] Thanks Ryan Ryan Yantis Communication Manager, IDVA 312-814-0778 (desk) 312-520-6958 (cell) ryan.yantis@illinois.gov From: "Yantis, Ryan" To: "Shay Drummond" "CATHY S" "BRUCE L" "LENARD F" CC: Date: 8/26/2015 7:56:25 PM Subject: Re: Draft Press Release/Statement on Veterans Home RespirsitorySituation ​Yes; I confirmed that with Cathy this evening during our conference call at 8:30. From: Shay Drummond Sent: Wednesday, August 26, 2015 8:26 PM To: Yantis, Ryan Subject: RE: Draft Press Release/Statement on Veterans Home Respirsitory Situation Ryan, The person from IVHQ who is quoted was Cathy Houston DON. Thanks! From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Wednesday, August 26, 2015 5:34 PM To: steve.felde@blessinghealthsystem.org; Shay Drummond; Arnold, Melaney; HOUSTON, CATHY S; elliot.kuida@blessinghealthsystem.org; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; VACA, BRUCE L; DIEHL, GWEN G; Little, Divya Mohan Cc: McGill, Patricia O; Ray, Jaimee M; SAWYER, HARRY H Subject: Draft Press Release/Statement on Veterans Home Respirsitory Situation Ladies and Gents Attached please find the draft working release/RTQ for the situation at Illinois Veterans' Home - Quincy. It is a collaborative effort of IDVA, IDPH and the Home, with information gleaned from previous calls and emails. The Overall Messages/Themes discussed on the conference call this evening: ​- (There is very low/low risk to the general public, unless they visited the Home during a period of exposure. However, this respiratory illness generally affects those with weaker immune systems - the young, old, those with suppressed immune systems, etc.) - There is a strong team approach to this situation and we are harnessing the talents and capabilities of the Home, Adams County Dept of Health, Blessing Hospital, IDPH, IDVA and others as needed. - We are working well together to identify any possible source of this illness on the Home campus; this is an ongoing effort. - There have been no known/reported fatalities associated with this illness; those identified have responded well to treatment. - There is no cause for alarm; this is a manageable situation and we are focusing talents, efforts, and appropriate resources to meet the needs. Next Steps: - Conf Call on Thurs, Aug 27 at 8 a.m. (0800) to review lab results and discuss release. - Finalize release based on Lab results and new patient info/Home info - Agree to time for release; prep any press event. - Notify Gov's Press Office - Pre-position release information with select elected officials (?) - Plan post-release Conf Call to review any outstanding issues. - Consider additional information-sharing conf. calls for next few days. Early Triggers - We need agreement after a trigger to push the release - A media query asking specific questions about the current medical situation (legionella, Legionnaire's Disease, citing high traffic to Blessing, etc.) - (A death related to Legionnaire's Disease, at Blessing or the Home)[ I realize this was not discussed, but may really be a game-changer as far as outreach] Thanks Ryan Ryan Yantis Communication Manager, IDVA 312-814-0778 (desk) 312-520-6958 (cell) ryan.yantis@illinois.gov From: "Yantis, Ryan" To: HOUSTON "CATHY S" "Erica L" "GWEN G" "Ryan X" "LENARD F" CC: "VACA, BRUCE L" "Shay Drummond" "Arnold, Melaney" Date: 8/26/2015 2:42:53 PM Subject: Re: PRESS RELEASE--IMPORTANT ​Standing By for the call. From: HOUSTON, CATHY Sent: Wednesday, August 26, 2015 3:30 PM To: Jeffries, Erica L; DIEHL, GWEN G; Yantis, Ryan X; WINNICKI, LENARD F Cc: VACA, BRUCE L; HOUSTON, CATHY S; Shay Drummond Subject: PRESS RELEASE--IMPORTANT Shay Drummond has just informed me that one of the residents in the hospital does now in fact have a positive Sputum Culture for Legionella. This was a different resident than the 2 confirmed cases. There are several urine tests that should be back by 8 PM tonight and to be quite honest they are expecting them to come back positive. IF these do in fact come back positive, Shay has spoken with Blessing Hospital who would like to have a united Press Release from IVH, ACHD and Blessing Hospital. Len, Are You able to set up a 4:30 conference call in which we can all be on this. I cc’d Shay on this email so it you will please include her for the meeting, she will forward on to the other people at ACHD and Blessing Hospital to be on the call also. Thanks. Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 From: "Arnold, Melaney" To: Yantis Ryan "Erica L ;Shay Drummond" Nirav CC: "Shay Drummond" "Shah, Nirav" "Clow, Bryan" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Neisen, Lisa \(PR\)" "Ray, Jaimee M" "McGill, Patricia O" "SAWYER, HARRY H" "DIEHL, GWEN G" "Walters, Lyndsey" "Beyer, Joseph" Date: 8/27/2015 12:03:23 PM Subject: RE: Final IVH-Quincy Respiratory Illness Release A t t a c h m e n t s : Legionella.docx Talking points/ Q&A attached. These are just some of the questions reporters may ask. Inf ormation in red, number of cases, will likely change. From: Yantis, Ryan Sent: Thursday, August 27, 2015 12:47 PM T o: Arnold, Melaney; Jeffries, Erica L; Shay Drummond; Shah, Nirav Cc: Shay Drummond; Shah, Nirav; C low, Bryan; WINNICKI, LENA RD F; HOUSTO N, CA THY S; Neisen, Lisa (PR); Ray , Jaimee M; McGill, Patricia O; SAWYER, HA RRY H; DIEHL, GWEN G; Walters, Lyndsey; Beyer, Joseph Subject: Final IV H-Quincy Respiratory Illness Release All Thanks to all for prompt responses, inputs, and assistance on this release, attached. Please rel ease internally to Bl essi ng Hospital staff, local elected officials, and Home staff who need to know. ​Let them know the rel ease is going to the media. I will send this to CMS for state-wide distribution, all media at 1:30 p.m. today. Shay, please share with your local media at that time. I'd ask that the PIOs share media calls and interest in short emails, for awareness. If there is a media referral to another agency/facility, emails are always appreciated. Thanks Ryan From: "Arnold, Melaney" To: Yantis Ryan Nirav "Erica L" "LENARD F" "CATHY S ;Shay Drummond" CC: Date: 8/27/2015 9:12:09 AM Subject: RE: Updated Release DRAFT Not all 8 cases are still at the hospital. 4 are back at the home – and that doesn’t mean all 4 are recovering. From: Yantis, Ryan Sent: Thursday, August 27, 2015 10:11 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: Re: Updated Release DRAFT - All With thanks and compliments. I've added one line I feel is critical to the lede: "There have been no known deaths related to this outbreak​." I also added the PIO contact, as discussed on the conf. call. Notable, other than one mention in a quote, we are not addressing the residents at Blessing and still under their care. As written, it indicates all 8 are back on the IVH-Q campus. Guidance? From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:36 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT With Director Shah’s edits. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:31 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - Thanks. ​Standing by. From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:28 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I know Director Shah is somewhat tied up at the moment and has not yet reviewed a draft I sent, but I would like to share this with Vets so you get an idea of what we’re thinking. Ryan – I tried to keep the language similar so GO approval would be quicker. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:00 AM To: Shah, Nirav; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - ​Dir. Shah No worries on my end and why I sent to the group. If we re-order the paragraphs with the updated numbers, we should be able to staff quickly and release shortly. Standing by Ryan From: Shah, Nirav Sent: Thursday, August 27, 2015 8:57 AM To: Yantis, Ryan; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - Thank you, Ryan. We are reviewing this now. I’m concerned that we are burying the lede. Isn’t the main story what’s discussed in the fourth paragraph? Would you mind if we switched up the order a bit? We will take a stab at that and send something out very soon. Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Ryan Date: Thursday, August 27, 2015 at 8:48 AM To: "Jeffries, Erica L" , Nirav Shah , "Arnold, Melaney" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" Subject: Updated Release DRAFT - All Apologies, but to ensure and synchronize, I adjusted the text in the fourth graph to reflect numbers from this morning's conf. call: "Home staff have been monitoring two residents who tested positive for Legionella, a bacteria associated with Legionnaires’ disease, and both residents have responded to treatment. Six (6) other residents are currently at Blessing Hospital and have also tested positive for Legionella. Legionnaires’ disease is transmitted by aerosolized water, meaning that there is no known risk of person-to-person exchange. ​" Also, the lead graph remains or do we excise the "18" from that graph? Ryan From: "Arnold, Melaney" To: "Shay Drummond" Ryan Nirav "Erica L" "LENARD F" "CATHY S" CC: Date: 8/27/2015 9:26:27 AM Subject: RE: Updated Release DRAFT I’m still working on the talking point – along with some messaging. I hope to have these out relatively soon. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Thursday, August 27, 2015 10:26 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - That is a good point as one is on comfort measures. From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:12 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: RE: Updated Release DRAFT Not all 8 cases are still at the hospital. 4 are back at the home – and that doesn’t mean all 4 are recovering. From: Yantis, Ryan Sent: Thursday, August 27, 2015 10:11 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: Re: Updated Release DRAFT - All With thanks and compliments. I've added one line I feel is critical to the lede: "There have been no known deaths related to this outbreak​." I also added the PIO contact, as discussed on the conf. call. Notable, other than one mention in a quote, we are not addressing the residents at Blessing and still under their care. As written, it indicates all 8 are back on the IVH-Q campus. Guidance? From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:36 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT With Director Shah’s edits. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:31 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - Thanks. ​Standing by. From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:28 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I know Director Shah is somewhat tied up at the moment and has not yet reviewed a draft I sent, but I would like to share this with Vets so you get an idea of what we’re thinking. Ryan – I tried to keep the language similar so GO approval would be quicker. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:00 AM To: Shah, Nirav; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - ​Dir. Shah No worries on my end and why I sent to the group. If we re-order the paragraphs with the updated numbers, we should be able to staff quickly and release shortly. Standing by Ryan From: Shah, Nirav Sent: Thursday, August 27, 2015 8:57 AM To: Yantis, Ryan; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT Thank you, Ryan. We are reviewing this now. I’m concerned that we are burying the lede. Isn’t the main story what’s discussed in the fourth paragraph? Would you mind if we switched up the order a bit? We will take a stab at that and send something out very soon. Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Ryan Date: Thursday, August 27, 2015 at 8:48 AM To: "Jeffries, Erica L" , Nirav Shah , "Arnold, Melaney" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" Subject: Updated Release DRAFT - All - Apologies, but to ensure and synchronize, I adjusted the text in the fourth graph to reflect numbers from this morning's conf. call: "Home staff have been monitoring two residents who tested positive for Legionella, a bacteria associated with Legionnaires’ disease, and both residents have responded to treatment. Six (6) other residents are currently at Blessing Hospital and have also tested positive for Legionella. Legionnaires’ disease is transmitted by aerosolized water, meaning that there is no known risk of person-to-person exchange. ​" Also, the lead graph remains or do we excise the "18" from that graph? Ryan From: "Arnold, Melaney" To: Jeffries "Erica L" Ryan CC: "Shay Drummond" "Shah, Nirav" "Clow, Bryan" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Neisen, Lisa \(PR\)" "Ray, Jaimee M" "McGill, Patricia O" "SAWYER, HARRY H" "DIEHL, GWEN G" "Walters, Lyndsey" "Beyer, Joseph" Date: 8/27/2015 11:41:18 AM Subject: RE: Updated Release DRAFT 1028 IDPH is good to go with this. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Thursday, August 27, 2015 12:35 PM To: Yantis, Ryan Cc: Arnold, Melaney; Shay Drummond; Shah, Nirav; Clow, Bryan; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR); Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G; Walters, Lyndsey; Beyer, Joseph Subject: Re: Updated Release DRAFT 1028 I have no objections to that. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 12:29, Yantis, Ryan wrote: All - Revised with Illinois Veterans' Home ​- Quincy spelled out in the headline. 1:30 PM to send to media? Immediate release to Blessing and Elected Officials? Ryan From: Arnold, Melaney Sent: Thursday, August 27, 2015 12:13 PM To: Yantis, Ryan; Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: RE: Updated Release DRAFT 1028 Thanks. I would spell out Illinois Veterans Home-Quincy in the headline. From: Yantis, Ryan Sent: Thursday, August 27, 2015 12:12 PM To: Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: Re: Updated Release DRAFT 1028 ​Ladies and Gents - Apologies for the slight delay. Graphic arts are not in my natural skill set and resetting the banner took a bit. Please find attached what I consider the final on the Press Release announcing the Respiratory Illness at IVH-Q. If there's a better headline, I am all ears. Otherwise this is ready for release to Blessing for staff, and to elected officials, as discussed. Ryan From: Shay Drummond Sent: Thursday, August 27, 2015 10:39 AM To: Shah, Nirav; Yantis, Ryan Cc: Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: RE: Updated Release DRAFT 1028 Looks ready! Thanks for you work. From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Thursday, August 27, 2015 10:38 AM To: Yantis, Ryan Cc: Shay Drummond; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: Re: Updated Release DRAFT 1028 Looks excellent. Thank you, Ryan. -Nirav On Aug 27, 2015, at 10:34 AM, Yantis, Ryan wrote: ​All - Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: "Arnold, Melaney" To: "Shay Drummond" CC: Date: 8/27/2015 12:01:23 PM Subject: RE: Updated Release DRAFT 1028 I sent them to Vets affairs a while ago, but haven’t heard back. I’ll send them around to our group now. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Thursday, August 27, 2015 1:01 PM To: Arnold, Melaney Subject: RE: Updated Release DRAFT 1028 Hi there, How are the talking points coming along? Thank you ⅛ From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 12:41 PM To: Jeffries, Erica L; Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Clow, Bryan; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR); Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G; Walters, Lyndsey; Beyer, Joseph Subject: RE: Updated Release DRAFT 1028 IDPH is good to go with this. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Thursday, August 27, 2015 12:35 PM To: Yantis, Ryan Cc: Arnold, Melaney; Shay Drummond; Shah, Nirav; Clow, Bryan; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR); Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G; Walters, Lyndsey; Beyer, Joseph Subject: Re: Updated Release DRAFT 1028 I have no objections to that. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 12:29, Yantis, Ryan wrote: All - Revised with Illinois Veterans' Home ​- Quincy spelled out in the headline. 1:30 PM to send to media? Immediate release to Blessing and Elected Officials? Ryan From: Arnold, Melaney Sent: Thursday, August 27, 2015 12:13 PM To: Yantis, Ryan; Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: RE: Updated Release DRAFT 1028 Thanks. I would spell out Illinois Veterans Home-Quincy in the headline. From: Yantis, Ryan Sent: Thursday, August 27, 2015 12:12 PM To: Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: Re: Updated Release DRAFT 1028 ​Ladies and Gents - Apologies for the slight delay. Graphic arts are not in my natural skill set and resetting the banner took a bit. Please find attached what I consider the final on the Press Release announcing the Respiratory Illness at IVH-Q. If there's a better headline, I am all ears. Otherwise this is ready for release to Blessing for staff, and to elected officials, as discussed. Ryan From: Shay Drummond Sent: Thursday, August 27, 2015 10:39 AM To: Shah, Nirav; Yantis, Ryan Cc: Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: RE: Updated Release DRAFT 1028 Looks ready! Thanks for you work. From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Thursday, August 27, 2015 10:38 AM To: Yantis, Ryan Cc: Shay Drummond; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: Re: Updated Release DRAFT 1028 Looks excellent. Thank you, Ryan. -Nirav On Aug 27, 2015, at 10:34 AM, Yantis, Ryan wrote: ​All - Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: "Arnold, Melaney" To: Yantis "Ryan ;Shay Drummond" Nirav "Erica L" Bryan CC: "WINNICKI, LENARD F" "HOUSTON, CATHY S" Lisa.Neisen@blessinghealthsystem.org "Ray, Jaimee M" "McGill, Patricia O" "SAWYER, HARRY H" "DIEHL, GWEN G" Date: 8/27/2015 11:13:41 AM Subject: RE: Updated Release DRAFT 1028 Thanks. I would spell out Illinois Veterans Home-Quincy in the headline. From: Yantis, Ryan Sent: Thursday, August 27, 2015 12:12 PM To: Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: Re: Updated Release DRAFT 1028 ​Ladies and Gents Apologies for the slight delay. Graphic arts are not in my natural skill set and resetting the banner took a bit. Please find attached what I consider the final on the Press Release announcing the Respiratory Illness at IVH-Q. If there's a better headline, I am all ears. Otherwise this is ready for release to Blessing for staff, and to elected officials, as discussed. Ryan From: Shay Drummond Sent: Thursday, August 27, 2015 10:39 AM To: Shah, Nirav; Yantis, Ryan Cc: Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: RE: Updated Release DRAFT 1028 Looks ready! Thanks for you work. From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Thursday, August 27, 2015 10:38 AM To: Yantis, Ryan Cc: Shay Drummond; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: Re: Updated Release DRAFT 1028 Looks excellent. Thank you, Ryan. -Nirav On Aug 27, 2015, at 10:34 AM, Yantis, Ryan wrote: ​All Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: Shay Drummond Sent: Thursday, August 27, 2015 10:29 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - Thanks, I am sure as this hits the wire we are going to have our phones burning up! From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:26 AM To: Shay Drummond; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I’m still working on the talking point – along with some messaging. I hope to have these out relatively soon. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Thursday, August 27, 2015 10:26 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - That is a good point as one is on comfort measures. From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:12 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: RE: Updated Release DRAFT Not all 8 cases are still at the hospital. 4 are back at the home – and that doesn’t mean all 4 are recovering. From: Yantis, Ryan Sent: Thursday, August 27, 2015 10:11 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: Re: Updated Release DRAFT - All With thanks and compliments. I've added one line I feel is critical to the lede: "There have been no known deaths related to this outbreak​." I also added the PIO contact, as discussed on the conf. call. Notable, other than one mention in a quote, we are not addressing the residents at Blessing and still under their care. As written, it indicates all 8 are back on the IVH-Q campus. Guidance? From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:36 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT With Director Shah’s edits. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:31 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - Thanks. ​Standing by. From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:28 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I know Director Shah is somewhat tied up at the moment and has not yet reviewed a draft I sent, but I would like to share this with Vets so you get an idea of what we’re thinking. Ryan – I tried to keep the language similar so GO approval would be quicker. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:00 AM To: Shah, Nirav; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - ​Dir. Shah No worries on my end and why I sent to the group. If we re-order the paragraphs with the updated numbers, we should be able to staff quickly and release shortly. Standing by Ryan From: Shah, Nirav Sent: Thursday, August 27, 2015 8:57 AM To: Yantis, Ryan; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT Thank you, Ryan. We are reviewing this now. I’m concerned that we are burying the lede. Isn’t the main story what’s discussed in the fourth paragraph? Would you mind if we switched up the order a bit? We will take a stab at that and send something out very soon. Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Ryan Date: Thursday, August 27, 2015 at 8:48 AM To: "Jeffries, Erica L" , Nirav Shah , "Arnold, Melaney" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" Subject: Updated Release DRAFT - All Apologies, but to ensure and synchronize, I adjusted the text in the fourth graph to reflect numbers from this morning's conf. call: "Home staff have been monitoring two residents who tested positive for Legionella, a bacteria associated with Legionnaires’ disease, and both residents have responded to treatment. Six (6) other residents are currently at Blessing Hospital and have also tested positive for Legionella. Legionnaires’ disease is transmitted by aerosolized water, meaning that there is no known risk of person-to-person exchange. ​" Also, the lead graph remains or do we excise the "18" from that graph? Ryan <2015-08-27 Vets Affairs - Legionella COORDINATING as of 1028am.docx> From: "Athar, Masood" To: Arnold "Melaney ;Champaign - Doug Toole ;Chicago - David Hass ;Edwardsville - Amy Yeager" "Divya Mohan ;Marion - Stephanie Martin ;Peoria - RaeAnn Tucker ;Rockford - Ellen Genrich ;Springfield - Emily Andrews" CC: Date: 8/27/2015 1:42:39 PM Subject: Article Attachments: SocialMedia&PH-2013.pdf Good article, please forward as you deem appropriate. Stay safe and healthy, and keeps others too! Thanks MA From: "Austin, Connie" To: "Shay Drummond" "Jon Campos" CC: Date: 8/27/2015 3:20:41 PM Subject: FW: Legionella Attachments: Trip Report 2013-062 Franklin CoRetirement Community CLEARED.pdf Here is the Ohio/CDC report of their similar outbreak in 2013. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: "Shay Drummond" "Jon Campos" CC: Date: 8/27/2015 10:32:40 AM Subject: FW: Memorial Medical Hospital Contacts for Lab Results From: Johnson, Bernard T. Sent: Thursday, August 27, 2015 11:32 AM To: Austin, Connie Cc: Cox, Robert F.; Culp, David Subject: Memorial Medical Hospital Contacts for Lab Results Importance: High Connie: The urine specimens from Quincy that were delivered yesterday to our lab in Springfield were delivered to Memorial Medical Hospital lab for testing for Legionella pneumophila testing (urine antigen). They were tested but the hospital lab cannot release the results until approved by the Outreach Laboratory Account Manager, Roger Batten, phone number 217-588-2820. The lab supervisor at Memorial is Jerry Lawhorn, 217-788-3057. Tom Johnson Bernard (Tom) Johnson Chief, Division of Laboratories Illinois Department of Public Health 825 N. Rutledge St. Springfield, IL 62702 Phone: 217-782-6562 Cell: 309-222-1312 Fax: 217-524-7924 Email: Bernard.Johnson@Illinois.gov From: "Austin, Connie" To: "Jon Campos" "Shay Drummond" CC: Date: 8/27/2015 7:05:31 PM Subject: FYI Attachments: cdcs_Legionella_ppt_August272015.pptx Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: "Shay Drummond" "Jon Campos" CC: "Morgan, Jodi" Date: 8/27/2015 11:33:16 AM Subject: hospitalizations/discharges One piece of information they want to have available about cases is when they were discharged. They have a number of 4 discharged I think not sure if that is correct. For the current 8 cases do you know if they were discharged, I know was discharged. Also just a note, when in INEDSS don’t enter anything about death in the general illness UNLESS the patient died, it pops up an error message otherwise, Very annoying feature I think ! So every day I think we need Onset dates range from ##/##/## to ##/##/## # lab confirmed Legionella cases # still hospitalized or # discharged # fatalities Thanks for all your hard work. What did you find out about Memorial results and getting those? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: "Jon Campos" CC: Date: 8/27/2015 6:55:24 AM Subject: RE: Outbreak number You should be able to add it to the INEDSS records now in epi area. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Jon Campos [mailto:jcampos@co.adams.il.us] Sent: Thursday, August 27, 2015 7:53 AM To: Austin, Connie Subject: RE: Outbreak number Connie , I have already started an ORS report. I have not submitted it, as new ills are still being reported. Should I close it out? Thanks Jon Campos RN Communicable Disease Coordinator/LEAD Coordinator Adams County Health Dept. 330 Vermont Quincy, IL 62301 217-222-8440 Ext: 163 217-222-8460 (Fax) jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 7:22 PM To: Cox, Robert F.; Kelly-Shannon, Kate D.; Morgan, Jodi; Albertson, Justin; Echols, Fred; McCann, Ken; Clegg, Whitney Cc: Shay Drummond; Jon Campos Subject: Outbreak number I quickly entered the very basic information in our ORS system on this outbreak. The lab needed an outbreak number so please feel free to use this for discussions/lab submission purposes as needed. IL2015-0427 Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: "Jon Campos" CC: Date: 8/27/2015 6:54:12 AM Subject: RE: Outbreak number Oh rats, we just typically put in a place holder so we can get the outbreak number, the final numbers will always be different, can you delete yours and we’ll use the one I have below? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Jon Campos [mailto:jcampos@co.adams.il.us] Sent: Thursday, August 27, 2015 7:53 AM To: Austin, Connie Subject: RE: Outbreak number Connie , I have already started an ORS report. I have not submitted it, as new ills are still being reported. Should I close it out? Thanks Jon Campos RN Communicable Disease Coordinator/LEAD Coordinator Adams County Health Dept. 330 Vermont Quincy, IL 62301 217-222-8440 Ext: 163 217-222-8460 (Fax) jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 7:22 PM To: Cox, Robert F.; Kelly-Shannon, Kate D.; Morgan, Jodi; Albertson, Justin; Echols, Fred; McCann, Ken; Clegg, Whitney Cc: Shay Drummond; Jon Campos Subject: Outbreak number I quickly entered the very basic information in our ORS system on this outbreak. The lab needed an outbreak number so please feel free to use this for discussions/lab submission purposes as needed. IL2015-0427 Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Beyer, Joseph" To: Arnold Melaney CC: "Jeffries, Erica L" "Yantis, Ryan" "Shay Drummond" "Shah, Nirav" "Clow, Bryan" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Neisen, Lisa \(PR\)" "Ray, Jaimee M" "McGill, Patricia O" "SAWYER, HARRY H" "DIEHL, GWEN G" "Walters, Lyndsey" Date: 8/27/2015 11:42:28 AM Subject: Re: Updated Release DRAFT 1028 Gov office as well Sent from my iPhone On Aug 27, 2015, at 12:41 PM, Arnold, Melaney wrote: IDPH is good to go with this. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Thursday, August 27, 2015 12:35 PM To: Yantis, Ryan Cc: Arnold, Melaney; Shay Drummond; Shah, Nirav; Clow, Bryan; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR); Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G; Walters, Lyndsey; Beyer, Joseph Subject: Re: Updated Release DRAFT 1028 I have no objections to that. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 12:29, Yantis, Ryan wrote: All - Revised with Illinois Veterans' Home ​- Quincy spelled out in the headline. 1:30 PM to send to media? Immediate release to Blessing and Elected Officials? Ryan From: Arnold, Melaney Sent: Thursday, August 27, 2015 12:13 PM To: Yantis, Ryan; Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: RE: Updated Release DRAFT 1028 Thanks. I would spell out Illinois Veterans Home-Quincy in the headline. From: Yantis, Ryan Sent: Thursday, August 27, 2015 12:12 PM To: Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: Re: Updated Release DRAFT 1028 ​Ladies and Gents - Apologies for the slight delay. Graphic arts are not in my natural skill set and resetting the banner took a bit. Please find attached what I consider the final on the Press Release announcing the Respiratory Illness at IVH-Q. If there's a better headline, I am all ears. Otherwise this is ready for release to Blessing for staff, and to elected officials, as discussed. Ryan From: Shay Drummond Sent: Thursday, August 27, 2015 10:39 AM To: Shah, Nirav; Yantis, Ryan Cc: Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: RE: Updated Release DRAFT 1028 Looks ready! Thanks for you work. From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Thursday, August 27, 2015 10:38 AM To: Yantis, Ryan Cc: Shay Drummond; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: Re: Updated Release DRAFT 1028 Looks excellent. Thank you, Ryan. -Nirav On Aug 27, 2015, at 10:34 AM, Yantis, Ryan wrote: ​All - Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: "DeWitt, Justin" To: "Tony Dede" CC: "Shay Drummond" "McCann, Ken" "Martin, Aaron" Date: 8/27/2015 10:22:55 AM Subject: RE: Legionella EH Questions Tony, For the question of the dishwashers my response is that commercial and even residential dishwashers operate at high enough temperature and duration to neutralize legionella. I would not hold significant concern for any “spitting” that occurs. It would be good to confirm that IVHQ is using a heat sanitizing cycle on their dishwasher (>180F). Thanks, JD From: Tony Dede [mailto:tdede@co.adams.il.us] Sent: Thursday, August 27, 2015 10:30 AM To: DeWitt, Justin Cc: Shay Drummond Subject: RE: Legionella EH Questions Importance: High I’m going to add another question. The guidance document allows use of the dish machines. However, some of those machines have splatter that “spits” out the edges of the doors. Should this be a concern? Is there is difference between hot water sanitizing machines and chemical sanitizing machines if there is a concern? ~Tony Tony Dede, LEHP Chief Environmental Sanitarian Adams County Health Department 330 Vermont Street Quincy, IL 62301 217-222-8440, ext. 124 tdede@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended onlyfor the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: DeWitt, Justin [mailto:Justin.Dewitt@Illinois.gov] Sent: Thursday, August 27, 2015 10:11 AM To: Tony Dede Cc: Shay Drummond Subject: Re: Legionella EH Questions Give me a few minutes. Justin DeWitt, P.E., LEED AP Chief of General Engineering Division of Environmental Health justin.dewitt@illinois.gov Illinois Department of Public Health 525 West Jefferson Street Springfield, Illinois 62761 (217)782-5830, Fax (217)785-5897 Visit our website at: http://www.idph.state.il.us/envhealth/ehhome.htm CONFIDENTIALITY NOTE: This e-mail and any attachments are confidential and may be protected by legal privilege. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of this e-mail or any attachment is prohibited. If you have received this e-mail in error, please notify me immediately and delete this copy from your system. Thank you for your cooperation. On Aug 27, 2015, at 9:59 AM, Tony Dede wrote: Justin, We’ve been asked some questions that I would like your input on. 1. Can the ice machines be shut off, sanitized, and then used for storage of purchased ice? 2. Can the dish washers use the spray hose if the facet head is removed? 3. Any concerns with steam tables in food service? If so, what precautions are needed? Thanks, ~Tony If needed, you can call my cell at 217-430-7780. Tony Dede, LEHP Chief Environmental Sanitarian Adams County Health Department 330 Vermont Street Quincy, IL 62301 217-222-8440, ext. 124 tdede@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended onlyfor the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "DeWitt, Justin" To: "Tony Dede" CC: "Shay Drummond" Date: 8/27/2015 9:10:33 AM Subject: Re: Legionella EH Questions Give me a few minutes. Justin DeWitt, P.E., LEED AP Chief of General Engineering Division of Environmental Health justin.dewitt@illinois.gov Illinois Department of Public Health 525 West Jefferson Street Springfield, Illinois 62761 (217)782-5830, Fax (217)785-5897 Visit our website at: http://www.idph.state.il.us/envhealth/ehhome.htm CONFIDENTIALITY NOTE: This e-mail and any attachments are confidential and may be protected by legal privilege. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of this e-mail or any attachment is prohibited. If you have received this e-mail in error, please notify me immediately and delete this copy from your system. Thank you for your cooperation. On Aug 27, 2015, at 9:59 AM, Tony Dede wrote: Justin, We’ve been asked some questions that I would like your input on. 1. Can the ice machines be shut off, sanitized, and then used for storage of purchased ice? 2. Can the dish washers use the spray hose if the facet head is removed? 3. Any concerns with steam tables in food service? If so, what precautions are needed? Thanks, ~Tony If needed, you can call my cell at 217-430-7780. Tony Dede, LEHP Chief Environmental Sanitarian Adams County Health Department 330 Vermont Street Quincy, IL 62301 217-222-8440, ext. 124 tdede@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended onlyfor the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "DeWitt, Justin" To: "Tony Dede" CC: "Shay Drummond" "Lamb, Molly" "Welch, Patricia" "McCann, Ken" "Mitchell, Joe" "Martin, Aaron" Date: 8/27/2015 1:51:41 PM Subject: RE: Legionella EH Questions Tony, My responses 1. We would want to know how the ice machines will be sanitized before responding. My thought is for the near term they should figure out sanitizing and worry about storing ice later, they have temp storage in place now. 2. CDC indicated that removing the aerator was sufficient to reduce risk to the employee using a sprayer to rinse dishes. The effectiveness of the sprayer will be reduced significantly and splashing may still occur. I recommend the use of a properly fitting N95 or better mask for the employee spraying the dishes. IDPH FDD is calling you to discuss and get better resolution on this point. 3. IDPH FDD will respond on this point. EH believes emptying, sanitizing and filling with clean bulk water should alleviate any concerns, but defer to FDD. Thanks, JD From: Tony Dede [mailto:tdede@co.adams.il.us] Sent: Thursday, August 27, 2015 10:00 AM To: DeWitt, Justin Cc: Shay Drummond Subject: Legionella EH Questions Importance: High Justin, We’ve been asked some questions that I would like your input on. 1. Can the ice machines be shut off, sanitized, and then used for storage of purchased ice? 2. Can the dish washers use the spray hose if the facet head is removed? 3. Any concerns with steam tables in food service? If so, what precautions are needed? Thanks, ~Tony If needed, you can call my cell at 217-430-7780. Tony Dede, LEHP Chief Environmental Sanitarian Adams County Health Department 330 Vermont Street Quincy, IL 62301 217-222-8440, ext. 124 tdede@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended onlyfor the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Emily Andrews" To: Arnold Melaney CC: Date: 8/27/2015 6:44:25 AM Subject: RE: Vets Home Legionella Thanks so much! I will be on the call with Shay this morning! Thank you, Emily Andrews, MS Health Educator Adams County Health Department 330 Vermont Street Quincy, IL 62301 217.222.8440 ext. 121 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, August 26, 2015 5:24 PM To: Emily Andrews Subject: Vets Home Legionella Hi Emily ~ We just got off a call with Veterans’ Affairs, Blessing Hospital, IDPH and Adams Co. Health Dept. We are finalizing a news release and have plans to issue it tomorrow morning. I believe Shay was on the call and said the news release would go to her for review. I will also send you a copy and loop you in. Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: "HOUSTON, CATHY" To: WINNICKI "LENARD F. ;Shay Drummond" BRUCE CC: Date: 8/27/2015 9:55:38 AM Subject: Legionella Tracking Log.xlsx Attachments: Legionella Tracking Log.xlsx Sorry updated again with more info. From: "HOUSTON, CATHY" To: "Shay Drummond" CC: "VACA, BRUCE" Date: 8/27/2015 9:40:41 AM Subject: Legionella Tracking Log.xlsx Attachments: Legionella Tracking Log.xlsx UPDATED From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/27/2015 4:32:22 PM Subject: Legionella Tracking Log.xlsx Attachments: Legionella Tracking Log.xlsx Updated with new cases at IVHQ and admitted today to Blessing. We need to talk in am to see if you have any other testing that has completed. Thanks! From: "HOUSTON, CATHY" To: Jeffries "Erica L" Ryan CC: "WINNICKI, LENARD F." "Shay Drummond" "Arnold, Melaney" "SAWYER, HARRY" "DIEHL, GWEN" Date: 8/27/2015 2:30:51 PM Subject: RE: WGEM Interview Req. On IVH-Q Campus They want to interview for Television. Bruce and I don’t really care to do this. We would prefer one of you to call them and do maybe a telephone interview? Can one of you please call him? WGEM Travis 217-228-6655 From: Jeffries, Erica L Sent: Thursday, August 27, 2015 3:23 PM To: Yantis, Ryan Cc: HOUSTON, CATHY; WINNICKI, LENARD F.; Shay Drummond; Arnold, Melaney; SAWYER, HARRY; DIEHL, GWEN Subject: Re: WGEM Interview Req. On IVH-Q Campus Did they ask specifically for someone from the home. If so, we should be taking the call. Cathy, if you're not comfortable then Len or Bruce should take it - or I'm happy to do so, as well. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 15:08, Yantis, Ryan wrote: Cathy & Shay Travis from WGEM is requesting a recorded interview with someone from the Home about the situation at the Home. He's looking for general questions - which are likely in the Q&A I recently re-sent. They can come to the Home ASAP, just need to know where and when if you are all interested/willing. ​ 217-228-6655 thanks - I am happy to chat / prep whoever is going to do this. 312-520-6958 Ryan From: "Jeffries, Erica L" To: Yantis Ryan CC: "Arnold, Melaney" "Shay Drummond" "Shah, Nirav" "Clow, Bryan J" "WINNICKI, LENARD F." "HOUSTON, CATHY" "Neisen, Lisa \(PR\)" "Ray, Jaimee M." "McGill, Trish" "SAWYER, HARRY" "DIEHL, GWEN" "Walters, Lyndsey" "Beyer, Joseph" Date: 8/27/2015 1:51:02 PM Subject: Re: FYI - 1st Hour Media IVH-Quincy Respiratory Illness Release Thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 14:40, Yantis, Ryan wrote: Health officials say several cases of Legionnaires' disease confirmed in Illinois Veterans Home http://www.wgem.com/story/29895140/2015/08/27/health-officials-say-several-cases-of-legionnaires-disease-confirmed-in-illinois-veterans-home (truncated Press Release; no issues) Legionnaires’ disease outbreak at IL Vets Home http://quincyjournal.com/above-the-fold/2015/08/27/legionnaires%E2%80%99-disease-outbreak-at-il-vets-home/ (Press Release reprint; no issues) Eight Cases of Legionnaires’ Disease at Illinois Veterans’ Home http://khmoradio.com/eight-cases-of-legionnaires-disease-at-illinois-veterans-home/?trackback=tsmclip (Fair, Balanced, Accurate [FBA] – good factual report​) From: "Jeffries, Erica L" To: Neisen "Lisa \(PR\)" CC: "Yantis, Ryan" "Shay Drummond" "Arnold, Melaney" "Shah, Nirav" "WINNICKI, LENARD F." "HOUSTON, CATHY" "Kuida, Elliot" "Powell, Betsey" Date: 8/27/2015 10:28:22 AM Subject: Re: Updated Release DRAFT 1028 Thanks, everyone, for providing your inputs. I think this is ready to go. We will be standing by to respond to queries per our conversation this morning. Thank you! Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 11:16, Neisen, Lisa (PR) wrote: > Hi RyanWe have reviewed the release, and would like to request a change in the 4th paragraph- changing “Blessing Hospital” to “local healthcare providers.” This change makes the sentence more accurate. Please send final version once ready. Do you have an estimated time on distribution of the release? We would like to share the information internally with our Board, staff and physicians to make them aware, prior to the public release. Thank you, Lisa K. Neisen Director, Public Relations & Comm. Blessing Hospital, 1135 Broadway Quincy, IL 62305 (217) 223-8400, ext. 4190 Lisa.neisen@blessinghealthsystem.org From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Thursday, August 27, 2015 10:34 AM To: Shay Drummond; Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR) Subject: Re: Updated Release DRAFT 1028 ​All - Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: Shay Drummond Sent: Thursday, August 27, 2015 10:29 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - Thanks, I am sure as this hits the wire we are going to have our phones burning up! From: "Jeffries, Erica L" To: "Shay Drummond" CC: "Yantis, Ryan" Date: 8/27/2015 10:31:14 AM Subject: Re: Updated Release DRAFT 1028 Ryan will send a final version shortly. Thanks, Shay. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 11:29, Shay Drummond wrote: Are you sending out the final version to us? From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Thursday, August 27, 2015 11:28 AM To: Neisen, Lisa (PR) Cc: Yantis, Ryan; Shay Drummond; Arnold, Melaney; Shah, Nirav; WINNICKI, LENARD F.; HOUSTON, CATHY; Kuida, Elliot; Powell, Betsey Subject: Re: Updated Release DRAFT 1028 Thanks, everyone, for providing your inputs. I think this is ready to go. We will be standing by to respond to queries per our conversation this morning. Thank you! Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 11:16, Neisen, Lisa (PR) wrote: Hi RyanWe have reviewed the release, and would like to request a change in the 4th paragraph- changing “Blessing Hospital” to “local healthcare providers.” This change makes the sentence more accurate. Please send final version once ready. Do you have an estimated time on distribution of the release? We would like to share the information internally with our Board, staff and physicians to make them aware, prior to the public release. Thank you, Lisa K. Neisen Director, Public Relations & Comm. Blessing Hospital, 1135 Broadway Quincy, IL 62305 (217) 223-8400, ext. 4190 Lisa.neisen@blessinghealthsystem.org From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Thursday, August 27, 2015 10:34 AM To: Shay Drummond; Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR) Subject: Re: Updated Release DRAFT 1028 ​All Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: Shay Drummond Sent: Thursday, August 27, 2015 10:29 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT Thanks, I am sure as this hits the wire we are going to have our phones burning up! From: "Jeffries, Erica L" To: Yantis Ryan CC: "Arnold, Melaney" "Shay Drummond" "Shah, Nirav" "Clow, Bryan J" "WINNICKI, LENARD F." "HOUSTON, CATHY" "Neisen, Lisa \(PR\)" "Ray, Jaimee M." "McGill, Trish" "SAWYER, HARRY" "DIEHL, GWEN" "Walters, Lyndsey" "Beyer, Joseph" Date: 8/27/2015 11:35:23 AM Subject: Re: Updated Release DRAFT 1028 I have no objections to that. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 12:29, Yantis, Ryan wrote: All - Revised with Illinois Veterans' Home ​- Quincy spelled out in the headline. 1:30 PM to send to media? Immediate release to Blessing and Elected Officials? Ryan From: Arnold, Melaney Sent: Thursday, August 27, 2015 12:13 PM To: Yantis, Ryan; Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: RE: Updated Release DRAFT 1028 Thanks. I would spell out Illinois Veterans Home-Quincy in the headline. From: Yantis, Ryan Sent: Thursday, August 27, 2015 12:12 PM To: Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: Re: Updated Release DRAFT 1028 ​Ladies and Gents - Apologies for the slight delay. Graphic arts are not in my natural skill set and resetting the banner took a bit. Please find attached what I consider the final on the Press Release announcing the Respiratory Illness at IVH-Q. If there's a better headline, I am all ears. Otherwise this is ready for release to Blessing for staff, and to elected officials, as discussed. Ryan From: Shay Drummond Sent: Thursday, August 27, 2015 10:39 AM To: Shah, Nirav; Yantis, Ryan Cc: Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: RE: Updated Release DRAFT 1028 Looks ready! Thanks for you work. From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Thursday, August 27, 2015 10:38 AM To: Yantis, Ryan Cc: Shay Drummond; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: Re: Updated Release DRAFT 1028 Looks excellent. Thank you, Ryan. -Nirav On Aug 27, 2015, at 10:34 AM, Yantis, Ryan wrote: ​All - Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: "Jeffries, Erica L" To: HOUSTON CATHY CC: "Yantis, Ryan" "WINNICKI, LENARD F." "Shay Drummond" "Arnold, Melaney" "SAWYER, HARRY" "DIEHL, GWEN" Date: 8/27/2015 2:33:54 PM Subject: Re: WGEM Interview Req. On IVH-Q Campus Bruce - please call me now: 312-814-2461. Thanks Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 15:30, HOUSTON, CATHY wrote: They want to interview for Television. Bruce and I don’t really care to do this. We would prefer one of you to call them and do maybe a telephone interview? Can one of you please call him? WGEM Travis 217-228-6655 From: Jeffries, Erica L Sent: Thursday, August 27, 2015 3:23 PM To: Yantis, Ryan Cc: HOUSTON, CATHY; WINNICKI, LENARD F.; Shay Drummond; Arnold, Melaney; SAWYER, HARRY; DIEHL, GWEN Subject: Re: WGEM Interview Req. On IVH-Q Campus Did they ask specifically for someone from the home. If so, we should be taking the call. Cathy, if you're not comfortable then Len or Bruce should take it - or I'm happy to do so, as well. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 15:08, Yantis, Ryan wrote: Cathy & Shay Travis from WGEM is requesting a recorded interview with someone from the Home about the situation at the Home. He's looking for general questions - which are likely in the Q&A I recently re-sent. They can come to the Home ASAP, just need to know where and when if you are all interested/willing. ​ 217-228-6655 thanks - I am happy to chat prep Whoever is going to do this. 312-520-6958 Ryan From: "Jeffries, Erica L" To: "Shay Drummond" CC: "Yantis, Ryan" "HOUSTON, CATHY" "WINNICKI, LENARD F." "Arnold, Melaney" "SAWYER, HARRY" "DIEHL, GWEN" Date: 8/27/2015 2:30:31 PM Subject: Re: WGEM Interview Req. On IVH-Q Campus If he wants someone from the home, then Cathy, I would appreciate it if you would take the call. I have asked Ryan to call you to help you prep for the interview. Please let me know if you have any issues with this. Thanks Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 15:29, Shay Drummond wrote: Hi I did an interview with WGEM –what is Legionella, signs, symptoms, general talking points. I suggested to Travis he call or email back. He was wanting to go on grounds and interview someone from IVH. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Thursday, August 27, 2015 3:23 PM To: Yantis, Ryan Cc: HOUSTON, CATHY; WINNICKI, LENARD F.; Shay Drummond; Arnold, Melaney; SAWYER, HARRY; DIEHL, GWEN Subject: Re: WGEM Interview Req. On IVH-Q Campus Did they ask specifically for someone from the home. If so, we should be taking the call. Cathy, if you're not comfortable then Len or Bruce should take it - or I'm happy to do so, as well. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 15:08, Yantis, Ryan wrote: Cathy & Shay Travis from WGEM is requesting a recorded interview with someone from the Home about the situation at the Home. He's looking for general questions - which are likely in the Q&A I recently re-sent. They can come to the Home ASAP, just need to know where and when if you are all interested/willing. ​ 217-228-6655 thanks - I am happy to chat / prep whoever is going to do this. 312-520-6958 Ryan From: "Jeffries, Erica L" To: Yantis Ryan CC: "HOUSTON, CATHY" "WINNICKI, LENARD F." "Shay Drummond" "Arnold, Melaney" "SAWYER, HARRY" "DIEHL, GWEN" Date: 8/27/2015 2:23:14 PM Subject: Re: WGEM Interview Req. On IVH-Q Campus Did they ask specifically for someone from the home. If so, we should be taking the call. Cathy, if you're not comfortable then Len or Bruce should take it - or I'm happy to do so, as well. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 15:08, Yantis, Ryan wrote: Cathy & Shay Travis from WGEM is requesting a recorded interview with someone from the Home about the situation at the Home. He's looking for general questions - which are likely in the Q&A I recently re-sent. They can come to the Home ASAP, just need to know where and when if you are all interested/willing. ​ 217-228-6655 thanks - I am happy to chat / prep whoever is going to do this. 312-520-6958 Ryan From: "Jon Campos" To: Austin Connie CC: Date: 8/27/2015 6:52:57 AM Subject: RE: Outbreak number Connie , I have already started an ORS report. I have not submitted it, as new ills are still being reported. Should I close it out? Thanks Jon Campos RN Com municable Disease Coordinator/LEAD Coordinator Adams County Health Dept. 330 Vermont Quincy, IL 62301 217-222-8440 Ext: 163 217-222-8460 (Fax) jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail m essage is intended only for the personal and confidential use of the designated recipients nam ed above. The documents accom panying this transmission m ay contain confidential health inform ation that is legally privileged. The authorized recipient of this inform ation is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissem ination, distribution or copying of this m essage is strictly prohibited. If you have received this e-m ail in error, please notify us and delete the original message. Thank you. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 7:22 PM To: Cox, Robert F.; Kelly-Shannon, Kate D.; Morgan, Jodi; Albertson, Justin; Echols, Fred; McCann, Ken; Clegg, Whitney Cc: Shay Drummond; Jon Campos Subject: Outbreak number I quickly entered the very basic information in our ORS system on this outbreak. The lab needed an outbreak number so please feel free to use this for discussions/lab submission purposes as needed. IL2015-0427 Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Jon Campos" To: Austin Connie CC: Date: 8/27/2015 6:54:50 AM Subject: RE: Outbreak number Ok no problem Jon Campos RN Communicable Disease Coordinator/LEAD Coordinator Adams County Health Dept. 330 Vermont Quincy, IL 62301 217-222-8440 Ext: 163 217-222-8460 (Fax) jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Thursday, August 27, 2015 7:54 AM To: Jon Campos Subject: RE: Outbreak number Oh rats, we just typically put in a place holder so we can get the outbreak number, the final numbers will always be different, can you delete yours and we’ll use the one I have below? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Jon Campos [mailto:jcampos@co.adams.il.us] Sent: Thursday, August 27, 2015 7:53 AM To: Austin, Connie Subject: RE: Outbreak number Connie , I have already started an ORS report. I have not submitted it, as new ills are still being reported. Should I close it out? Thanks Jon Campos RN Communicable Disease Coordinator/LEAD Coordinator Adams County Health Dept. 330 Vermont Quincy, IL 62301 217-222-8440 Ext: 163 217-222-8460 (Fax) jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Wednesday, August 26, 2015 7:22 PM To: Cox, Robert F.; Kelly-Shannon, Kate D.; Morgan, Jodi; Albertson, Justin; Echols, Fred; McCann, Ken; Clegg, Whitney Cc: Shay Drummond; Jon Campos Subject: Outbreak number I quickly entered the very basic information in our ORS system on this outbreak. The lab needed an outbreak number so please feel free to use this for discussions/lab submission purposes as needed. IL2015-0427 Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Martin, Aaron" To: 'tdede@co.adams.il.us' CC: Date: 8/27/2015 3:26:51 PM Subject: COC Form Test Codes Tony, Feel free to call me if necessary but here are the Test Codes you’ll need: · · · M212 – Legionella Species Confirmation On the same form add M215 – Pure Culture Preparation and Shipping. This is new and we haven’t yet worked out a shipping address. We anticipate shipping to CDC directly and I may have that information tomorrow. For now, I recommend noting this test code in the Comment/Special Instruction Field and that we will advise of the shipping location as soon as possible. M163 – Legionella Broad Screen on the DNA/PCR Form Aaron Martin, LEHP Indoor Air Quality and Healthy Homes Program Manager Illinois Department of Public Health, Division of Environmental Health 525 W. Jefferson St., Springfield, IL 62761 217.785.5886 (office) I 217.306.5656 (mobile) I aaron.martin@illinois.gov ---------------------------- From: "Martin, Aaron" To: 'tdede@co.adams.il.us' CC: Date: 8/27/2015 8:33:15 AM Subject: FW: COCs Attachments: Legionella COC R1 (3).doc DNA Testing COC R3 2012.12.17.docx From: Steinheimer, Craig Sent: Tuesday, August 25, 2015 4:02 PM To: Martin, Aaron; McCann, Ken; Mitchell, Joe Subject: FW: COCs FYI, New chain of custody for legionella specific. From: Bish, Jeromy [mailto:jbish@EMSL.com] Sent: Tuesday, August 25, 2015 3:56 PM To: Steinheimer, Craig Subject: COCs Hi Craig, Attached are the COCs for legionella and PCR analysis. For the legionella test please select M212 For the PCR please write in M163 for the analysis Jeromy Bish Sales Account Representative EMSL Analytical, Inc. 200 Route 130 North Cinnaminson, NJ 08077 Phone: 856-303-2570 Fax: Toll Free: 800-220-3675 Lab Hours: Mon-Friday 7AM-10PM, Saturday 8AM-5PM, Sunday On-Call Some of the resources EMSL Analytical, Inc. offers to our clients: LABConnect Order Products Client Corner Training Additional Resources Sampling Videos --------------------------------------------------------------------------------------------------------------------------------“This email may contain privileged and confidential information and is solely for the use of the sender's intended recipient(s). If you are not the intended recipient of this communication, you are hereby notified that any unauthorized review, use, dissemination, distribution, downloading, or copying of this communication is strictly prohibited. If you received this email in error, please notify the sender by reply email and delete all copies and attachments. Thank you.” From: "Morgan, Jodi" To: "Shay Drummond" jcampos@co.adams.il.us CC: Date: 8/27/2015 8:20:45 AM Subject: labs Shay & Jon, Questions/Requests: Were you able to find out about the employee who went to Dr. Altman? Can you fax the negative results to me? 217/524-0962 For we also need the onset date of illness. Connie will not say numbers until she has confirmation that the individual had pneumonia/+ CXR. Going forward: Continue to collect a urinary antigen for legionella for all persons with symptoms. We do not need any additional NP/OP swabs. According to the line list, there are 16 sputums pending… OK to collect 5 more then that should be enough. Isolates should be sent to IDPH lab I checked with IDPH lab here today…he was going to try and find out when they thought the latest results would be available. Thanks! Jodi Jodi Morgan, RN BSN CIC Infection Prevention & Control Communicable Disease Control Section Office of Health Protection Illinois Department of Public Health 525 W. Jefferson Springfield, IL 62761-0001 T: 217-782-2016 F: 217-524-0962 Jodi.Morgan@illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Morgan, Jodi" To: "Shay Drummond" CC: "Austin, Connie" Date: 8/27/2015 8:52:37 AM Subject: sputum Hi Shay, Please continue to send the sputum cultures for legionella to the Iowa lab (or wherever it was determined.) Neither Springfield hospital does legionella cultures. Mike from IDPH office is going to come to Quincy and pick up urine specimens today. Thanks! Jodi Morgan, RN BSN CIC Infection Prevention & Control Communicable Disease Control Section Office of Health Protection Illinois Department of Public Health 525 W. Jefferson Springfield, IL 62761-0001 T: 217-782-2016 F: 217-524-0962 Jodi.Morgan@illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Shah, Nirav" To: Yantis Ryan CC: "Shay Drummond" "Arnold, Melaney" "Jeffries, Erica L" "WINNICKI, LENARD F" "HOUSTON, CATHY S" Lisa.Neisen@blessinghealthsystem.org Date: 8/27/2015 9:38:27 AM Subject: Re: Updated Release DRAFT 1028 Looks excellent. Thank you, Ryan. -Nirav On Aug 27, 2015, at 10:34 AM, Yantis, Ryan wrote: ​All - Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: Shay Drummond Sent: Thursday, August 27, 2015 10:29 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT Thanks, I am sure as this hits the wire we are going to have our phones burning up! From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:26 AM To: Shay Drummond; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - I’m still working on the talking point – along with some messaging. I hope to have these out relatively soon. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Thursday, August 27, 2015 10:26 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - That is a good point as one is on comfort measures. From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:12 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: RE: Updated Release DRAFT - Not all 8 cases are still at the hospital. 4 are back at the home – and that doesn’t mean all 4 are recovering. From: Yantis, Ryan Sent: Thursday, August 27, 2015 10:11 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: Re: Updated Release DRAFT - All - With thanks and compliments. I've added one line I feel is critical to the lede: "There have been no known deaths related to this outbreak​." I also added the PIO contact, as discussed on the conf. call. Notable, other than one mention in a quote, we are not addressing the residents at Blessing and still under their care. As written, it indicates all 8 are back on the IVH-Q campus. Guidance? From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:36 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - With Director Shah’s edits. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:31 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - Thanks. ​Standing by. From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:28 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - I know Director Shah is somewhat tied up at the moment and has not yet reviewed a draft I sent, but I would like to share this with Vets so you get an idea of what we’re thinking. Ryan – I tried to keep the language similar so GO approval would be quicker. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:00 AM To: Shah, Nirav; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - ​Dir. Shah - No worries on my end and why I sent to the group. If we re-order the paragraphs with the updated numbers, we should be able to staff quickly and release shortly. Standing by Ryan From: Shah, Nirav Sent: Thursday, August 27, 2015 8:57 AM To: Yantis, Ryan; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - Thank you, Ryan. We are reviewing this now. I’m concerned that we are burying the lede. Isn’t the main story what’s discussed in the fourth paragraph? Would you mind if we switched up the order a bit? We will take a stab at that and send something out very soon. Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Ryan Date: Thursday, August 27, 2015 at 8:48 AM To: "Jeffries, Erica L" , Nirav Shah , "Arnold, Melaney" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" Subject: Updated Release DRAFT - All - Apologies, but to ensure and synchronize, I adjusted the text in the fourth graph to reflect numbers from this morning's conf. call: "Home staff have been monitoring two residents who tested positive for Legionella, a bacteria associated with Legionnaires’ disease, and both residents have responded to treatment. Six (6) other residents are currently at Blessing Hospital and have also tested positive for Legionella. Legionnaires’ disease is transmitted by aerosolized water, meaning that there is no known risk of person-to-person exchange. ​" Also, the lead graph remains or do we excise the "18" from that graph? Ryan <2015-08-27 Vets Affairs - Legionella COORDINATING as of 1028am.docx> From: "Shay Drummond" To: ;Roberts Vickie "Linda\(Linda.Manley@blessinghealthsystem.org\);" CC: "Austin, Connie \(Connie.Austin@Illinois.gov\)" jodi.Morgan@illinois.gov Date: 8/27/2015 9:22:52 AM Subject: FW: sputum Eric, Thanks for the update. See below from IDPH – continue to send sputum’s to either LabCorp’s or Iowa, which ever one you feel we can get the quickest turnaround time. Also we will need whatever lab you use for the sputum’s to send isolates to the IDPH Springfield lab once they have their testing done. Can you assist us in confirmations and tracking of this process? This correlation is going to be key to making sure we are on the right track with our source of from our EH samples. Eric, are the urines ready for pick up to go to Springfield? I will have staff pick up as soon as you say so we are ready to go. IDPH is headed our way to get them. Thanks, Shay From: Morgan, Jodi [mailto:Jodi.Morgan@illinois.gov] Sent: Thursday, August 27, 2015 9:53 AM To: Shay Drummond Cc: Austin, Connie Subject: sputum Hi Shay, Please continue to send the sputum cultures for legionella to the Iowa lab (or wherever it was determined.) Neither Springfield hospital does legionella cultures. Mike from IDPH office is going to come to Quincy and pick up urine specimens today. Thanks! Jodi Morgan, RN BSN CIC Infection Prevention & Control Communicable Disease Control Section Office of Health Protection Illinois Department of Public Health 525 W. Jefferson Springfield, IL 62761-0001 T: 217-782-2016 F: 217-524-0962 Jodi.Morgan@illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Shay Drummond" To: Clegg "Whitney <" "\(Whitney.Clegg@illinois.gov\);>" CC: Date: 8/27/2015 3:19:38 PM Subject: Legionella Tracking Log (3).xlsx Attachments: Legionella Tracking Log (3).xlsx From: "Shay Drummond" To: Austin "Connie \(Connie.Austin@Illinois.gov\);Jon Campos ;;>" CC: Date: 8/27/2015 9:47:20 AM Subject: Legionella Tracking Log.xlsx Attachments: Legionella Tracking Log.xlsx See IVH tracking as of 1045am. Shay From: "Shay Drummond" To: Austin Connie CC: "Jon Campos" "Morgan, Jodi" Date: 8/27/2015 11:34:52 AM Subject: Re: hospitalizations/discharges Will do! Lab is at lunch - waiting for call back. Samples are getting picked up, now here. Sent from my iPhone On Aug 27, 2015, at 12:33 PM, Austin, Connie wrote: One piece of information they want to have available about cases is when they were discharged. They have a number of 4 discharged I think not sure if that is correct. For the current 8 cases do you know if they were discharged, I know was discharged. Also just a note, when in INEDSS don’t enter anything about death in the general illness UNLESS the patient died, it pops up an error message otherwise, Very annoying feature I think ! So every day I think we need Onset dates range from ##/##/## to ##/##/## # lab confirmed Legionella cases # still hospitalized or # discharged # fatalities Thanks for all your hard work. What did you find out about Memorial results and getting those? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Shay Drummond" To: Austin Connie CC: Date: 8/27/2015 3:26:13 PM Subject: RE: Legionella Can you please send me again all of the info you would like daily reported back, I think I accidently deleted the email. Thanks! From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Thursday, August 27, 2015 4:21 PM To: Shay Drummond; Jon Campos Subject: FW: Legionella Here is the Ohio/CDC report of their similar outbreak in 2013. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Shay Drummond" To: Arnold Melaney Ryan Nirav "Erica L" "LENARD F" "CATHY S" CC: Date: 8/27/2015 9:25:39 AM Subject: RE: Updated Release DRAFT That is a good point as one is on comfort measures. From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:12 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: RE: Updated Release DRAFT Not all 8 cases are still at the hospital. 4 are back at the home – and that doesn’t mean all 4 are recovering. From: Yantis, Ryan Sent: Thursday, August 27, 2015 10:11 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: Re: Updated Release DRAFT - All With thanks and compliments. I've added one line I feel is critical to the lede: "There have been no known deaths related to this outbreak​." I also added the PIO contact, as discussed on the conf. call. Notable, other than one mention in a quote, we are not addressing the residents at Blessing and still under their care. As written, it indicates all 8 are back on the IVH-Q campus. Guidance? From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:36 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT With Director Shah’s edits. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:31 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - Thanks. ​Standing by. From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:28 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I know Director Shah is somewhat tied up at the moment and has not yet reviewed a draft I sent, but I would like to share this with Vets so you get an idea of what we’re thinking. Ryan – I tried to keep the language similar so GO approval would be quicker. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:00 AM To: Shah, Nirav; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - ​Dir. Shah No worries on my end and why I sent to the group. If we re-order the paragraphs with the updated numbers, we should be able to staff quickly and release shortly. Standing by Ryan From: Shah, Nirav Sent: Thursday, August 27, 2015 8:57 AM To: Yantis, Ryan; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT Thank you, Ryan. We are reviewing this now. I’m concerned that we are burying the lede. Isn’t the main story what’s discussed in the fourth paragraph? Would you mind if we switched up the order a bit? We will take a stab at that and send something out very soon. Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Ryan Date: Thursday, August 27, 2015 at 8:48 AM To: "Jeffries, Erica L" , Nirav Shah , "Arnold, Melaney" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" Subject: Updated Release DRAFT - All Apologies, but to ensure and synchronize, I adjusted the text in the fourth graph to reflect numbers from this morning's conf. call: "Home staff have been monitoring two residents who tested positive for Legionella, a bacteria associated with Legionnaires’ disease, and both residents have responded to treatment. Six (6) other residents are currently at Blessing Hospital and have also tested positive for Legionella. Legionnaires’ disease is transmitted by aerosolized water, meaning that there is no known risk of person-to-person exchange. ​" Also, the lead graph remains or do we excise the "18" from that graph? Ryan From: "Shay Drummond" To: Arnold Melaney Ryan Nirav "Erica L" "LENARD F" "CATHY S" CC: Date: 8/27/2015 9:29:05 AM Subject: RE: Updated Release DRAFT Thanks, I am sure as this hits the wire we are going to have our phones burning up! From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:26 AM To: Shay Drummond; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I’m still working on the talking point – along with some messaging. I hope to have these out relatively soon. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Thursday, August 27, 2015 10:26 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - That is a good point as one is on comfort measures. From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:12 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: RE: Updated Release DRAFT Not all 8 cases are still at the hospital. 4 are back at the home – and that doesn’t mean all 4 are recovering. From: Yantis, Ryan Sent: Thursday, August 27, 2015 10:11 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: Re: Updated Release DRAFT - All With thanks and compliments. I've added one line I feel is critical to the lede: "There have been no known deaths related to this outbreak​." I also added the PIO contact, as discussed on the conf. call. Notable, other than one mention in a quote, we are not addressing the residents at Blessing and still under their care. As written, it indicates all 8 are back on the IVH-Q campus. Guidance? From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:36 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT With Director Shah’s edits. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:31 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - Thanks. ​Standing by. From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:28 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I know Director Shah is somewhat tied up at the moment and has not yet reviewed a draft I sent, but I would like to share this with Vets so you get an idea of what we’re thinking. Ryan – I tried to keep the language similar so GO approval would be quicker. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:00 AM To: Shah, Nirav; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - ​Dir. Shah No worries on my end and why I sent to the group. If we re-order the paragraphs with the updated numbers, we should be able to staff quickly and release shortly. Standing by Ryan From: Shah, Nirav Sent: Thursday, August 27, 2015 8:57 AM To: Yantis, Ryan; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT Thank you, Ryan. We are reviewing this now. I’m concerned that we are burying the lede. Isn’t the main story what’s discussed in the fourth paragraph? Would you mind if we switched up the order a bit? We will take a stab at that and send something out very soon. Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Ryan Date: Thursday, August 27, 2015 at 8:48 AM To: "Jeffries, Erica L" , Nirav Shah , "Arnold, Melaney" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" Subject: Updated Release DRAFT - All Apologies, but to ensure and synchronize, I adjusted the text in the fourth graph to reflect numbers from this morning's conf. call: "Home staff have been monitoring two residents who tested positive for Legionella, a bacteria associated with Legionnaires’ disease, and both residents have responded to treatment. Six (6) other residents are currently at Blessing Hospital and have also tested positive for Legionella. Legionnaires’ disease is transmitted by aerosolized water, meaning that there is no known risk of person-to-person exchange. ​" Also, the lead graph remains or do we excise the "18" from that graph? Ryan From: "Shay Drummond" To: Beyer Joseph Melaney CC: "Jeffries, Erica L" "Yantis, Ryan" "Shah, Nirav" "Clow, Bryan" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Neisen, Lisa \(PR\)" "Ray, Jaimee M" "McGill, Patricia O" "SAWYER, HARRY H" "DIEHL, GWEN G" "Walters, Lyndsey" Date: 8/27/2015 11:43:26 AM Subject: RE: Updated Release DRAFT 1028 Good here! From: Beyer, Joseph [mailto:Joseph.Beyer@illinois.gov] Sent: Thursday, August 27, 2015 12:42 PM To: Arnold, Melaney Cc: Jeffries, Erica L; Yantis, Ryan; Shay Drummond; Shah, Nirav; Clow, Bryan; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR); Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G; Walters, Lyndsey Subject: Re: Updated Release DRAFT 1028 Gov office as well Sent from my iPhone On Aug 27, 2015, at 12:41 PM, Arnold, Melaney wrote: IDPH is good to go with this. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Thursday, August 27, 2015 12:35 PM To: Yantis, Ryan Cc: Arnold, Melaney; Shay Drummond; Shah, Nirav; Clow, Bryan; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR); Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G; Walters, Lyndsey; Beyer, Joseph Subject: Re: Updated Release DRAFT 1028 I have no objections to that. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 12:29, Yantis, Ryan wrote: All - Revised with Illinois Veterans' Home ​- Quincy spelled out in the headline. 1:30 PM to send to media? Immediate release to Blessing and Elected Officials? Ryan From: Arnold, Melaney Sent: Thursday, August 27, 2015 12:13 PM To: Yantis, Ryan; Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: RE: Updated Release DRAFT 1028 Thanks. I would spell out Illinois Veterans Home-Quincy in the headline. From: Yantis, Ryan Sent: Thursday, August 27, 2015 12:12 PM To: Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: Re: Updated Release DRAFT 1028 ​Ladies and Gents - Apologies for the slight delay. Graphic arts are not in my natural skill set and resetting the banner took a bit. Please find attached what I consider the final on the Press Release announcing the Respiratory Illness at IVH-Q. If there's a better headline, I am all ears. Otherwise this is ready for release to Blessing for staff, and to elected officials, as discussed. Ryan From: Shay Drummond Sent: Thursday, August 27, 2015 10:39 AM To: Shah, Nirav; Yantis, Ryan Cc: Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: RE: Updated Release DRAFT 1028 Looks ready! Thanks for you work. From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Thursday, August 27, 2015 10:38 AM To: Yantis, Ryan Cc: Shay Drummond; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: Re: Updated Release DRAFT 1028 Looks excellent. Thank you, Ryan. -Nirav On Aug 27, 2015, at 10:34 AM, Yantis, Ryan wrote: ​All - Updated: ? ? ? New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: "Shay Drummond" To: Jeffries "Erica L" CC: Date: 8/27/2015 10:31:47 AM Subject: RE: Updated Release DRAFT 1028 Great, thank you! Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Thursday, August 27, 2015 11:31 AM To: Shay Drummond Cc: Yantis, Ryan Subject: Re: Updated Release DRAFT 1028 Ryan will send a final version shortly. Thanks, Shay. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 11:29, Shay Drummond wrote: Are you sending out the final version to us? From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Thursday, August 27, 2015 11:28 AM To: Neisen, Lisa (PR) Cc: Yantis, Ryan; Shay Drummond; Arnold, Melaney; Shah, Nirav; WINNICKI, LENARD F.; HOUSTON, CATHY; Kuida, Elliot; Powell, Betsey Subject: Re: Updated Release DRAFT 1028 Thanks, everyone, for providing your inputs. I think this is ready to go. We will be standing by to respond to queries per our conversation this morning. Thank you! Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 11:16, Neisen, Lisa (PR) wrote: Hi RyanWe have reviewed the release, and would like to request a change in the 4th paragraph- changing “Blessing Hospital” to “local healthcare providers.” This change makes the sentence more accurate. Please send final version once ready. Do you have an estimated time on distribution of the release? We would like to share the information internally with our Board, staff and physicians to make them aware, prior to the public release. Thank you, Lisa K. Neisen Director, Public Relations & Comm. Blessing Hospital, 1135 Broadway Quincy, IL 62305 (217) 223-8400, ext. 4190 Lisa.neisen@blessinghealthsystem.org From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Thursday, August 27, 2015 10:34 AM To: Shay Drummond; Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR) Subject: Re: Updated Release DRAFT 1028 ​All Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: Shay Drummond Sent: Thursday, August 27, 2015 10:29 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT Thanks, I am sure as this hits the wire we are going to have our phones burning up! From: "Shay Drummond" To: Shah Nirav Ryan CC: "Arnold, Melaney" "Jeffries, Erica L" "WINNICKI, LENARD F" "HOUSTON, CATHY S" Lisa.Neisen@blessinghealthsystem.org Date: 8/27/2015 9:39:15 AM Subject: RE: Updated Release DRAFT 1028 Looks ready! Thanks for you work. From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Thursday, August 27, 2015 10:38 AM To: Yantis, Ryan Cc: Shay Drummond; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: Re: Updated Release DRAFT 1028 Looks excellent. Thank you, Ryan. -Nirav On Aug 27, 2015, at 10:34 AM, Yantis, Ryan wrote: ​All - Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: Shay Drummond Sent: Thursday, August 27, 2015 10:29 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT Thanks, I am sure as this hits the wire we are going to have our phones burning up! From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:26 AM To: Shay Drummond; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I’m still working on the talking point – along with some messaging. I hope to have these out relatively soon. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Thursday, August 27, 2015 10:26 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - That is a good point as one is on comfort measures. From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:12 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: RE: Updated Release DRAFT Not all 8 cases are still at the hospital. 4 are back at the home – and that doesn’t mean all 4 are recovering. From: Yantis, Ryan Sent: Thursday, August 27, 2015 10:11 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: Re: Updated Release DRAFT - All - With thanks and compliments. I've added one line I feel is critical to the lede: "There have been no known deaths related to this outbreak​." I also added the PIO contact, as discussed on the conf. call. Notable, other than one mention in a quote, we are not addressing the residents at Blessing and still under their care. As written, it indicates all 8 are back on the IVH-Q campus. Guidance? From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:36 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT With Director Shah’s edits. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:31 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - Thanks. ​Standing by. From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:28 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I know Director Shah is somewhat tied up at the moment and has not yet reviewed a draft I sent, but I would like to share this with Vets so you get an idea of what we’re thinking. Ryan – I tried to keep the language similar so GO approval would be quicker. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:00 AM To: Shah, Nirav; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - ​Dir. Shah - No worries on my end and why I sent to the group. If we re-order the paragraphs with the updated numbers, we should be able to staff quickly and release shortly. Standing by Ryan From: Shah, Nirav Sent: Thursday, August 27, 2015 8:57 AM To: Yantis, Ryan; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT Thank you, Ryan. We are reviewing this now. I’m concerned that we are burying the lede. Isn’t the main story what’s discussed in the fourth paragraph? Would you mind if we switched up the order a bit? We will take a stab at that and send something out very soon. Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Ryan Date: Thursday, August 27, 2015 at 8:48 AM To: "Jeffries, Erica L" , Nirav Shah , "Arnold, Melaney" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" Subject: Updated Release DRAFT - All - Apologies, but to ensure and synchronize, I adjusted the text in the fourth graph to reflect numbers from this morning's conf. call: "Home staff have been monitoring two residents who tested positive for Legionella, a bacteria associated with Legionnaires’ disease, and both residents have responded to treatment. Six (6) other residents are currently at Blessing Hospital and have also tested positive for Legionella. Legionnaires’ disease is transmitted by aerosolized water, meaning that there is no known risk of person-to-person exchange. ​" Also, the lead graph remains or do we excise the "18" from that graph? Ryan <2015-08-27 Vets Affairs - Legionella COORDINATING as of 1028am.docx> From: "Shay Drummond" To: Jeffries "Erica L" CC: Date: 8/27/2015 10:29:34 AM Subject: RE: Updated Release DRAFT 1028 Are you sending out the final version to us? From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Thursday, August 27, 2015 11:28 AM To: Neisen, Lisa (PR) Cc: Yantis, Ryan; Shay Drummond; Arnold, Melaney; Shah, Nirav; WINNICKI, LENARD F.; HOUSTON, CATHY; Kuida, Elliot; Powell, Betsey Subject: Re: Updated Release DRAFT 1028 Thanks, everyone, for providing your inputs. I think this is ready to go. We will be standing by to respond to queries per our conversation this morning. Thank you! Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 11:16, Neisen, Lisa (PR) wrote: Hi RyanWe have reviewed the release, and would like to request a change in the 4th paragraph- changing “Blessing Hospital” to “local healthcare providers.” This change makes the sentence more accurate. Please send final version once ready. Do you have an estimated time on distribution of the release? We would like to share the information internally with our Board, staff and physicians to make them aware, prior to the public release. Thank you, Lisa K. Neisen Director, Public Relations & Comm. Blessing Hospital, 1135 Broadway Quincy, IL 62305 (217) 223-8400, ext. 4190 Lisa.neisen@blessinghealthsystem.org From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Thursday, August 27, 2015 10:34 AM To: Shay Drummond; Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR) Subject: Re: Updated Release DRAFT 1028 ​All Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​ ny other edits / concerns? A From: Shay Drummond Sent: Thursday, August 27, 2015 10:29 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT Thanks, I am sure as this hits the wire we are going to have our phones burning up! From: "Shay Drummond" To: Arnold Melaney CC: Date: 8/27/2015 12:00:52 PM Subject: RE: Updated Release DRAFT 1028 Hi there, How are the talking points coming along? Thank you ⅛ From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 12:41 PM To: Jeffries, Erica L; Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Clow, Bryan; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR); Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G; Walters, Lyndsey; Beyer, Joseph Subject: RE: Updated Release DRAFT 1028 IDPH is good to go with this. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Thursday, August 27, 2015 12:35 PM To: Yantis, Ryan Cc: Arnold, Melaney; Shay Drummond; Shah, Nirav; Clow, Bryan; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR); Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G; Walters, Lyndsey; Beyer, Joseph Subject: Re: Updated Release DRAFT 1028 I have no objections to that. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 12:29, Yantis, Ryan wrote: All - Revised with Illinois Veterans' Home ​- Quincy spelled out in the headline. 1:30 PM to send to media? Immediate release to Blessing and Elected Officials? Ryan From: Arnold, Melaney Sent: Thursday, August 27, 2015 12:13 PM To: Yantis, Ryan; Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: RE: Updated Release DRAFT 1028 Thanks. I would spell out Illinois Veterans Home-Quincy in the headline. From: Yantis, Ryan Sent: Thursday, August 27, 2015 12:12 PM To: Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: Re: Updated Release DRAFT 1028 ​Ladies and Gents - Apologies for the slight delay. Graphic arts are not in my natural skill set and resetting the banner took a bit. Please find attached what I consider the final on the Press Release announcing the Respiratory Illness at IVH-Q. If there's a better headline, I am all ears. Otherwise this is ready for release to Blessing for staff, and to elected officials, as discussed. Ryan From: Shay Drummond Sent: Thursday, August 27, 2015 10:39 AM To: Shah, Nirav; Yantis, Ryan Cc: Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: RE: Updated Release DRAFT 1028 Looks ready! Thanks for you work. From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Thursday, August 27, 2015 10:38 AM To: Yantis, Ryan Cc: Shay Drummond; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: Re: Updated Release DRAFT 1028 Looks excellent. Thank you, Ryan. -Nirav On Aug 27, 2015, at 10:34 AM, Yantis, Ryan wrote: ​All - Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: "Shay Drummond" To: Jeffries "Erica L" Ryan CC: "HOUSTON, CATHY" "WINNICKI, LENARD F." "Arnold, Melaney" "SAWYER, HARRY" "DIEHL, GWEN" Date: 8/27/2015 2:29:18 PM S u b j e c t : RE: WGEM Interview Req. On IVH-Q Campus Hi I did an interview with WGEM –what is Legionella, signs, symptoms, general talking points. I suggested to Travis he call or email back. He was wanting to go on grounds and interview someone from IVH. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Thursday, August 27, 2015 3:23 PM To: Yantis, Ryan Cc: HOUSTON, CATHY; WINNICKI, LENARD F.; Shay Drummond; Arnold, Melaney; SAWYER, HARRY; DIEHL, GWEN Subject: Re: WGEM Interview Req. On IVH-Q Campus Did they ask specifically for someone from the home. If so, we should be taking the call. Cathy, if you're not comfortable then Len or Bruce should take it - or I'm happy to do so, as well. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 15:08, Yantis, Ryan wrote: Cathy & Shay Travis from WGEM is requesting a recorded interview with someone from the Home about the situation at the Home. He's looking for general questions - which are likely in the Q&A I recently re-sent. They can come to the Home ASAP, just need to know where and when if you are all interested/willing. ​ 217-228-6655 thanks - I am happy to chat / prep whoever is going to do this. 312-520-6958 Ryan From: "Tony Dede" To: justin.dewitt@illinois.gov CC: "Shay Drummond" Date: 8/27/2015 8:59:35 AM Subject: Legionella EH Questions Justin, We’ve been asked some questions that I would like your input on. 1. Can the ice machines be shut off, sanitized, and then used for storage of purchased ice? 2. Can the dish washers use the spray hose if the facet head is removed? 3. Any concerns with steam tables in food service? If so, what precautions are needed? Thanks, ~Tony If needed, you can call my cell at 217-430-7780. Tony Dede, LEHP Chief Environmental Sanitarian Adams County Health Department 330 Vermont Street Quincy, IL 62301 217-222-8440, ext. 124 tdede@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended onlyfor the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Tony Dede" To: DeWitt Justin CC: "Shay Drummond" Date: 8/27/2015 9:29:33 AM Subject: RE: Legionella EH Questions I’m going to add another question. The guidance document allows use of the dish machines. However, some of those machines have splatter that “spits” out the edges of the doors. Should this be a concern? Is there is difference between hot water sanitizing machines and chemical sanitizing machines if there is a concern? ~Tony Tony Dede, LEHP Chief Environmental Sanitarian Adams County Health Department 330 Vermont Street Quincy, IL 62301 217-222-8440, ext. 124 tdede@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended onlyfor the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: DeWitt, Justin [mailto:Justin.Dewitt@Illinois.gov] Sent: Thursday, August 27, 2015 10:11 AM To: Tony Dede Cc: Shay Drummond Subject: Re: Legionella EH Questions Give me a few minutes. Justin DeWitt, P.E., LEED AP Chief of General Engineering Division of Environmental Health justin.dewitt@illinois.gov Illinois Department of Public Health 525 West Jefferson Street Springfield, Illinois 62761 (217)782-5830, Fax (217)785-5897 Visit our website at: http://www.idph.state.il.us/envhealth/ehhome.htm CONFIDENTIALITY NOTE: This e-mail and any attachments are confidential and may be protected by legal privilege. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of this e-mail or any attachment is prohibited. If you have received this e-mail in error, please notify me immediately and delete this copy from your system. Thank you for your cooperation. On Aug 27, 2015, at 9:59 AM, Tony Dede wrote: Justin, We’ve been asked some questions that I would like your input on. 1. Can the ice machines be shut off, sanitized, and then used for storage of purchased ice? 2. Can the dish washers use the spray hose if the facet head is removed? 3. Any concerns with steam tables in food service? If so, what precautions are needed? Thanks, ~Tony If needed, you can call my cell at 217-430-7780. Tony Dede, LEHP Chief Environmental Sanitarian Adams County Health Department 330 Vermont Street Quincy, IL 62301 217-222-8440, ext. 124 tdede@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended onlyfor the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Yantis, Ryan" To: Jeffries "Erica L" CC: "Arnold, Melaney" "Shay Drummond" "Shah, Nirav" "Clow, Bryan" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Neisen, Lisa \(PR\)" "Ray, Jaimee M" "McGill, Patricia O" "SAWYER, HARRY H" "DIEHL, GWEN G" "Walters, Lyndsey" "Beyer, Joseph" Date: 8/27/2015 2:46:24 PM Subject: 2nd Hour Media IVH-Quincy Respiratory Illness Release FYSA - AP story as source from Quincy - now state and leaning national 8 treated for Legionnaires’ disease at Quincy veterans home (St Louis) http://fox2now.com/2015/08/27/8-treated-for-legionnaires-disease-at-quincy-veterans-home/ FBA; mentions DOC LD case last month 8 treated for Legionnaires' disease at Quincy veterans home (Bloomington) http://www.pantagraph.com/news/state-and-regional/illinois/treated-for-legionnaires-disease-at-quincy-veterans-home/article_050691c8-9546-5673-a359cfb1e2d41877.html FBA; mentions DOC LD case last month 8 treated for Legionnaires' disease at Quincy veterans home http://www.newsbug.info/news/national/illinois/treated-for-legionnaires-disease-at-quincy-veterans-home/article_cb019565-3b1d-515a-9b69-5c6aeed3f213.html From: Jeffries, Erica L Sent: Thursday, August 27, 2015 2:51 PM To: Yantis, Ryan Cc: Arnold, Melaney; Shay Drummond; Shah, Nirav; Clow, Bryan; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR); Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G; Walters, Lyndsey; Beyer, Joseph Subject: Re: FYI - 1st Hour Media IVH-Quincy Respiratory Illness Release Thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 14:40, Yantis, Ryan wrote: Health officials say several cases of Legionnaires' disease confirmed in Illinois Veterans Home http://www.wgem.com/story/29895140/2015/08/27/health-officials-say-several-cases-of-legionnaires-disease-confirmed-in-illinois-veterans-home (truncated Press Release; no issues) Legionnaires’ disease outbreak at IL Vets Home http://quincyjournal.com/above-the-fold/2015/08/27/legionnaires%E2%80%99-disease-outbreak-at-il-vets-home/ (Press Release reprint; no issues) Eight Cases of Legionnaires’ Disease at Illinois Veterans’ Home http://khmoradio.com/eight-cases-of-legionnaires-disease-at-illinois-veterans-home/?trackback=tsmclip (Fair, Balanced, Accurate [FBA] – good factual report​) From: "Yantis, Ryan" To: Arnold Melaney "Erica L ;Shay Drummond" Nirav CC: "Shay Drummond" "Shah, Nirav" "Clow, Bryan" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Neisen, Lisa \(PR\)" "Ray, Jaimee M" "McGill, Patricia O" "SAWYER, HARRY H" "DIEHL, GWEN G" "Walters, Lyndsey" "Beyer, Joseph" Date: 8/27/2015 11:47:09 AM Subject: Final IVH-Quincy Respiratory Illness Release A t t a c h m e n t s : 2015-08-27 IDVA-IDPH Release onRespiratory Illiness at IVH-Q FINAL R.docx All Thanks to all for prompt responses, inputs, and assistance on this release, attached. Please release internally to Blessing Hospital staff, local elected officials, and Home staff who need to know. ​Let them know the release is going to the media. I will send this to CMS for state-wide distribution, all media at 1:30 p.m. today. Shay, please share with your local media at that time. I'd ask that the PIOs share media calls and interest in short emails, for awareness. If there is a media referral to another agency/facility, emails are always appreciated. Thanks Ryan From: "Yantis, Ryan" To: Arnold Melaney "Erica L ;Shay Drummond" Nirav CC: "Clow, Bryan" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Neisen, Lisa \(PR\)" "Ray, Jaimee M" "McGill, Patricia O" "SAWYER, HARRY H" "DIEHL, GWEN G" "Walters, Lyndsey" "Beyer, Joseph" Date: 8/27/2015 1:40:45 PM Subject: FYI - 1st Hour Media IVH-Quincy Respiratory Illness Release Health officials say several cases of Legionnaires' disease confirmed in Illinois Veterans Home http://www.wgem.com/story/29895140/2015/08/27/health-officials-say-several-cases-of-legionnaires-disease-confirmed-in-illinois-veterans-home (truncated Press Release; no issues) Legionnaires’ disease outbreak at IL Vets Home http://quincyjournal.com/above-the-fold/2015/08/27/legionnaires%E2%80%99-disease-outbreak-at-il-vets-home/ (Press Release reprint; no issues) Eight Cases of Legionnaires’ Disease at Illinois Veterans’ Home http://khmoradio.com/eight-cases-of-legionnaires-disease-at-illinois-veterans-home/?trackback=tsmclip (Fair, Balanced, Accurate [FBA] – good factual report​) From: "Yantis, Ryan" To: Jeffries "Erica L" CC: "Arnold, Melaney" "Shay Drummond" "Shah, Nirav" "Clow, Bryan" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Neisen, Lisa \(PR\)" "Ray, Jaimee M" "McGill, Patricia O" "SAWYER, HARRY H" "DIEHL, GWEN G" "Walters, Lyndsey" "Beyer, Joseph" Date: 8/27/2015 4:43:14 PM Subject: FYSA 4th Hour Media IVH-Quincy Respiratory Illness Release ​AP Wire story Spreading Washington Times, National Public Radio http://www.washingtontimes.com/news/2015/aug/27/8-treated-for-legionnaires-disease-at-quincy-veter/​ As written, a re-play of the release.... no issues. Additional email query from ABC 7 Chicago, Chuck Goudie, investigative reporter. He also asked about the ​"source of the Warren Barr Gold Coast infection" Apparently a swanky skilled care facility in downtown Chicago. Told him he was asking the wrong Ryan. From: Yantis, Ryan Sent: Thursday, August 27, 2015 3:46 PM To: Jeffries, Erica L Cc: Arnold, Melaney; Shay Drummond; Shah, Nirav; Clow, Bryan; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR); Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G; Walters, Lyndsey; Beyer, Joseph Subject: 2nd Hour Media IVH-Quincy Respiratory Illness Release FYSA - AP story as source from Quincy - now state and leaning national 8 treated for Legionnaires’ disease at Quincy veterans home (St Louis) http://fox2now.com/2015/08/27/8-treated-for-legionnaires-disease-at-quincy-veterans-home/ FBA; mentions DOC LD case last month 8 treated for Legionnaires' disease at Quincy veterans home (Bloomington) http://www.pantagraph.com/news/state-and-regional/illinois/treated-for-legionnaires-disease-at-quincy-veterans-home/article_050691c8-9546-5673-a359cfb1e2d41877.html FBA; mentions DOC LD case last month 8 treated for Legionnaires' disease at Quincy veterans home http://www.newsbug.info/news/national/illinois/treated-for-legionnaires-disease-at-quincy-veterans-home/article_cb019565-3b1d-515a-9b69-5c6aeed3f213.html From: Jeffries, Erica L Sent: Thursday, August 27, 2015 2:51 PM To: Yantis, Ryan Cc: Arnold, Melaney; Shay Drummond; Shah, Nirav; Clow, Bryan; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR); Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G; Walters, Lyndsey; Beyer, Joseph Subject: Re: FYI - 1st Hour Media IVH-Quincy Respiratory Illness Release Thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 14:40, Yantis, Ryan wrote: Health officials say several cases of Legionnaires' disease confirmed in Illinois Veterans Home http://www.wgem.com/story/29895140/2015/08/27/health-officials-say-several-cases-of-legionnaires-disease-confirmed-in-illinois-veterans-home (truncated Press Release; no issues) Legionnaires’ disease outbreak at IL Vets Home http://quincyjournal.com/above-the-fold/2015/08/27/legionnaires%E2%80%99-disease-outbreak-at-il-vets-home/ (Press Release reprint; no issues) Eight Cases of Legionnaires’ Disease at Illinois Veterans’ Home http://khmoradio.com/eight-cases-of-legionnaires-disease-at-illinois-veterans-home/?trackback=tsmclip (Fair, Balanced, Accurate [FBA] – good factual report​) From: "Yantis, Ryan" To: "Shay Drummond" CC: "Arnold, Melaney" "Felde, Steve" sdrummond@co.adams.il.us Date: 8/27/2015 8:59:07 AM Subject: PIO Contact - Please add to release ​PIO Contacts and areas of responsibility Veterans & IVH-Q : Ryan Yantis, IDVA PIO (d) 312-814-0778 IDPH and Disease: Blessing Hospital: (c) 312-520-6958 ryan.yantis@illinois.gov Melaney Arnold, IDPH PIO ​(d) 217.558.0500 (c) 217.836.6438 melaney.arnold@illinois.gov ​Steve Felde, Sr. Comms Spec. (217)223-8400, ext. 4191​ steve.felde@blessinghealthsystem.org Environmental/ACHD: Shay Drummond, Office: 217-222-8440 x148 Cell: 217-316-2795 sdrummond@co.adams.il.us ​ ​ From: Shay Drummond Sent: Thursday, August 27, 2015 9:18 AM To: Yantis, Ryan Subject: Contacts Our PIO for this event is myself See contact info below Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Yantis, Ryan" To: Goudie Chuck CC: "Arnold, Melaney" sdrummond@co.adams.il.us Date: 8/27/2015 4:21:38 PM S u b j e c t : Re: Quincy vet home Chuck The Home staff is working with the Adams County Health Department and the Illinois Department of Public Health to investigate which system or systems might have played a role in the transmission of legionella. They are all working to identify, isolate, and remediate these systems.​ While the investigation and testing is underway, the Home has taken some water systems offline in an abundance of caution, and alternate systems are being used to support residents and staff. Currently eight (8) residents at the Veterans’ Home in Quincy have tested positive for Legionnaires’ disease. From: Goudie, Chuck Sent: Thursday, August 27, 2015 5:11 PM To: Yantis, Ryan Cc: Arnold, Melaney; sdrummond@co.adams.il.us Subject: Quincy vet home Ryan— Good afternoon. Has the water system there been deemed unusable until a source cause is determined? Still looking at 8 infected? Thanks, Chuck Goudie Investigative Reporter ABC-TV 190 N. State St. Chicago, Illinois 60601 (312)750-7101 From: "Yantis, Ryan" To: Arnold Melaney Nirav "Erica L" "LENARD F" "CATHY S ;Shay Drummond" CC: Date: 8/27/2015 9:11:44 AM Subject: Re: Updated Release DRAFT - Attachments: 2015-08-27 Vets Affairs -Legionella COORDINATING as of 10am.docx ​Apologies. Coordinating version now attached. Ryan From: Yantis, Ryan Sent: Thursday, August 27, 2015 10:10 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: Re: Updated Release DRAFT - All With thanks and compliments. I've added one line I feel is critical to the lede: "There have been no known deaths related to this outbreak​." I also added the PIO contact, as discussed on the conf. call. Notable, other than one mention in a quote, we are not addressing the residents at Blessing and still under their care. As written, it indicates all 8 are back on the IVH-Q campus. Guidance? From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:36 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT With Director Shah’s edits. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:31 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - Thanks. ​Standing by. From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:28 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I know Director Shah is somewhat tied up at the moment and has not yet reviewed a draft I sent, but I would like to share this with Vets so you get an idea of what we’re thinking. Ryan – I tried to keep the language similar so GO approval would be quicker. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:00 AM To: Shah, Nirav; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - ​Dir. Shah No worries on my end and why I sent to the group. If we re-order the paragraphs with the updated numbers, we should be able to staff quickly and release shortly. Standing by Ryan From: Shah, Nirav Sent: Thursday, August 27, 2015 8:57 AM To: Yantis, Ryan; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT Thank you, Ryan. We are reviewing this now. I’m concerned that we are burying the lede. Isn’t the main story what’s discussed in the fourth paragraph? Would you mind if we switched up the order a bit? We will take a stab at that and send something out very soon. Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Ryan Date: Thursday, August 27, 2015 at 8:48 AM To: "Jeffries, Erica L" , Nirav Shah , "Arnold, Melaney" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" Subject: Updated Release DRAFT - All Apologies, but to ensure and synchronize, I adjusted the text in the fourth graph to reflect numbers from this morning's conf. call: "Home staff have been monitoring two residents who tested positive for Legionella, a bacteria associated with Legionnaires’ disease, and both residents have responded to treatment. Six (6) other residents are currently at Blessing Hospital and have also tested positive for Legionella. Legionnaires’ disease is transmitted by aerosolized water, meaning that there is no known risk of person-to-person exchange. ​" Also, the lead graph remains or do we excise the "18" from that graph? Ryan From: "Yantis, Ryan" To: Arnold Melaney Nirav "Erica L" "LENARD F" "CATHY S ;Shay Drummond" CC: Date: 8/27/2015 9:10:56 AM Subject: Re: Updated Release DRAFT All With thanks and compliments. I've added one line I feel is critical to the lede: "There have been no known deaths related to this outbreak​." I also added the PIO contact, as discussed on the conf. call. Notable, other than one mention in a quote, we are not addressing the residents at Blessing and still under their care. As written, it indicates all 8 are back on the IVH-Q campus. Guidance? From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:36 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT With Director Shah’s edits. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:31 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - Thanks. ​Standing by. From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:28 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I know Director Shah is somewhat tied up at the moment and has not yet reviewed a draft I sent, but I would like to share this with Vets so you get an idea of what we’re thinking. Ryan – I tried to keep the language similar so GO approval would be quicker. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:00 AM To: Shah, Nirav; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - ​Dir. Shah No worries on my end and why I sent to the group. If we re-order the paragraphs with the updated numbers, we should be able to staff quickly and release shortly. Standing by Ryan From: Shah, Nirav Sent: Thursday, August 27, 2015 8:57 AM To: Yantis, Ryan; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT Thank you, Ryan. We are reviewing this now. I’m concerned that we are burying the lede. Isn’t the main story what’s discussed in the fourth paragraph? Would you mind if we switched up the order a bit? We will take a stab at that and send something out very soon. Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Ryan Date: Thursday, August 27, 2015 at 8:48 AM To: "Jeffries, Erica L" , Nirav Shah , "Arnold, Melaney" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" Subject: Updated Release DRAFT - All Apologies, but to ensure and synchronize, I adjusted the text in the fourth graph to reflect numbers from this morning's conf. call: "Home staff have been monitoring two residents who tested positive for Legionella, a bacteria associated with Legionnaires’ disease, and both residents have responded to treatment. Six (6) other residents are currently at Blessing Hospital and have also tested positive for Legionella. Legionnaires’ disease is transmitted by aerosolized water, meaning that there is no known risk of person-to-person exchange. ​" Also, the lead graph remains or do we excise the "18" from that graph? Ryan From: "Yantis, Ryan" To: Jeffries "Erica L" "Lisa \(PR\)" CC: "Shay Drummond" "Arnold, Melaney" "Shah, Nirav" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Kuida, Elliot" "Powell, Betsey" Date: 8/27/2015 10:46:42 AM Subject: Re: Updated Release DRAFT 1028 ​Working up final layout now. Will send to all ASAP. Thanks From: Jeffries, Erica L Sent: Thursday, August 27, 2015 11:28 AM To: Neisen, Lisa (PR) Cc: Yantis, Ryan; Shay Drummond; Arnold, Melaney; Shah, Nirav; WINNICKI, LENARD F; HOUSTON, CATHY S; Kuida, Elliot; Powell, Betsey Subject: Re: Updated Release DRAFT 1028 Thanks, everyone, for providing your inputs. I think this is ready to go. We will be standing by to respond to queries per our conversation this morning. Thank you! Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 11:16, Neisen, Lisa (PR) wrote: > Hi RyanWe have reviewed the release, and would like to request a change in the 4th paragraph- changing “Blessing Hospital” to “local healthcare providers.” This change makes the sentence more accurate. Please send final version once ready. Do you have an estimated time on distribution of the release? We would like to share the information internally with our Board, staff and physicians to make them aware, prior to the public release. Thank you, Lisa K. Neisen Director, Public Relations & Comm. Blessing Hospital, 1135 Broadway Quincy, IL 62305 (217) 223-8400, ext. 4190 Lisa.neisen@blessinghealthsystem.org From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Thursday, August 27, 2015 10:34 AM To: Shay Drummond; Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Neisen, Lisa (PR) Subject: Re: Updated Release DRAFT 1028 ​All Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: Shay Drummond Sent: Thursday, August 27, 2015 10:29 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT Thanks, I am sure as this hits the wire we are going to have our phones burning up! From: "Yantis, Ryan" To: "Shay Drummond" Melaney Nirav "Erica L" "LENARD F" "CATHY S ;; >" CC: Date: 8/27/2015 9:34:19 AM Subject: Re: Updated Release DRAFT 1028 Attachments: 2015-08-27 Vets Affairs -Legionella COORDINATING as of 1028am.docx ​All Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: Shay Drummond Sent: Thursday, August 27, 2015 10:29 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT Thanks, I am sure as this hits the wire we are going to have our phones burning up! From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:26 AM To: Shay Drummond; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I’m still working on the talking point – along with some messaging. I hope to have these out relatively soon. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Thursday, August 27, 2015 10:26 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - That is a good point as one is on comfort measures. From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:12 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: RE: Updated Release DRAFT Not all 8 cases are still at the hospital. 4 are back at the home – and that doesn’t mean all 4 are recovering. From: Yantis, Ryan Sent: Thursday, August 27, 2015 10:11 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: Re: Updated Release DRAFT - All With thanks and compliments. I've added one line I feel is critical to the lede: "There have been no known deaths related to this outbreak​." I also added the PIO contact, as discussed on the conf. call. Notable, other than one mention in a quote, we are not addressing the residents at Blessing and still under their care. As written, it indicates all 8 are back on the IVH-Q campus. Guidance? From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:36 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - With Director Shah’s edits. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:31 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - Thanks. ​Standing by. From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:28 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I know Director Shah is somewhat tied up at the moment and has not yet reviewed a draft I sent, but I would like to share this with Vets so you get an idea of what we’re thinking. Ryan – I tried to keep the language similar so GO approval would be quicker. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:00 AM To: Shah, Nirav; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - ​Dir. Shah No worries on my end and why I sent to the group. If we re-order the paragraphs with the updated numbers, we should be able to staff quickly and release shortly. Standing by Ryan From: Shah, Nirav Sent: Thursday, August 27, 2015 8:57 AM To: Yantis, Ryan; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT Thank you, Ryan. We are reviewing this now. I’m concerned that we are burying the lede. Isn’t the main story what’s discussed in the fourth paragraph? Would you mind if we switched up the order a bit? We will take a stab at that and send something out very soon. Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Ryan Date: Thursday, August 27, 2015 at 8:48 AM To: "Jeffries, Erica L" , Nirav Shah , "Arnold, Melaney" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" Subject: Updated Release DRAFT - All Apologies, but to ensure and synchronize, I adjusted the text in the fourth graph to reflect numbers from this morning's conf. call: "Home staff have been monitoring two residents who tested positive for Legionella, a bacteria associated with Legionnaires’ disease, and both residents have responded to treatment. Six (6) other residents are currently at Blessing Hospital and have also tested positive for Legionella. Legionnaires’ disease is transmitted by aerosolized water, meaning that there is no known risk of person-to-person exchange. ​" Also, the lead graph remains or do we excise the "18" from that graph? Ryan From: "Yantis, Ryan" To: Arnold "Melaney ;Shay Drummond" Nirav "Erica L" Bryan CC: "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Neisen, Lisa \(PR\)" "Ray, Jaimee M" "McGill, Patricia O" "SAWYER, HARRY H" "DIEHL, GWEN G" "Walters, Lyndsey" "Beyer, Joseph" Date: 8/27/2015 11:29:37 AM Subject: Re: Updated Release DRAFT 1028 Attachments: 2015-08-27 IDVA-IDPH Release onRespiratory Illiness at IVH-Q FINAL R.docx All Revised with Illinois Veterans' Home ​- Quincy spelled out in the headline. 1:30 PM to send to media? Immediate release to Blessing and Elected Officials? Ryan From: Arnold, Melaney Sent: Thursday, August 27, 2015 12:13 PM To: Yantis, Ryan; Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: RE: Updated Release DRAFT 1028 Thanks. I would spell out Illinois Veterans Home-Quincy in the headline. From: Yantis, Ryan Sent: Thursday, August 27, 2015 12:12 PM To: Shay Drummond; Shah, Nirav; Jeffries, Erica L; Clow, Bryan Cc: Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org; Ray, Jaimee M; McGill, Patricia O; SAWYER, HARRY H; DIEHL, GWEN G Subject: Re: Updated Release DRAFT 1028 ​Ladies and Gents Apologies for the slight delay. Graphic arts are not in my natural skill set and resetting the banner took a bit. Please find attached what I consider the final on the Press Release announcing the Respiratory Illness at IVH-Q. If there's a better headline, I am all ears. Otherwise this is ready for release to Blessing for staff, and to elected officials, as discussed. Ryan From: Shay Drummond Sent: Thursday, August 27, 2015 10:39 AM To: Shah, Nirav; Yantis, Ryan Cc: Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: RE: Updated Release DRAFT 1028 Looks ready! Thanks for you work. From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Thursday, August 27, 2015 10:38 AM To: Yantis, Ryan Cc: Shay Drummond; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: Re: Updated Release DRAFT 1028 Looks excellent. Thank you, Ryan. -Nirav On Aug 27, 2015, at 10:34 AM, Yantis, Ryan wrote: ​All Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: Shay Drummond Sent: Thursday, August 27, 2015 10:29 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT Thanks, I am sure as this hits the wire we are going to have our phones burning up! From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:26 AM To: Shay Drummond; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I’m still working on the talking point – along with some messaging. I hope to have these out relatively soon. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Thursday, August 27, 2015 10:26 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - That is a good point as one is on comfort measures. From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:12 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: RE: Updated Release DRAFT Not all 8 cases are still at the hospital. 4 are back at the home – and that doesn’t mean all 4 are recovering. From: Yantis, Ryan Sent: Thursday, August 27, 2015 10:11 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: Re: Updated Release DRAFT - All With thanks and compliments. I've added one line I feel is critical to the lede: "There have been no known deaths related to this outbreak​." I also added the PIO contact, as discussed on the conf. call. Notable, other than one mention in a quote, we are not addressing the residents at Blessing and still under their care. As written, it indicates all 8 are back on the IVH-Q campus. Guidance? From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:36 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT With Director Shah’s edits. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:31 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - Thanks. ​Standing by. From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:28 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I know Director Shah is somewhat tied up at the moment and has not yet reviewed a draft I sent, but I would like to share this with Vets so you get an idea of what we’re thinking. Ryan – I tried to keep the language similar so GO approval would be quicker. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:00 AM To: Shah, Nirav; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - ​Dir. Shah No worries on my end and why I sent to the group. If we re-order the paragraphs with the updated numbers, we should be able to staff quickly and release shortly. Standing by Ryan From: Shah, Nirav Sent: Thursday, August 27, 2015 8:57 AM To: Yantis, Ryan; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT Thank you, Ryan. We are reviewing this now. I’m concerned that we are burying the lede. Isn’t the main story what’s discussed in the fourth paragraph? Would you mind if we switched up the order a bit? We will take a stab at that and send something out very soon. Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Ryan Date: Thursday, August 27, 2015 at 8:48 AM To: "Jeffries, Erica L" , Nirav Shah , "Arnold, Melaney" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" Subject: Updated Release DRAFT - All Apologies, but to ensure and synchronize, I adjusted the text in the fourth graph to reflect numbers from this morning's conf. call: "Home staff have been monitoring two residents who tested positive for Legionella, a bacteria associated with Legionnaires’ disease, and both residents have responded to treatment. Six (6) other residents are currently at Blessing Hospital and have also tested positive for Legionella. Legionnaires’ disease is transmitted by aerosolized water, meaning that there is no known risk of person-to-person exchange. ​" Also, the lead graph remains or do we excise the "18" from that graph? Ryan <2015-08-27 Vets Affairs - Legionella COORDINATING as of 1028am.docx> From: "Yantis, Ryan" To: "Shay Drummond" Nirav "Erica L" Bryan CC: "Arnold, Melaney" "WINNICKI, LENARD F" "HOUSTON, CATHY S" Lisa.Neisen@blessinghealthsystem.org "Ray, Jaimee M" "McGill, Patricia O" "SAWYER, HARRY H" "DIEHL, GWEN G" Date: 8/27/2015 11:11:54 AM Subject: Re: Updated Release DRAFT 1028 Attachments: 2015-08-27 IDVA-IDPH Release onRespiratory Illiness at IVH-Q FINAL.docx ​Ladies and Gents Apologies for the slight delay. Graphic arts are not in my natural skill set and resetting the banner took a bit. Please find attached what I consider the final on the Press Release announcing the Respiratory Illness at IVH-Q. If there's a better headline, I am all ears. Otherwise this is ready for release to Blessing for staff, and to elected officials, as discussed. Ryan From: Shay Drummond Sent: Thursday, August 27, 2015 10:39 AM To: Shah, Nirav; Yantis, Ryan Cc: Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: RE: Updated Release DRAFT 1028 Looks ready! Thanks for you work. From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Thursday, August 27, 2015 10:38 AM To: Yantis, Ryan Cc: Shay Drummond; Arnold, Melaney; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Lisa.Neisen@blessinghealthsystem.org Subject: Re: Updated Release DRAFT 1028 Looks excellent. Thank you, Ryan. -Nirav On Aug 27, 2015, at 10:34 AM, Yantis, Ryan wrote: ​All Updated: New sentence order in the lede Removed Blessing PIO from the contacts at the bottom, per quest of Ms Neisen. Tightened Cathy Houston's quote. ​Any other edits / concerns? From: Shay Drummond Sent: Thursday, August 27, 2015 10:29 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT Thanks, I am sure as this hits the wire we are going to have our phones burning up! From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:26 AM To: Shay Drummond; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I’m still working on the talking point – along with some messaging. I hope to have these out relatively soon. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Thursday, August 27, 2015 10:26 AM To: Arnold, Melaney; Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - That is a good point as one is on comfort measures. From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Thursday, August 27, 2015 10:12 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: RE: Updated Release DRAFT Not all 8 cases are still at the hospital. 4 are back at the home – and that doesn’t mean all 4 are recovering. From: Yantis, Ryan Sent: Thursday, August 27, 2015 10:11 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S; Shay Drummond Subject: Re: Updated Release DRAFT - All With thanks and compliments. I've added one line I feel is critical to the lede: "There have been no known deaths related to this outbreak​." I also added the PIO contact, as discussed on the conf. call. Notable, other than one mention in a quote, we are not addressing the residents at Blessing and still under their care. As written, it indicates all 8 are back on the IVH-Q campus. Guidance? From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:36 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT - With Director Shah’s edits. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:31 AM To: Arnold, Melaney; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - Thanks. ​Standing by. From: Arnold, Melaney Sent: Thursday, August 27, 2015 9:28 AM To: Yantis, Ryan; Shah, Nirav; Jeffries, Erica L; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: RE: Updated Release DRAFT I know Director Shah is somewhat tied up at the moment and has not yet reviewed a draft I sent, but I would like to share this with Vets so you get an idea of what we’re thinking. Ryan – I tried to keep the language similar so GO approval would be quicker. From: Yantis, Ryan Sent: Thursday, August 27, 2015 9:00 AM To: Shah, Nirav; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT - ​Dir. Shah No worries on my end and why I sent to the group. If we re-order the paragraphs with the updated numbers, we should be able to staff quickly and release shortly. Standing by Ryan From: Shah, Nirav Sent: Thursday, August 27, 2015 8:57 AM To: Yantis, Ryan; Jeffries, Erica L; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S Subject: Re: Updated Release DRAFT Thank you, Ryan. We are reviewing this now. I’m concerned that we are burying the lede. Isn’t the main story what’s discussed in the fourth paragraph? Would you mind if we switched up the order a bit? We will take a stab at that and send something out very soon. Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Ryan Date: Thursday, August 27, 2015 at 8:48 AM To: "Jeffries, Erica L" , Nirav Shah , "Arnold, Melaney" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" Subject: Updated Release DRAFT - All Apologies, but to ensure and synchronize, I adjusted the text in the fourth graph to reflect numbers from this morning's conf. call: "Home staff have been monitoring two residents who tested positive for Legionella, a bacteria associated with Legionnaires’ disease, and both residents have responded to treatment. Six (6) other residents are currently at Blessing Hospital and have also tested positive for Legionella. Legionnaires’ disease is transmitted by aerosolized water, meaning that there is no known risk of person-to-person exchange. ​" Also, the lead graph remains or do we excise the "18" from that graph? Ryan <2015-08-27 Vets Affairs - Legionella COORDINATING as of 1028am.docx> From: "Yantis, Ryan" To: HOUSTON "CATHY S" "Erica L" CC: "WINNICKI, LENARD F" "Shay Drummond" "Arnold, Melaney" "SAWYER, HARRY H" "DIEHL, GWEN G" Date: 8/27/2015 2:38:27 PM Subject: Re: WGEM Interview Req. On IVH-Q Campus ​Emails crossed at the same time. I am happy to talk to the reporter, but they are a local station, looking for someone on camera, on campus. I still feel it's best for the local folks to talk to the local media. I am not hanging you out to dry and will help prep whoever it is. If, not, then I am happy to do the interview remotely. Need an update on remediation steps - in very clear language.. From: HOUSTON, CATHY Sent: Thursday, August 27, 2015 3:30 PM To: Jeffries, Erica L; Yantis, Ryan Cc: WINNICKI, LENARD F; Shay Drummond; Arnold, Melaney; SAWYER, HARRY H; DIEHL, GWEN G Subject: RE: WGEM Interview Req. On IVH-Q Campus They want to interview for Television. Bruce and I don’t really care to do this. We would prefer one of you to call them and do maybe a telephone interview? Can one of you please call him? WGEM Travis 217-228-6655 From: Jeffries, Erica L Sent: Thursday, August 27, 2015 3:23 PM To: Yantis, Ryan Cc: HOUSTON, CATHY; WINNICKI, LENARD F.; Shay Drummond; Arnold, Melaney; SAWYER, HARRY; DIEHL, GWEN Subject: Re: WGEM Interview Req. On IVH-Q Campus Did they ask specifically for someone from the home. If so, we should be taking the call. Cathy, if you're not comfortable then Len or Bruce should take it - or I'm happy to do so, as well. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 15:08, Yantis, Ryan wrote: Cathy & Shay Travis from WGEM is requesting a recorded interview with someone from the Home about the situation at the Home. He's looking for general questions - which are likely in the Q&A I recently re-sent. They can come to the Home ASAP, just need to know where and when if you are all interested/willing. ​ 217-228-6655 thanks - I am happy to chat / prep whoever is going to do this. 312-520-6958 Ryan From: "Yantis, Ryan" To: "Shay Drummond" "Erica L" CC: "HOUSTON, CATHY S" "WINNICKI, LENARD F" "Arnold, Melaney" "SAWYER, HARRY H" "DIEHL, GWEN G" Date: 8/27/2015 2:31:05 PM Subject: Re: WGEM Interview Req. On IVH-Q Campus ​Thanks Len, Cathy, and/or Bruce.... standing by for your call when you are ready. 312-520-6958 I'll talk you through the process Ryan From: Shay Drummond Sent: Thursday, August 27, 2015 3:29 PM To: Jeffries, Erica L; Yantis, Ryan Cc: HOUSTON, CATHY S; WINNICKI, LENARD F; Arnold, Melaney; SAWYER, HARRY H; DIEHL, GWEN G Subject: RE: WGEM Interview Req. On IVH-Q Campus Hi I did an interview with WGEM –what is Legionella, signs, symptoms, general talking points. I suggested to Travis he call or email back. He was wanting to go on grounds and interview someone from IVH. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Thursday, August 27, 2015 3:23 PM To: Yantis, Ryan Cc: HOUSTON, CATHY; WINNICKI, LENARD F.; Shay Drummond; Arnold, Melaney; SAWYER, HARRY; DIEHL, GWEN Subject: Re: WGEM Interview Req. On IVH-Q Campus Did they ask specifically for someone from the home. If so, we should be taking the call. Cathy, if you're not comfortable then Len or Bruce should take it - or I'm happy to do so, as well. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 27, 2015, at 15:08, Yantis, Ryan wrote: Cathy & Shay Travis from WGEM is requesting a recorded interview with someone from the Home about the situation at the Home. He's looking for general questions - which are likely in the Q&A I recently re-sent. They can come to the Home ASAP, just need to know where and when if you are all interested/willing. ​ 217-228-6655 thanks - I am happy to chat / prep whoever is going to do this. 312-520-6958 Ryan From: "Yantis, Ryan" To: Arnold "Melaney ;Shay Drummond" "LENARD F" "CATHY S" "BRUCE L" "Erica L" "GWEN G" CC: "SAWYER, HARRY H" Date: 8/27/2015 2:26:45 PM Subject: Updating TP and Q&A Attachments: Legionella TP & Q&A 2015-08-27 301 pmVA.docx Legionella TP & Q&A 2015-08-27 301 pmVA (1).docx ​All Updated with IV-Q info/steps and a date-time-stamp. Good to use From: Arnold, Melaney Sent: Thursday, August 27, 2015 2:59 PM To: Yantis, Ryan; Shay Drummond Subject: RE: Steve Eighinger Quincy Herald Whig 217-221-3377 Thanks From: Yantis, Ryan Sent: Thursday, August 27, 2015 2:55 PM To: Shay Drummond; Arnold, Melaney Subject: Steve Eighinger Quincy Herald Whig 217-221-3377 ​Likely to call each of you for info on environmental steps (Shay) and disease details (Melaney) From: "Arnold, Melaney" To: Austin Connie "Craig ;Shay Drummond" CC: Date: 8/28/2015 7:48:12 PM Subject: Fwd: IDVA/IDPH Press Release: Two Deaths at Illinois Veterans’ Home-Quincy (after-hours email list) Attachments: 2015-08-28 IDVA-IDPH Release Two Dead at IVH-Q FINAL R.docx ATT00001.htm Begin forwarded message: From: "Yantis, Ryan" Date: August 28, 2015 at 8:39:10 PM CDT To: CMS.IISNEWS Subject: IDVA/IDPH Press Release: Two Deaths at Illinois Veterans’ Home-Quincy (after-hours email list) For Immediate Release Aug. 28, 2015 CONTACTS: See Below Two Deaths at Illinois Veterans’ Home-Quincy Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of two residents at the Illinois Veterans’ Home-Quincy. The two residents, both of whom had underlying medical conditions, were among the 23 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “The Illinois Department of Veterans’ Affairs (IDVA) and our Quincy Home staff are deeply saddened by the passing of these two veterans, just as we are when any of our residents pass. Our thoughts and prayers are with the family, friends, and caretakers of these residents.” said Erica Jeffries, Director, IDVA. “We are keenly focused on making all of our Homes places for residents to live and thrive, and we work very hard to provide the safest, most sanitary, and pleasant living arrangements for our heroes. We will continue to work closely with IDPH and the local healthcare providers to remediate these issues as quickly as possible to ensure the safety and well-being of all of our residents.” “Legionnaires’ disease can range from a mild respiratory illness to severe pneumonia and death,” said IDPH Director Nirav D. Shah, M.D., J.D. “It can take up to 14 days to become ill after exposure, so we could see additional cases. Because the elderly and those with underlying medical conditions are at greater risk of serious illness, we are working diligently to identify residents or staff who have respiratory illness and provide medical treatment to them as quickly as possible.” Names of the deceased are being withheld to allow families to notify other family and friends. We will work with the families and ask others to respect their privacy at this difficult time. IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. For more information about Legionnaires’ disease, visit the IDPH website. For media seeking additional information, please contact: IDVA / IVH-Quincy: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d)217-222-8440 x148 (c)217-316-2795 sdrummond@co.adams.il.us ### From: "Arnold, Melaney" To: Yantis "Ryan ;Shay Drummond" "LENARD F" CC: "Little, Divya Mohan" Date: 8/28/2015 9:30:37 AM Subject: Media strategy Morning ~ IDPH’s thoughts on media strategy. It looks like we’re going to see a pretty big jump in numbers today. And some of the cases are not doing well. However, we do not propose a news release today. The only new thing we would have is the updated numbers. IDPH is working to update our website, we’ll have a banner on the home page for Legionnaires’ disease that will link directly to our Legionnaires’ info page. On that page we plan on posting the daily numbers. We’re being transparent, but not continuing to put this in the media’s eye. If/when we see deaths – at that time I think we’ll need a news release, possibly even a news conference if all administrators agree. Thoughts? Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: "Arnold, Melaney" To: Austin Connie "Craig ;Shay Drummond" CC: Date: 8/28/2015 7:53:23 PM Subject: Re: IDVA/IDPH Press Release: Two Deaths at Illinois Veterans’ Home-Quincy (after-hours email list) I couldn't find Jarrad's e mail On Aug 28, 2015, at 8:48 PM, Arnold, Melaney wrote: Begin forwarded message: From: "Yantis, Ryan" Date: August 28, 2015 at 8:39:10 PM CDT To: CMS.IISNEWS Subject: IDVA/IDPH Press Release: Two Deaths at Illinois Veterans’ Home-Quincy (after-hours email list) For Immediate Release Aug. 28, 2015 CONTACTS: Two Deaths at Illinois Veterans’ Home-Quincy See Below Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of two residents at the Illinois Veterans’ Home-Quincy. The two residents, both of whom had underlying medical conditions, were among the 23 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “The Illinois Department of Veterans’ Affairs (IDVA) and our Quincy Home staff are deeply saddened by the passing of these two veterans, just as we are when any of our residents pass. Our thoughts and prayers are with the family, friends, and caretakers of these residents.” said Erica Jeffries, Director, IDVA. “We are keenly focused on making all of our Homes places for residents to live and thrive, and we work very hard to provide the safest, most sanitary, and pleasant living arrangements for our heroes. We will continue to work closely with IDPH and the local healthcare providers to remediate these issues as quickly as possible to ensure the safety and well-being of all of our residents.” “Legionnaires’ disease can range from a mild respiratory illness to severe pneumonia and death,” said IDPH Director Nirav D. Shah, M.D., J.D. “It can take up to 14 days to become ill after exposure, so we could see additional cases. Because the elderly and those with underlying medical conditions are at greater risk of serious illness, we are working diligently to identify residents or staff who have respiratory illness and provide medical treatment to them as quickly as possible.” Names of the deceased are being withheld to allow families to notify other family and friends. We will work with the families and ask others to respect their privacy at this difficult time. IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. For more information about Legionnaires’ disease, visit the IDPH website. For media seeking additional information, please contact: IDVA / IVH-Quincy: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d)217-222-8440 x148 (c)217-316-2795 sdrummond@co.adams.il.us ### <2015-08-28 IDVA-IDPH Release Two Dead at IVH-Q FINAL R.docx> From: "Arnold, Melaney" To: Yantis Ryan CC: "Smith, Mitch" "Shay Drummond" Date: 8/28/2015 4:21:10 PM Subject: Re: New York Times request Ryan - is this posted on vets website? If not, I could provide the link to the IDPH site On Aug 28, 2015, at 4:44 PM, Yantis, Ryan wrote: ​ From: Smith, Mitch Sent: Friday, August 28, 2015 4:38 PM To: Yantis, Ryan Subject: New York Times request Hi Ryan, I'm a Chicago-based New York Times reporter following the Legionnaires' cases in Quincy. Can you please send me the most recent press release, and include me on the distribution list for any updates? Thanks for your help. -Mitch Smith Mitch Smith The New York Times, Chicago bureau mitch.smith@nytimes.com O: 312-552-7209 C: 913-568-8847 From: "Arnold, Melaney" To: Yantis "Ryan ;Shay Drummond" "LENARD F" "CATHY S" "Erica L" "HARRY H" Nirav CC: Date: 8/28/2015 11:18:34 AM Subject: RE: Updated TP/Q&A Attachments: Legionella.docx Thanks Ryan. I also updated some of the talking points, the main ones being that we don’t know if all 23 confirmed cases are Legionnaires’ disease or the milder form – so I changed it to say 23 cases of legionellosis. Shay – you may know more about this. Also – one staff member is now included in the cases. Q.6 A6. Are all 23 cases residents, or are staff members ill as well? Is staff at risk? All cases except for one, are residents. Some staff members have been at risk of exposure as well from aerosolized water sources. We are working diligently to make sure any place where Legionella bacteria could grow at the home is addressed – i.e. cleaned. And the CDC typically does not recommend moving long-term care residents. From: Yantis, Ryan Sent: Friday, August 28, 2015 12:01 PM To: Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; SAWYER, HARRY H; Shah, Nirav Subject: Updated TP/Q&A All - updated overall cases, added Q&A 7 from my ABC 7 query yesterday, added numbers to Q&A​'s for easier tracking & updating, and updated "as of " date/time stamp Attached. From: "Austin, Connie" To: "Jerrod Welch" CC: "Arnold, Melaney" Date: 8/28/2015 7:56:33 PM Subject: FW: IDVA/IDPH Press Release: Two Deaths at Illinois Veterans’ Home-Quincy (after-hours email list) Attachments: 2015-08-28 IDVA-IDPH Release Two Dead at IVH-Q FINAL R.docx ATT00001.htm Jerrod.. FYI Begin forwarded message: For Immediate Release Aug. 28, 2015 CONTACTS: See Below Two Deaths at Illinois Veterans’ Home-Quincy Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of two residents at the Illinois Veterans’ Home-Quincy. The two residents, both of whom had underlying medical conditions, were among the 23 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “The Illinois Department of Veterans’ Affairs (IDVA) and our Quincy Home staff are deeply saddened by the passing of these two veterans, just as we are when any of our residents pass. Our thoughts and prayers are with the family, friends, and caretakers of these residents.” said Erica Jeffries, Director, IDVA. “We are keenly focused on making all of our Homes places for residents to live and thrive, and we work very hard to provide the safest, most sanitary, and pleasant living arrangements for our heroes. We will continue to work closely with IDPH and the local healthcare providers to remediate these issues as quickly as possible to ensure the safety and well-being of all of our residents.” “Legionnaires’ disease can range from a mild respiratory illness to severe pneumonia and death,” said IDPH Director Nirav D. Shah, M.D., J.D. “It can take up to 14 days to become ill after exposure, so we could see additional cases. Because the elderly and those with underlying medical conditions are at greater risk of serious illness, we are working diligently to identify residents or staff who have respiratory illness and provide medical treatment to them as quickly as possible.” Names of the deceased are being withheld to allow families to notify other family and friends. We will work with the families and ask others to respect their privacy at this difficult time. IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. For more information about Legionnaires’ disease, visit the IDPH website. For media seeking additional information, please contact: IDVA / IVH-Quincy: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d)217-222-8440 x148 (c)217-316-2795 sdrummond@co.adams.il.us ### From: "Austin, Connie" To: "Jerrod Welch" "Jon Campos" "Shay Drummond" CC: Date: 8/28/2015 8:02:55 PM Subject: ppt. Attachments: cdcs_Legionella_ppt_August282015.pptx In case this is helpful. We are missing a number of the pending cases and the 2 new community cases on the epi curve and the 2 food service employees on the map. But this gives a general sense. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: "Jerrod Welch" "Jon Campos" "Shay Drummond" CC: Date: 8/28/2015 8:02:55 PM Subject: ppt. Attachments: cdcs_Legionella_ppt_August282015.pptx In case this is helpful. We are missing a number of the pending cases and the 2 new community cases on the epi curve and the 2 food service employees on the map. But this gives a general sense. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: "Shay Drummond" CC: "Morgan, Jodi" "Conover, Craig" Date: 8/28/2015 11:41:11 AM Subject: RE: For your review Okay, did the 2 non pneumonias have resp symptoms. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 12:32 PM To: Austin, Connie Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Update: Blessing has been discharging a few – they now have 20 patients (1 has been discharged, and 2 pending discharge) I have a conference call with them at 1:00pm Also it looks like we have pneumonia dx on all of our positives but two – that was first pass on our spreadsheet. Getting labs filed and reviewed with Jon. I also presented your questions to Cathy at IVH. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:45 AM To: Shay Drummond Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Okay I gave Melaney 23 and she seemed content with that, so if we get more questions I think I would give 23 lab confirmed, I didn’t check and should have, how many have pneumonia? Otherwise some may be Legionnaires’ disease and some may be Pontiac fever. If they ask, 12 of the 23 residents and one staff are hospitalized, 2 residents discharged and 8 residents are at IVH being treated. Onsets from July 24 through August 26. CDC’s questions for the day. What is the S. pneumo vaccination program at the facility (I think the thought there is to decrease respiratory illnesses that you can prevent) and also reduce risk of having Legionella affect someone who has S pneumo. Craig, any thoughts about influenza vaccination early? I will ask our intern to check on the next question which is how many of the negatives had urine antigens done within 48 hours of their onset, may need to be re-tested as it can take 48-72 hours for the test to be positive. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:11 AM To: Austin, Connie Subject: RE: For your review No there are currently 23 in Blessing With 12 of those being positive 6 negative and pending labs. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:07 AM To: Shay Drummond Subject: RE: For your review So 22 residents, 1 staff 12 of the 23 are currently hospitalized and 2 were discharged, so 9 never hospitalized? just want to make sure that is correct? Latest onset I saw was 8/26. We have a new intern do you want him to enter some of these in INEDSS? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:02 AM To: Austin, Connie Subject: For your review Illinois Veteran Home 23 Confirmed positive Urine antigens – all are residents and 1 staff 23 patients in Blessing from IVH with 12 confirmed urine antigen – and additional labs pending 1 patient is in ICU none are on vents 1 is in IMC IVH is monitoring approx.. 35 residents with 8 positives in that group. IVH has 2 residents that were hospitalized and have been discharged – both were urine positives Illinois Veterans Home Staff 5 with signs and symptoms one is hospitalized in ICU and is a positive. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: "Shay Drummond" CC: Date: 8/28/2015 10:07:20 AM S u b j e c t : RE: For your review So 22 residents, 1 staff 12 of the 23 are currently hospitalized and 2 were discharged, so 9 never hospitalized? just want to make sure that is correct? Latest onset I saw was 8/26. We have a new intern do you want him to enter some of these in INEDSS? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:02 A M T o: Austin, C onnie Subject: For y our review Illinois Veteran Home 23 Confirmed positive Urine antigens – all are residents and 1 staff 23 patients in Blessing from IVH with 12 confirmed urine antigen – and additional labs pending 1 patient is in ICU none are on vents 1 is in IMC IVH is monitoring approx.. 35 residents with 8 positives in that group. IVH has 2 residents that were hospitalized and have been discharged – both were urine positives Illinois Veterans Home Staff 5 with signs and symptoms one is hospitalized in ICU and is a positive. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: "Shay Drummond" CC: Date: 8/28/2015 12:59:41 PM Subject: RE: For your review Can you fax the lab slips for these 4? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 12:46 PM To: Austin, Connie Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review We are reviewing we just got results for four more positive cases. One was previously a negative and they must have gotten two urines as one is now positive. That is in-patient and it is Staff is positive is positive is positive All in patient. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 12:41 PM To: Shay Drummond Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Okay, did the 2 non pneumonias have resp symptoms. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 12:32 PM To: Austin, Connie Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Update: Blessing has been discharging a few – they now have 20 patients (1 has been discharged, and 2 pending discharge) I have a conference call with them at 1:00pm Also it looks like we have pneumonia dx on all of our positives but two – that was first pass on our spreadsheet. Getting labs filed and reviewed with Jon. I also presented your questions to Cathy at IVH. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:45 AM To: Shay Drummond Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Okay I gave Melaney 23 and she seemed content with that, so if we get more questions I think I would give 23 lab confirmed, I didn’t check and should have, how many have pneumonia? Otherwise some may be Legionnaires’ disease and some may be Pontiac fever. If they ask, 12 of the 23 residents and one staff are hospitalized, 2 residents discharged and 8 residents are at IVH being treated. Onsets from July 24 through August 26. CDC’s questions for the day. What is the S. pneumo vaccination program at the facility (I think the thought there is to decrease respiratory illnesses that you can prevent) and also reduce risk of having Legionella affect someone who has S pneumo. Craig, any thoughts about influenza vaccination early? I will ask our intern to check on the next question which is how many of the negatives had urine antigens done within 48 hours of their onset, may need to be re-tested as it can take 48-72 hours for the test to be positive. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:11 AM To: Austin, Connie Subject: RE: For your review No there are currently 23 in Blessing With 12 of those being positive 6 negative and pending labs. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:07 AM To: Shay Drummond Subject: RE: For your review So 22 residents, 1 staff 12 of the 23 are currently hospitalized and 2 were discharged, so 9 never hospitalized? just want to make sure that is correct? Latest onset I saw was 8/26. We have a new intern do you want him to enter some of these in INEDSS? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:02 AM To: Austin, Connie Subject: For your review Illinois Veteran Home 23 Confirmed positive Urine antigens – all are residents and 1 staff 23 patients in Blessing from IVH with 12 confirmed urine antigen – and additional labs pending 1 patient is in ICU none are on vents 1 is in IMC IVH is monitoring approx.. 35 residents with 8 positives in that group. IVH has 2 residents that were hospitalized and have been discharged – both were urine positives Illinois Veterans Home Staff 5 with signs and symptoms one is hospitalized in ICU and is a positive. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: "Shay Drummond" CC: Date: 8/28/2015 10:08:04 AM Subj ect: RE: For your review Also, we put thru an Epi-X which notifies all states about the situation in case there are visitors to the home that develop Legionella in another state. It asks them to notify us of any possible linked cases. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:06 AM To: Austin, Connie Subject: FW: For your review There was one new admission yesterday And one patient that presented to ED and then returned to IVH From: Shay Drummond Sent: Friday, August 28, 2015 11:02 AM To: Austin, Connie (Connie.Austin@Illinois.gov) Subject: For your review Illinois Veteran Home 23 Confirmed positive Urine antigens – all are residents and 1 staff 23 patients in Blessing from IVH with 12 confirmed urine antigen – and additional labs pending 1 patient is in ICU none are on vents 1 is in IMC IVH is monitoring approx.. 35 residents with 8 positives in that group. IVH has 2 residents that were hospitalized and have been discharged – both were urine positives Illinois Veterans Home Staff 5 with signs and symptoms one is hospitalized in ICU and is a positive. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: "Shay Drummond" CC: "Morgan, Jodi" "Conover, Craig" Date: 8/28/2015 10:45:07 AM Subject: RE: For your review Okay I gave Melaney 23 and she seemed content with that, so if we get more questions I think I would give 23 lab confirmed, I didn’t check and should have, how many have pneumonia? Otherwise some may be Legionnaires’ disease and some may be Pontiac fever. If they ask, 12 of the 23 residents and one staff are hospitalized, 2 residents discharged and 8 residents are at IVH being treated. Onsets from July 24 through August 26. CDC’s questions for the day. What is the S. pneumo vaccination program at the facility (I think the thought there is to decrease respiratory illnesses that you can prevent) and also reduce risk of having Legionella affect someone who has S pneumo. Craig, any thoughts about influenza vaccination early? I will ask our intern to check on the next question which is how many of the negatives had urine antigens done within 48 hours of their onset, may need to be re-tested as it can take 48-72 hours for the test to be positive. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:11 AM To: Austin, Connie Subject: RE: For your review No there are currently 23 in Blessing With 12 of those being positive 6 negative and pending labs. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:07 AM To: Shay Drummond Subject: RE: For your review So 22 residents, 1 staff 12 of the 23 are currently hospitalized and 2 were discharged, so 9 never hospitalized? just want to make sure that is correct? Latest onset I saw was 8/26. We have a new intern do you want him to enter some of these in INEDSS? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:02 AM To: Austin, Connie Subject: For your review Illinois Veteran Home 23 Confirmed positive Urine antigens – all are residents and 1 staff 23 patients in Blessing from IVH with 12 confirmed urine antigen – and additional labs pending 1 patient is in ICU none are on vents 1 is in IMC IVH is monitoring approx.. 35 residents with 8 positives in that group. IVH has 2 residents that were hospitalized and have been discharged – both were urine positives Illinois Veterans Home Staff 5 with signs and symptoms one is hospitalized in ICU and is a positive. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: "Shay Drummond" Craig CC: Date: 8/28/2015 1:39:41 PM Subject: RE: ICU patients Not good thanks for letting us know. We have found 7 who had their urine antigen taken prior to 48 hours after onset and may need a re-test if Legionella is still on the suspect diagnosis list. Will fax to you. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 2:33 PM To: Austin, Connie; Conover, Craig Subject: ICU patients Importance: High We now have two in ICU that are diminishing rapidly Staff - is now ARDS And Resident Coded and was resuscitated Both on vent. I think we need to prepare that these may Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: "Shay Drummond" CC: Date: 8/28/2015 5:21:03 PM Subject: RE: lab testing update Get it all Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 6:21 PM To: Austin, Connie Subject: RE: lab testing update On phone with labCorps- she is looking up brand, she also wanted to know if we wanted to know machine From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 6:17 PM To: Shay Drummond Subject: RE: lab testing update I can tell you on the phone there is one that is better than another but this below doesn’t have the brand name. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 From: Shay Drummond Sent: Friday, August 28, 2015 6:02 PM To: Conover, Craig; Austin, Connie Cc: Echols, Fred; Morgan, Jodi; Kelly-Shannon, Kate D. Subject: RE: lab testing update Legionella pneumophila Urinary Antigen Test Number: 182246 CPT: 87449 Related Information Specimen Urine Volume 5 mL Container Sterile screw-cap container Storage Refrigerate. Instructions Causes for Swab specimen; inappropriate specimen transport device; unlabeled specimen or name discrepancy between specimen and request label; Rejection specimen received after prolonged delay (usually more than 72 hours); nonurine specimen Reference Interval No Legionella pneumophila serogroup 1 antigen detected Use Confirm the diagnosis of Legionella pneumophila serogroup 1 infection Limitations This test will not detect species or serogroups other than Legionella pneumophila serogroup 1. Methodology Enzyme immunoassay (EIA) Additional Legionella pneumophila has been estimated to cause 80% to 85% of Legionella infections, with serogroup 1 accounting for most of these. Information Current methods of diagnosis for Legionella infection include culture and DFA. All of these other tests require a high quality respiratory specimen to perform this test and, unfortunately, many patients with Legionella infection do not produce sputum. A number of investigators have shown that a specific soluble antigen was present in the urine of patients with Legionnaires' disease, which can be detected both early and late in the disease. References Berdal PP, Farshy CE, Feelley JC. Detection of Legionella pneumophila antigen in urine by enzyme-linked immunospecific assay. J Clin Microbiol. 1979 May; 9(5):575-578. PubMed 383744 Kohler RB, Zimmerman SE, Wilson E, et al. Rapid immunoassay diagnosis of Legionnaires' disease: Detection and partial characterization of urinary antigen. Ann Intern Med. 1981 May; 94(5):601-605. PubMed 7235392 Reingold AL, Thomason BM, Brake BJ, Thacker L, Wilkinson HW, Kuritsky JN. Legionellapneumonia in the United States: The distribution of serogroups and species causing human illness. J Infect Dis. 1984 May; 149(5):819. PubMed 6726009 From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Friday, August 28, 2015 5:47 PM To: Austin, Connie Cc: Shay Drummond; Echols, Fred; Morgan, Jodi; Kelly-Shannon, Kate D. Subject: Re: lab testing update False positives are very rare. How close to the facility does she live? iPhone. itypos. iapologize. On Aug 28, 2015, at 5:42 PM, "Austin, Connie" wrote: When I talked to CDC they said if the person has clinically compatible symptoms and is positive you would consider them a case. Do you know what test kit LabCorp uses? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 5:08 PM To: Austin, Connie Subject: RE: lab testing update Yes you should have her H&P we just faxed all info over. Presented to ambulatory with cough and fever was treated in ambulatory clinic and is at home. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 5:07 PM To: Shay Drummond; Conover, Craig Subject: RE: lab testing update Is she symptomatic? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 5:01 PM To: Austin, Connie; Conover, Craig; Shah, Nirav Subject: lab testing update Hi there. is being interviewed now and so far no connection to the IVH….What is the data on false positives? Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. FromTo: "Shay Drummond" CC: Date: 8/28/2015 5:16:55 PM Subject: RE: lab testing update I can tell you on the phone there is one that is better than another but this below doesn?t have the brand name. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond Sent: Friday, August 28, 2015 6:02 PM To: Conover, Craig; Austin, Connie Cc: Echols, Fred; Morgan, Jodi; Kelly-Shannon, Kate D. Subject: RE: lab testing update Legionella pneumophila Urinary Antigen Test Number: 182246 CPT: 87449 Related Information Wm Specimen Urine Volume 5 mL Container Sterile screw-cap container Storage Refrigerate. Instructions Causes for Swab specimen; inappropriate specimen transport device; unlabeled specimen or name discrepancy between specimen and request label; Rejection specimen received after prolonged delay (usually more than 72 hours); nonurine specimen Reference Interval No Legionella pneumophila serogroup 1 antigen detected Use Confirm the diagnosis of Legionella pneumophila serogroup 1 infection Limitations This test will not detect species or serogroups other than Legionella pneumophila serogroup 1. Methodology Enzyme immunoassay (EIA) Additional Legionella pneumophila has been estimated to cause 80% to 85% of Legionella infections, with serogroup 1 accounting for most of these. Information Current methods of diagnosis for Legionella infection include culture and DFA. All of these other tests require a high quality respiratory specimen to perform this test and, unfortunately, many patients with Legionella infection do not produce sputum. A number of investigators have shown that a specific soluble antigen was present in the urine of patients with Legionnaires' disease, which can be detected both early and late in the disease. References Berdal PP, Farshy CE, Feelley JC. Detection of Legionella pneumophila antigen in urine by enzyme-linked immunospecific assay. J Clin Microbiol. 1979 May; 9(5):575-578. PubMed 383744 Kohler RB, Zimmerman SE, Wilson E, et al. Rapid immunoassay diagnosis of Legionnaires' disease: Detection and partial characterization of urinary antigen. Ann Intern Med. 1981 May; 94(5):601-605. PubMed 7235392 Reingold AL, Thomason BM, Brake BJ, Thacker L, Wilkinson HW, Kuritsky JN. Legionellapneumonia in the United States: The distribution of serogroups and species causing human illness. J Infect Dis. 1984 May; 149(5):819. PubMed 6726009 From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Friday, August 28, 2015 5:47 PM To: Austin, Connie Cc: Shay Drummond; Echols, Fred; Morgan, Jodi; Kelly-Shannon, Kate D. Subject: Re: lab testing update False positives are very rare. How close to the facility does she live? iPhone. itypos. iapologize. On Aug 28, 2015, at 5:42 PM, "Austin, Connie" wrote: When I talked to CDC they said if the person has clinically compatible symptoms and is positive you would consider them a case. Do you know what test kit LabCorp uses? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 5:08 PM To: Austin, Connie Subject: RE: lab testing update Yes you should have her H&P we just faxed all info over. Presented to ambulatory with cough and fever was treated in ambulatory clinic and is at home. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 5:07 PM To: Shay Drummond; Conover, Craig Subject: RE: lab testing update Is she symptomatic? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 5:01 PM To: Austin, Connie; Conover, Craig; Shah, Nirav Subject: lab testing update Hi there. is being interviewed now and so far no connection to the IVH….What is the data on false positives? Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: Shah "Nirav ;Shay Drummond" Craig CC: Date: 8/28/2015 5:20:50 PM Subject: RE: lab testing update CDC said to count as a case if clinically compatible and urine antigen positive. There are two test kits by the same manufacturer and the one type is preferable to the other. At this time we do not know which type Memorial Hosp uses and which type Lab Corp uses. She also said that keep in mind as people are doing increased testing, this person obviously may have acquired Legionella somewhere else, so for now, I think if the person does not walk/hike/visit etc at IVH that we call her a community case until we have any additional cases that might change our minds about considering her part of the IVH situation. Shay, CDC says they are willing to do a urine antigen on the discordant result ones if needed. She also mentioned sputums but I think those people would all have been put on antibiotics by now so sputums would not be likely to help I don’t think. Craig may have additional thoughts. I think we’d mainly be worried about these outliers. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shah, Nirav Sent: Friday, August 28, 2015 5:50 PM To: Shay Drummond; Austin, Connie; Conover, Craig Subject: Re: lab testing update Thank you, Shay. This is important — please keep us updated. If we’re talking about the urine antigen, I think the false positive rate is virtually zero. The others on this email would know better than I, though. Thanks, Nirav Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Spring?eld, IL 62761 (217) 557-2556 [i 1. s; From: Shay Drummond Date: Friday, August 28, 2015 at 5:01 PM To: "Austin, Connie'I "Conover, Craig" Nirav Shah Subject: lab testing update Hi there. I is being interviewed now and so far no connection to the is the data on false positives? Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Of?ce: 217-222-8440 x148 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and con?dential use of the designated recipients named above. The documents accompanying this transmission may contain con?dential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been ful?lled. If the reader of this message is not the intended recipient, you are hereby noti?ed that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: "Jerrod Welch" "Shay Drummond" "Jon Campos" CC: "Culp, David" "Holmes, Tal" "Echols, Fred" "Shah, Nirav" Date: 8/28/2015 7:10:45 PM Subject: RE: This is similar, may not be identical to what is going to go out Jerrod, We also wanted to make sure you knew what a great job your staff are doing. It is great to see such dedicated public health folks working on this and we are fortunate that your staff are very organized, competent and cool under pressure. Since the incubation period can be up to 14 days I hope each of your staff will take care of themselves and make sure to give themselves appropriate breaks so they do not become too stressed. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Friday, August 28, 2015 7:38 PM To: Austin, Connie; Shay Drummond; Jon Campos Cc: Arnold, Melaney Subject: RE: This is similar, may not be identical to what is going to go out Thank you for getting this to us. I think we’re touching base with all the PIOs in the morning prior to any releases if I’m not mistaken. That will be beneficial to us as well. JCW From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 7:36 PM To: Jerrod Welch; Shay Drummond; Jon Campos Cc: Arnold, Melaney Subject: This is similar, may not be identical to what is going to go out Adams county colleagues, I am not sure of when this will go out there are approvals from GO office that are needed. Legionnaires’ Disease Deaths at Illinois Veterans’ Home-Quincy Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of two residents at the Illinois Veterans’ Home-Quincy among the 23 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “Our Quincy Home staff and the Illinois Department of Veterans’ Affairs (IDVA) are deeply saddened….,” said Erica L. Jeffries, Director, IDVA. “….” “Legionnaires’ disease can range from a mild respiratory illness to severe pneumonia and death,” said IDPH Director Nirav D. Shah, M.D., J.D. “It can take up to 14 days to become ill after exposure, so we could see additional cases. Because the elderly and those with underlying medical conditions are at greater risk of serious illness, we are working diligently to identify residents or staff who have respiratory illness and provide medical treatment to them as quickly as possible.” IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as whirlpool spas, hot tubs, humidifiers, hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. For more information about Legionnaires’ disease, visit the IDPH website For media seeking additional information, please contact: IDVA / IVH-Q: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d) 217-222-8440 x148 (c) 217-316-2795 sdrummond@co.adams.il.us Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From : "Austin, Connie" To: "Jerrod Welch" "Shay Drummond" "Jon Campos" CC: "Arnold, Melaney" Date: 8/28/2015 6:35:40 PM S u b j e c t : This is similar, may not be identical to what is going to go out Adams county colleagues, I am not sure of when this will go out there are approvals from GO office that are needed. Legionnaires’ Disease Deaths at Illinois Veterans’ Home-Quincy Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of two residents at the Illinois Veterans’ Home-Quincy among the 23 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “Our Quincy Home staff and the Illinois Department of Veterans’ Affairs (IDVA) are deeply saddened….,” said Erica L. Jeffries, Director, IDVA. “….” “Legionnaires’ disease can range from a mild respiratory illness to severe pneumonia and death,” said IDPH Director Nirav D. Shah, M.D., J.D. “It can take up to 14 days to become ill after exposure, so we could see additional cases. Because the elderly and those with underlying medical conditions are at greater risk of serious illness, we are working diligently to identify residents or staff who have respiratory illness and provide medical treatment to them as quickly as possible.” IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as whirlpool spas, hot tubs, humidifiers, hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. For more information about Legionnaires’ disease, visit the IDPH website For media seeking additional information, please contact: IDVA / IVH-Q: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d) 217-222-8440 x148 (c) 217-316-2795 sdrummond@co.adams.il.us Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Clegg, Whitney" To: "Shay Drummond" 'jcampos@co.adams.il.us' CC: Date: 8/28/2015 7:56:32 AM Subject: Re: Legionella Tracking Log (3).xlsx Whitney cell phone 952-994-3835 Justin cell phone 515-230-2870 Call anytime if you need us From: Shay Drummond Sent: Thursday, August 27, 2015 4:19:38 PM To: Clegg, Whitney Subject: Legionella Tracking Log (3).xlsx From: "Clegg, Whitney" To: 'jcampos@co.adams.il.us' CC: Date: 8/28/2015 11:29:51 AM Subject: Symptoms of new legionella cases Hi Jon, Are you able to get the ED notes or symptom history for any of the new confirmed legionella cases? We're lacking on symptom information for many of the new ones. We can get symptom history for the residents at the facility. Thanks, Whitney From: "Conover, Craig" To: "Shay Drummond" Connie CC: Date: 8/28/2015 2:29:56 PM Subject: RE: Need Guidance Tests show people develop immunity against a second Legionella infection (but how long immunity lasts is unknown). I think potential source of legionella have all been remediated. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 3:16 PM To: Austin, Connie; Conover, Craig Subject: Need Guidance Importance: High Hi getting calls from families of hospital patients – hospital is discharging pretty quickly Concerns about ill going back to home to recover. The concern is that the home has not found the source and recurring question is how are they going to get well if they are being discharged back into a legionella environment. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Echols, Fred" To: ;Conover Craig Connie Justin Whitney Andrew "Kate D." Melaney Aaron CC: "McCann, Ken" "Holmes, Tal" Date: 8/28/2015 5:20:53 PM Subject: Weekend Coverage - Legionellosis Outbreak in Adams Co. Attachments: Weekend Coverage forLegionellosis Outbreak in Adams Co 08282015.pdf To All, The attached document contains contact information for IDPH and Adams Co. HD staff that will be the point of contact for outbreak issues that arise over the weekend. Respectfully Yours, Fredrick L. Echols, MD Chief,Communicable Diseases Illinois Department of Public Health Phone: 217-782-2016 Fax: 217-524-0962 Email: Fred.Echols@Illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/28/2015 8:26:19 AM Subject: Legionella Tracking Log - 8 28 15 - AM.xlsx Attachments: Legionella Tracking Log - 8 28 15 - AM.xlsx Updated as of 09:00. All residents that have not had a UA obtained yet at IVHQ on this listing are being done this am. From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/28/2015 11:54:06 AM Subject: RE: Status Update Flu vaccine ordered not here yet. Pneumonia Vaccines—YES I sent you updated list of additional residents this am. None since that I am aware of. What else can you do for me?? Hum want a new job? Lol VA (not Illinois VA—that you have been on numerous calls with) the VA that we have to report to here in Quincy—Federal. They are concerned that only tests are urines that we are diagnosing with. (just between you and me for now) From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 12:28 PM To: HOUSTON, CATHY Subject: RE: Status Update Cathy no we don’t need any more, thanks! Urines continue. Are you seeing any more residents or staff with signs and symptoms? What other data or lab reports do we still need to get to you? Anything else I can help you with? Also do your residents get pneumonia vaccines? And one more question, do you have flu vaccine in for staff and residents, yet? From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Friday, August 28, 2015 12:14 PM To: Shay Drummond Subject: RE: Status Update We have not been collecting the NP/OP. We sent those back to you yesterday. Do you want us to still attempt to get those? From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:49 AM To: Manley, Linda (Linda.Manley@blessinghealthsystem.org); Roberts, Vickie; Merrick, Robert (Robert.Merrick@blessinghospital.com); Loyd, David (David.Loyd@blessinghealthsystem.org); HOUSTON, CATHY Cc: Jon Campos; Jerrod Welch Subject: Status Update Good morning, We currently have 23 lab confirmed cases. There are 23 cases hospitalized – of those we have 12 positives 6 negatives and 5 pending results IVH is currently caring for 35 residents with signs and symptoms and there are 8 positives in that group, and many labs pending IVH has two staff hospitalized with one in ICU who is pending labs and the other a positive. Labs: We want to continue to collect urines on all presenting with signs and symptoms and any that you can collect sputum’s. Also all urines can go through LabCorp’s at this point. We have gotten urines on all ill residents at the home and they will be sending any new labs through Blessing. Blood – we had sent an email a few days ago about lab holding blood for further testing. This was a CDC request – since then due to the large number of positive legionella – they do not need any blood specimens or NP/OP sent to CDC. We are working on getting all cases into INEDSS and updated. We do have two CSTE Fellows from the CDC who are conducting detailed epi interviews with patients to assist in the investigation. They are spending time at IVH this morning. Environmental controls have been ongoing since Monday at IVH. Please feel free to call or email if you have any questions or if you think we need a quick call today prior to the weekend. Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/28/2015 11:13:55 AM Subject: RE: Status Update We have not been collecting the NP/OP. We sent those back to you yesterday. Do you want us to still attempt to get those? From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:49 AM To: Manley, Linda (Linda.Manley@blessinghealthsystem.org); Roberts, Vickie; Merrick, Robert (Robert.Merrick@blessinghospital.com); Loyd, David (David.Loyd@blessinghealthsystem.org); HOUSTON, CATHY Cc: Jon Campos; Jerrod Welch Subject: Status Update Good morning, We currently have 23 lab confirmed cases. There are 23 cases hospitalized – of those we have 12 positives 6 negatives and 5 pending results IVH is currently caring for 35 residents with signs and symptoms and there are 8 positives in that group, and many labs pending IVH has two staff hospitalized with one in ICU who is pending labs and the other a positive. Labs: We want to continue to collect urines on all presenting with signs and symptoms and any that you can collect sputum’s. Also all urines can go through LabCorp’s at this point. We have gotten urines on all ill residents at the home and they will be sending any new labs through Blessing. Blood – we had sent an email a few days ago about lab holding blood for further testing. This was a CDC request – since then due to the large number of positive legionella – they do not need any blood specimens or NP/OP sent to CDC. We are working on getting all cases into INEDSS and updated. We do have two CSTE Fellows from the CDC who are conducting detailed epi interviews with patients to assist in the investigation. They are spending time at IVH this morning. Environmental controls have been ongoing since Monday at IVH. Please feel free to call or email if you have any questions or if you think we need a quick call today prior to the weekend. Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 Description: Description: National Public Health CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Jeffries, Erica L" To: Yantis Ryan CC: "Arnold, Melaney" "WINNICKI, LENARD F." "HOUSTON, CATHY" "Shay Drummond" "Shah, Nirav" Date: 8/28/2015 9:09:25 PM S u b j e c t : Re: Press Release Follow Up Spoke with Director Shah earlier regarding the press conference. We concluded that we will wait to see what happens over the next 24-48 hours. If more patients expire, we will plan to hold a joint conference on Monday morning. I'll be coordinating with you, Ryan, for guidance on that. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 28, 2015, at 22:03, Yantis, Ryan wrote: ​All - as of this email (10 pm). Two media calls - Quincy Herald-Whig (Matt Hopt) asking if water turned off at the home; responded on background with talking points. Asked if someone would be available for interview. Not tonight WGEM, Chad Mahoney (217-242-1043) to confirm release, and asking for on-camera interview / press conf. Told him we had done interview; will announce if there will be a press conf. No email queries ​ Will need to consider a press event of some sort. Thanks to all on the effort to get this release sorted out and sent. We can use this as the template, should there be additional deaths. Thanks From: "Jeffries, Erica L" To: "Shay Drummond" CC: "Yantis, Ryan" "Arnold, Melaney" "WINNICKI, LENARD F." "HOUSTON, CATHY" "Shah, Nirav" Date: 8/28/2015 9:44:18 PM Subject: Re: Press Release Follow Up That's good news, Shay. If we can do anything more to help, let us know. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 28, 2015, at 22:43, Shay Drummond wrote: I have had 2 calls and an interview with WGEM scheduled in the morning. The water department has been receiving lots of inquiries as to the water being shut off and I did speak with Jeff Conte this evening in regards to those inquiries. Locally our media team tends to be pretty sensitive to the situation such as this and I hope they continue to maintain that approach. From the local perspective I think the meeting is going very well and because of our good relationships with them they're going to be respectful and mindful of the families. Sent from my iPhone On Aug 28, 2015, at 10:03 PM, Yantis, Ryan wrote: ​All - as of this email (10 pm). Two media calls - Quincy Herald-Whig (Matt Hopt) asking if water turned off at the home; responded on background with talking points. Asked if someone would be available for interview. Not tonight WGEM, Chad Mahoney (217-242-1043) to confirm release, and asking for on-camera interview / press conf. Told him we had done interview; will announce if there will be a press conf. No email queries ​ Will need to consider a press event of some sort. Thanks to all on the effort to get this release sorted out and sent. We can use this as the template, should there be additional deaths. Thanks From: "Jerrod Welch" To: Austin "Connie <" "\(Connie.Austin@Illinois.gov\);>" CC: Date: 8/28/2015 5:35:14 PM Subject: FW: lab testing update Hi Connie, Thank you for working with us so much on this. It’s been a massive help. Could you loop me in on the email chain as well. Also, I’m in contact with our coroner and he’s awaiting guidance on what pathologies we will be asking for. I think Jodi was working on that but I wonder about a status. Thx, JCW From: Shay Drummond Sent: Friday, August 28, 2015 6:25 PM To: Jerrod Welch; Jon Campos Subject: FW: lab testing update Importance: High See info below on case counts and urine testing From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 6:21 PM To: Shah, Nirav; Shay Drummond; Conover, Craig Subject: RE: lab testing update CDC said to count as a case if clinically compatible and urine antigen positive. There are two test kits by the same manufacturer and the one type is preferable to the other. At this time we do not know which type Memorial Hosp uses and which type Lab Corp uses. She also said that keep in mind as people are doing increased testing, this person obviously may have acquired Legionella somewhere else, so for now, I think if the person does not walk/hike/visit etc at IVH that we call her a community case until we have any additional cases that might change our minds about considering her part of the IVH situation. Shay, CDC says they are willing to do a urine antigen on the discordant result ones if needed. She also mentioned sputums but I think those people would all have been put on antibiotics by now so sputums would not be likely to help I don’t think. Craig may have additional thoughts. I think we’d mainly be worried about these outliers. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shah, Nirav Sent: Friday, August 28, 2015 5:50 PM To: Shay Drummond; Austin, Connie; Conover, Craig Subject: Re: lab testing update Thank you, Shay. This is important — please keep us updated. If we’re talking about the urine antigen, I think the false positive rate is virtually zero. The others on this email would know better than I, though. Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Friday, August 28, 2015 at 5:01 PM To: "Austin, Connie" , "Conover, Craig" , Nirav Shah Subject: lab testing update Hi there. DH is being interviewed now and so far no connection to the IVH….What is the data on false positives? Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Jerrod Welch" To: Nirav.Shah@illinois.gov CC: Date: 8/28/2015 7:24:05 PM Subject: Re: This is similar, may not be identical to what is going to go out Thanks, will do. Thank to you soon, JCW Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Shah, Nirav Date: Fri, Aug 28, 2015 8:16 PM To: Jerrod Welch;Austin, Connie;Shay Drummond;Jon Campos; Cc: Culp, David;Holmes, Tal;Echols, Fred; Subject:Re: This is similar, may not be identical to what is going to go out Jerrod, I want to echo Connie’s email below. We are extremely grateful for the leadership you and your team have shown over the past days. Thank you very much for being such great partners here. Shay already has my number, but don’t hesitate to call me at 312-952-6092 anytime if you need anything at all. Best, Nirav Shah _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Jerrod Welch Date: Friday, August 28, 2015 at 8:13 PM To: "Austin, Connie" , Shay Drummond , Jon Campos Cc: "Culp, David" , "Holmes, Tal" , "Echols, Fred" , Nirav Shah Subject: Re: This is similar, may not be identical to what is going to go out Thanks Connie. I agree, they are pretty awesome! Have a good night. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Austin, Connie Date: Fri, Aug 28, 2015 8:10 PM To: Jerrod Welch;Shay Drummond;Jon Campos; Cc: Culp, David;Holmes, Tal;Echols, Fred;Shah, Nirav; Subject:RE: This is similar, may not be identical to what is going to go out Jerrod, We also wanted to make sure you knew what a great job your staff are doing. It is great to see such dedicated public health folks working on this and we are fortunate that your staff are very organized, competent and cool under pressure. Since the incubation period can be up to 14 days I hope each of your staff will take care of themselves and make sure to give themselves appropriate breaks so they do not become too stressed. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Friday, August 28, 2015 7:38 PM To: Austin, Connie; Shay Drummond; Jon Campos Cc: Arnold, Melaney Subject: RE: This is similar, may not be identical to what is going to go out Thank you for getting this to us. I think we’re touching base with all the PIOs in the morning prior to any releases if I’m not mistaken. That will be beneficial to us as well. JCW From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 7:36 PM To: Jerrod Welch; Shay Drummond; Jon Campos Cc: Arnold, Melaney Subject: This is similar, may not be identical to what is going to go out Adams county colleagues, I am not sure of when this will go out there are approvals from GO office that are needed. Legionnaires’ Disease Deaths at Illinois Veterans’ Home-Quincy Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of two residents at the Illinois Veterans’ Home-Quincy among the 23 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “Our Quincy Home staff and the Illinois Department of Veterans’ Affairs (IDVA) are deeply saddened….,” said Erica L. Jeffries, Director, IDVA. “….” “Legionnaires’ disease can range from a mild respiratory illness to severe pneumonia and death,” said IDPH Director Nirav D. Shah, M.D., J.D. “It can take up to 14 days to become ill after exposure, so we could see additional cases. Because the elderly and those with underlying medical conditions are at greater risk of serious illness, we are working diligently to identify residents or staff who have respiratory illness and provide medical treatment to them as quickly as possible.” IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as whirlpool spas, hot tubs, humidifiers, hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. For more information about Legionnaires’ disease, visit the IDPH website For media seeking additional information, please contact: IDVA / IVH-Q: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d) 217-222-8440 x148 (c) 217-316-2795 sdrummond@co.adams.il.us Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Jerrod Welch" To: Connie.Austin@Illinois.gov "Shay Drummond" "Jon Campos" CC: David.Culp@Illinois.gov Tal.Holmes@illinois.gov Fred.Echols@Illinois.gov Nirav.Shah@illinois.gov Date: 8/28/2015 7:13:00 PM Subject: Re: This is similar, may not be identical to what is going to go out Thanks Connie. I agree, they are pretty awesome! Have a good night. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Austin, Connie Date: Fri, Aug 28, 2015 8:10 PM To: Jerrod Welch;Shay Drummond;Jon Campos; Cc: Culp, David;Holmes, Tal;Echols, Fred;Shah, Nirav; Subject:RE: This is similar, may not be identical to what is going to go out Jerrod, We also wanted to make sure you knew what a great job your staff are doing. It is great to see such dedicated public health folks working on this and we are fortunate that your staff are very organized, competent and cool under pressure. Since the incubation period can be up to 14 days I hope each of your staff will take care of themselves and make sure to give themselves appropriate breaks so they do not become too stressed. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Friday, August 28, 2015 7:38 PM To: Austin, Connie; Shay Drummond; Jon Campos Cc: Arnold, Melaney Subject: RE: This is similar, may not be identical to what is going to go out Thank you for getting this to us. I think we’re touching base with all the PIOs in the morning prior to any releases if I’m not mistaken. That will be beneficial to us as well. JCW From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 7:36 PM To: Jerrod Welch; Shay Drummond; Jon Campos Cc: Arnold, Melaney Subject: This is similar, may not be identical to what is going to go out Adams county colleagues, I am not sure of when this will go out there are approvals from GO office that are needed. Legionnaires’ Disease Deaths at Illinois Veterans’ Home-Quincy Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of two residents at the Illinois Veterans’ Home-Quincy among the 23 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “Our Quincy Home staff and the Illinois Department of Veterans’ Affairs (IDVA) are deeply saddened….,” said Erica L. Jeffries, Director, IDVA. “….” “Legionnaires’ disease can range from a mild respiratory illness to severe pneumonia and death,” said IDPH Director Nirav D. Shah, M.D., J.D. “It can take up to 14 days to become ill after exposure, so we could see additional cases. Because the elderly and those with underlying medical conditions are at greater risk of serious illness, we are working diligently to identify residents or staff who have respiratory illness and provide medical treatment to them as quickly as possible.” IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as whirlpool spas, hot tubs, humidifiers, hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. For more information about Legionnaires’ disease, visit the IDPH website For media seeking additional information, please contact: IDVA / IVH-Q: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d) 217-222-8440 x148 (c) 217-316-2795 sdrummond@co.adams.il.us Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Jerrod Welch" To: Austin "Connie ;Shay Drummond ;Jon Campos" CC: "Arnold, Melaney" Date: 8/28/2015 6:37:55 PM S u b j e c t : RE: This is similar, may not be identical to what is going to go out Thank you for getting this to us. I think we’re touching base with all the PIOs in the morning prior to any releases if I’m not mistaken. That will be beneficial to us as well. JCW From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 7:36 PM To: Jerrod Welch; Shay Drummond; Jon Campos Cc: Arnold, Melaney Subject: This is similar, may not be identical to what is going to go out Adams county colleagues, I am not sure of when this will go out there are approvals from GO office that are needed. Legionnaires’ Disease Deaths at Illinois Veterans’ Home-Quincy Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of two residents at the Illinois Veterans’ Home-Quincy among the 23 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “Our Quincy Home staff and the Illinois Department of Veterans’ Affairs (IDVA) are deeply saddened….,” said Erica L. Jeffries, Director, IDVA. “….” “Legionnaires’ disease can range from a mild respiratory illness to severe pneumonia and death,” said IDPH Director Nirav D. Shah, M.D., J.D. “It can take up to 14 days to become ill after exposure, so we could see additional cases. Because the elderly and those with underlying medical conditions are at greater risk of serious illness, we are working diligently to identify residents or staff who have respiratory illness and provide medical treatment to them as quickly as possible.” IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as whirlpool spas, hot tubs, humidifiers, hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. For more information about Legionnaires’ disease, visit the IDPH website For media seeking additional information, please contact: IDVA / IVH-Q: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d) 217-222-8440 x148 (c) 217-316-2795 sdrummond@co.adams.il.us Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Morgan, Jodi" To: "Shay Drummond" CC: "Johnson, Bernard T." "Austin, Connie" "Echols, Fred" "Cox, Robert F." "Conover, Craig" Date: 8/28/2015 5:52:49 PM Subject: CLARIFICATION RE: Fresh frozen tissue specimens Shay, Please use this instead. I made a couple of changes. From: Morgan, Jodi Sent: Friday, August 28, 2015 6:12 PM To: Austin, Connie Subject: instructions · · · · · · · Below are instructions for fresh-frozen tissue specimens. Once collected, the specimens must be kept frozen at < -20⁰C. They cannot be sent out to IDPH lab until Monday, so we will have to determine how the specimens will be transported to IDPH lab (either by courier or shipped—this is still under discussion). The Blessing Hospital lab will have to store the collected specimens until then, so we should verify they have the capability for appropriate temperature storage. The same IDPH lab form used for urine antigen specimens should be completed and sent with specimen. Per CDC guidelines, use dry ice for shipment of fresh frozen tissue. If excessively hot, it is recommended to use a combination of dry ice and a frozen gel pack for packaging. PLEASE NOTE: if the patient was on antibiotics, the culture may not grow legionella and an isolate may not be obtained. It’s important that the family also is informed of this prior to agreeing to collection of any specimens. CDC has requested fresh-frozen tissue specimens for legionella testing. Guidance from CDC on collecting pathology specimens: Fresh-frozen tissue may be submitted for culture and molecular-based assays. The preferred pulmonary sites include: 1. Hilar lung with segmental bronchi, primary bronchi, and trachea 2. Peripheral pulmonary parenchyma from both lungs Specimen Shipping Instructions for Legionella Testing During Outbreak Investigations Specimen Type Tests Available Minimum Preparation Requirements Respiratory Specimens (sputum, BAL, tracheal aspirate, tissue, etc.)† Culture, PCR, DFA 500 μl None Short-term Storage Long-term Storage Shipping (next day, Monday – Thursday) Freeze immediately < -20⁰C Freeze < -20⁰C Ship frozen < -20⁰C (super cold packs) http://www.cdc.gov/legionella/downloads/shipping-instructions.pdf Also from CDC path instructions: Please include relevant documentation (1) a cover letter outlining a brief clinical history, including relevant demographic / epidemiologic information (2) a completed lab submission form (can use IDPH form) (3) a copy of (a) the autopsy report (preliminary or final) or (b) surgical pathology report (4) copies of pertinent laboratory results (microbiology, hematology, serology, culture, and/or biochemical) (5) images (clinical and/or gross autopsy photos) Thanks, Jodi Jodi Morgan, RN BSN CIC Infection Prevention & Control Communicable Disease Control Section Office of Health Protection Illinois Department of Public Health 525 W. Jefferson Springfield, IL 62761-0001 T: 217-782-2016 F: 217-524-0962 Jodi.Morgan@illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Morgan, Jodi" To: "Shay Drummond" CC: "Johnson, Bernard T." "Austin, Connie" "Echols, Fred" "Cox, Robert F." "Conover, Craig" Date: 8/28/2015 5:49:02 PM Subject: Fresh frozen tissue specimens Shay, Please see email below. From: Morgan, Jodi Sent: Friday, August 28, 2015 6:12 PM To: Austin, Connie Subject: instructions · · · · · · · Below are instructions for fresh-frozen tissue specimens. Once collected, the specimens must be kept frozen at < -20⁰C. They cannot be sent out to IDPH lab until Monday, so we will have to determine how the specimens will be transported to IDPH lab (either by courier or shipped—this is still under discussion). The Blessing Hospital lab will have to store the collected specimens until then, so we should verify they have the capability for appropriate temperature storage. The same IDPH lab form used for urine antigen specimens should be completed and sent with specimen. Per CDC guidelines, use dry ice for shipment of fresh frozen tissue. If excessively hot, it is recommended to use a combination of dry ice and a frozen gel pack for packaging. PLEASE NOTE: if the patient was on antibiotics, the culture may not grow legionella and an isolate may not be obtained. It’s important that the family also is informed of this. CDC has requested fresh-frozen tissue specimens for legionella testing. Guidance from CDC on collecting pathology specimens: Fresh-frozen tissue may be submitted for culture and molecular-based assays. The preferred pulmonary sites include: 1. Hilar lung with segmental bronchi, primary bronchi, and trachea 2. Peripheral pulmonary parenchyma from both lungs Specimen Shipping Instructions for Legionella Testing During Outbreak Investigations Specimen Type Tests Available Minimum Preparation Requirements Respiratory Specimens (sputum, BAL, tracheal aspirate, tissue, etc.)† Culture, PCR, DFA 500 μl None Short-term Storage Long-term Storage Shipping (next day, Monday – Thursday) Freeze immediately < -20⁰C Freeze < -20⁰C Ship frozen < -20⁰C (super cold packs) http://www.cdc.gov/legionella/downloads/shipping-instructions.pdf Also from CDC path instructions: Please include relevant documentation (1) a cover letter outlining a brief clinical history, including relevant demographic / epidemiologic information (2) a completed lab submission form (can use IDPH form) (3) a copy of (a) the autopsy report (preliminary or final) or (b) surgical pathology report (4) copies of pertinent laboratory results (microbiology, hematology, serology, culture, and/or biochemical) (5) images (clinical and/or gross autopsy photos) Thanks, Jodi Jodi Morgan, RN BSN CIC Infection Prevention & Control Communicable Disease Control Section Office of Health Protection Illinois Department of Public Health 525 W. Jefferson Springfield, IL 62761-0001 T: 217-782-2016 F: 217-524-0962 Jodi.Morgan@illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Morgan, Jodi" To: "Shay Drummond" CC: Date: 8/28/2015 11:51:25 AM Subject: RE: For your review Is the one who is ⁷ employee? From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 12:46 PM To: Austin, Connie Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review We are reviewing we just got results for four more positive cases. One was previously a negative and they must have gotten two urines as one is now positive. That is in-patient and it is Staff is positive is positive is positive All in patient. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 12:41 PM To: Shay Drummond Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Okay, did the 2 non pneumonias have resp symptoms. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 12:32 PM To: Austin, Connie Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Update: Blessing has been discharging a few – they now have 20 patients (1 has been discharged, and 2 pending discharge) I have a conference call with them at 1:00pm Also it looks like we have pneumonia dx on all of our positives but two – that was first pass on our spreadsheet. Getting labs filed and reviewed with Jon. I also presented your questions to Cathy at IVH. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:45 AM To: Shay Drummond Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Okay I gave Melaney 23 and she seemed content with that, so if we get more questions I think I would give 23 lab confirmed, I didn’t check and should have, how many have pneumonia? Otherwise some may be Legionnaires’ disease and some may be Pontiac fever. If they ask, 12 of the 23 residents and one staff are hospitalized, 2 residents discharged and 8 residents are at IVH being treated. Onsets from July 24 through August 26. CDC’s questions for the day. What is the S. pneumo vaccination program at the facility (I think the thought there is to decrease respiratory illnesses that you can prevent) and also reduce risk of having Legionella affect someone who has S pneumo. Craig, any thoughts about influenza vaccination early? I will ask our intern to check on the next question which is how many of the negatives had urine antigens done within 48 hours of their onset, may need to be re-tested as it can take 48-72 hours for the test to be positive. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:11 AM To: Austin, Connie Subject: RE: For your review No there are currently 23 in Blessing With 12 of those being positive 6 negative and pending labs. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:07 AM To: Shay Drummond Subject: RE: For your review So 22 residents, 1 staff 12 of the 23 are currently hospitalized and 2 were discharged, so 9 never hospitalized? just want to make sure that is correct? Latest onset I saw was 8/26. We have a new intern do you want him to enter some of these in INEDSS? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:02 AM To: Austin, Connie Subject: For your review Illinois Veteran Home 23 Confirmed positive Urine antigens – all are residents and 1 staff 23 patients in Blessing from IVH with 12 confirmed urine antigen – and additional labs pending 1 patient is in ICU none are on vents 1 is in IMC IVH is monitoring approx.. 35 residents with 8 positives in that group. IVH has 2 residents that were hospitalized and have been discharged – both were urine positives Illinois Veterans Home Staff 5 with signs and symptoms one is hospitalized in ICU and is a positive. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shah, Nirav" To: "Jerrod Welch" "Connie ;Shay Drummond ;JonCampos" CC: "Culp, David" "Holmes, Tal" "Echols, Fred" Date: 8/28/2015 7:16:35 PM Subject: Re: This is similar, may not be identical to what is going to go out Jerrod, I want to echo Connie’s email below. We are extremely grateful for the leadership you and your team have shown over the past days. Thank you very much for being such great partners here. Shay already has my number, but don’t hesitate to call me at 312-952-6092 anytime if you need anything at all. Best, Nirav Shah _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Jerrod Welch Date: Friday, August 28, 2015 at 8:13 PM To: "Austin, Connie" , Shay Drummond , Jon Campos Cc: "Culp, David" , "Holmes, Tal" , "Echols, Fred" , Nirav Shah Subject: Re: This is similar, may not be identical to what is going to go out Thanks Connie. I agree, they are pretty awesome! Have a good night. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Austin, Connie Date: Fri, Aug 28, 2015 8:10 PM To: Jerrod Welch;Shay Drummond;Jon Campos; Cc: Culp, David;Holmes, Tal;Echols, Fred;Shah, Nirav; Subject:RE: This is similar, may not be identical to what is going to go out Jerrod, We also wanted to make sure you knew what a great job your staff are doing. It is great to see such dedicated public health folks working on this and we are fortunate that your staff are very organized, competent and cool under pressure. Since the incubation period can be up to 14 days I hope each of your staff will take care of themselves and make sure to give themselves appropriate breaks so they do not become too stressed. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Friday, August 28, 2015 7:38 PM To: Austin, Connie; Shay Drummond; Jon Campos Cc: Arnold, Melaney Subject: RE: This is similar, may not be identical to what is going to go out Thank you for getting this to us. I think we’re touching base with all the PIOs in the morning prior to any releases if I’m not mistaken. That will be beneficial to us as well. JCW From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 7:36 PM To: Jerrod Welch; Shay Drummond; Jon Campos Cc: Arnold, Melaney Subject: This is similar, may not be identical to what is going to go out Adams county colleagues, I am not sure of when this will go out there are approvals from GO office that are needed. Legionnaires’ Disease Deaths at Illinois Veterans’ Home-Quincy Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of two residents at the Illinois Veterans’ Home-Quincy among the 23 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “Our Quincy Home staff and the Illinois Department of Veterans’ Affairs (IDVA) are deeply saddened….,” said Erica L. Jeffries, Director, IDVA. “….” “Legionnaires’ disease can range from a mild respiratory illness to severe pneumonia and death,” said IDPH Director Nirav D. Shah, M.D., J.D. “It can take up to 14 days to become ill after exposure, so we could see additional cases. Because the elderly and those with underlying medical conditions are at greater risk of serious illness, we are working diligently to identify residents or staff who have respiratory illness and provide medical treatment to them as quickly as possible.” IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as whirlpool spas, hot tubs, humidifiers, hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. For more information about Legionnaires’ disease, visit the IDPH website For media seeking additional information, please contact: IDVA / IVH-Q: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d) 217-222-8440 x148 (c) 217-316-2795 sdrummond@co.adams.il.us Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Shay Drummond" To: Austin "Connie <" "\(Connie.Austin@Illinois.gov\);>" CC: Date: 8/28/2015 10:02:04 AM Subject: For your review Illinois Veteran Home 23 Confirmed positive Urine antigens – all are residents and 1 staff 23 patients in Blessing from IVH with 12 confirmed urine antigen – and additional labs pending 1 patient is in ICU none are on vents 1 is in IMC IVH is monitoring approx.. 35 residents with 8 positives in that group. IVH has 2 residents that were hospitalized and have been discharged – both were urine positives Illinois Veterans Home Staff 5 with signs and symptoms one is hospitalized in ICU and is a positive. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Austin "Connie <" "\(Connie.Austin@Illinois.gov\);>" CC: Date: 8/28/2015 10:27:18 AM Subject: FW: BRIEF synopsis of ACHD EH activity at IVH Monday afternoon: · Met with EH staff from IDPH (Aaron Martin, Justin DeWitt, Derra (sp?)) and Frank Shimpkis (Chief IDPH Plumbing Inspector) · Myself and IDPH EH team met with Dave Clifford, Chief Engineer from IVH · Assessed possibilities on Legionella based on two confirmed positive patients o Focused on cooling tower, fountains, and bathing tubs likely used by patients. · IDPH collected water samples from fountains, cooling tower, and reservoir tank for bathing tub in Elmore East. · IDPH collected swabs of inlets of tubs and interior of connected shower heads on tubs in both Elmore East and Elmore West. · Recommendations from IDPH Draft guidance were shared and implementation began Wednesday Afternoon: · Aaron Martin and Justin DeWitt returned to IVH. · Additional information from Dave Clifford suggested that central hot water tank may be associated with outbreak. o Tank 2 was cycled out of service at the beginning of July. o Tank was removed from heat to replace valve o Tank was unheated until cycled back into service on 8/6/15 · IDPH EH Team collected samples (swabs) for culturing and PCR analysis on the following: o Markword Café sinks o Elmore Shower o 12th Street Fountain o Sunken Garden Fountain o Cooling tower basin o Cooling tower weir · Water samples were also collected on the following: o Hot water storage tank #1 (1000 gallons) (at time of visit was cycled into service to allow draining and swabbing of Tank #2) o Hot water storage tank #2 (1500 gallons) which was in use, but removed from use and drained. Thursday Afternoon: · ACHD EH staff met with Dave Clifford. · Rex Pflantz, Josh Johnson, and Mitchell Housewright walked through all resident care facilities to document progress of IVH following water restriction guidelines. Observations indicated that IVH was actively addressing guidelines. ACHD EH staff found approximately 3 sinks were not following guidelines, but were immediately addressed by IVH staff. · There were additional sinks and drinking fountains not following guidelines in shelter houses and administration buildings. However, these were not highest priority for IVH staff · Aaron Martin asked Tony Dede to recollect and submit samples that were collected on Monday 8/26 for PCR analysis. Due to communication glitches with lab, PCR was not initially collected. Mr. Dede collected samples with the assistance of Robin Shellabarger, ACHD Public Health Associate. · Tony Dede also collected 2 swab samples from the interior of hot water tank #2. · All collected were shipped via UPS that day. Friday: Cooling tank undergoing cleaning as of 0700. From: "Shay Drummond" To: Austin "Connie <" "\(Connie.Austin@Illinois.gov\);>" CC: Date: 8/28/2015 10:05:35 AM Subject: FW: For your review There was one new admission yesterday And one patient that presented to ED and then returned to IVH From: Shay Drummond Sent: Friday, August 28, 2015 11:02 AM To: Austin, Connie (Connie.Austin@Illinois.gov) Subject: For your review Illinois Veteran Home 23 Confirmed positive Urine antigens – all are residents and 1 staff 23 patients in Blessing from IVH with 12 confirmed urine antigen – and additional labs pending 1 patient is in ICU none are on vents 1 is in IMC IVH is monitoring approx.. 35 residents with 8 positives in that group. IVH ha s 2 residents that were hospitalized and have been discharged – both were urine positives Illinois Veterans Home Staff 5 with signs and symptoms one is hospitalized in ICU and is a positive. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Austin "Connie \(Connie.Austin@Illinois.gov\);" CC: Date: 8/28/2015 2:15:44 PM Subject: Need Guidance Hi getting calls from families of hospital patients – hospital is discharging pretty quickly Concerns about ill going back to home to recover. The concern is that the home has not found the source and recurring question is how are they going to get well if they are being discharged back into a legionella environment. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Austin Connie CC: "Morgan, Jodi" "Conover, Craig" Date: 8/28/2015 11:46:21 AM Subject: RE: For your review We are reviewing we just got results for four more positive cases. One was previously a negative and they must have gotten two urines as one is now positive. That is in-patient and it is Staff is positive . is positive is positive All in patient. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 12:41 PM To: Shay Drummond Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Okay, did the 2 non pneumonias have resp symptoms. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 12:32 PM To: Austin, Connie Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Update: Blessing has been discharging a few – they now have 20 patients (1 has been discharged, and 2 pending discharge) I have a conference call with them at 1:00pm Also it looks like we have pneumonia dx on all of our positives but two – that was first pass on our spreadsheet. Getting labs filed and reviewed with Jon. I also presented your questions to Cathy at IVH. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:45 AM To: Shay Drummond Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Okay I gave Melaney 23 and she seemed content with that, so if we get more questions I think I would give 23 lab confirmed, I didn’t check and should have, how many have pneumonia? Otherwise some may be Legionnaires’ disease and some may be Pontiac fever. If they ask, 12 of the 23 residents and one staff are hospitalized, 2 residents discharged and 8 residents are at IVH being treated. Onsets from July 24 through August 26. CDC’s questions for the day. What is the S. pneumo vaccination program at the facility (I think the thought there is to decrease respiratory illnesses that you can prevent) and also reduce risk of having Legionella affect someone who has S pneumo. Craig, any thoughts about influenza vaccination early? I will ask our intern to check on the next question which is how many of the negatives had urine antigens done within 48 hours of their onset, may need to be re-tested as it can take 48-72 hours for the test to be positive. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:11 AM To: Austin, Connie Subject: RE: For your review No there are currently 23 in Blessing With 12 of those being positive 6 negative and pending labs. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:07 AM To: Shay Drummond Subject: RE: For your review So 22 residents, 1 staff 12 of the 23 are currently hospitalized and 2 were discharged, so 9 never hospitalized? just want to make sure that is correct? Latest onset I saw was 8/26. We have a new intern do you want him to enter some of these in INEDSS? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:02 AM To: Austin, Connie Subject: For your review Illinois Veteran Home 23 Confirmed positive Urine antigens – all are residents and 1 staff 23 patients in Blessing from IVH with 12 confirmed urine antigen – and additional labs pending 1 patient is in ICU none are on vents 1 is in IMC IVH is monitoring approx.. 35 residents with 8 positives in that group. IVH has 2 residents that were hospitalized and have been discharged – both were urine positives Illinois Veterans Home Staff 5 with signs and symptoms one is hospitalized in ICU and is a positive. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Austin Connie CC: "Morgan, Jodi" "Conover, Craig" Date: 8/28/2015 10:47:56 AM Subject: RE: For your review I will follow up on their vaccination plan. I know historically they do all influenza vaccine in house. I just got 1250 doses of quad and can give if that is recommended. Thanks! From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:45 AM To: Shay Drummond Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Okay I gave Melaney 23 and she seemed content with that, so if we get more questions I think I would give 23 lab confirmed, I didn’t check and should have, how many have pneumonia? Otherwise some may be Legionnaires’ disease and some may be Pontiac fever. If they ask, 12 of the 23 residents and one staff are hospitalized, 2 residents discharged and 8 residents are at IVH being treated. Onsets from July 24 through August 26. CDC’s questions for the day. What is the S. pneumo vaccination program at the facility (I think the thought there is to decrease respiratory illnesses that you can prevent) and also reduce risk of having Legionella affect someone who has S pneumo. Craig, any thoughts about influenza vaccination early? I will ask our intern to check on the next question which is how many of the negatives had urine antigens done within 48 hours of their onset, may need to be re-tested as it can take 48-72 hours for the test to be positive. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:11 AM To: Austin, Connie Subject: RE: For your review No there are currently 23 in Blessing With 12 of those being positive 6 negative and pending labs. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:07 AM To: Shay Drummond Subject: RE: For your review So 22 residents, 1 staff 12 of the 23 are currently hospitalized and 2 were discharged, so 9 never hospitalized? just want to make sure that is correct? Latest onset I saw was 8/26. We have a new intern do you want him to enter some of these in INEDSS? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:02 AM To: Austin, Connie Subject: For your review Illinois Veteran Home 23 Confirmed positive Urine antigens – all are residents and 1 staff 23 patients in Blessing from IVH with 12 confirmed urine antigen – and additional labs pending 1 patient is in ICU none are on vents 1 is in IMC IVH is monitoring approx.. 35 residents with 8 positives in that group. IVH has 2 residents that were hospitalized and have been discharged – both were urine positives Illinois Veterans Home Staff 5 with signs and symptoms one is hospitalized in ICU and is a positive. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Morgan Jodi CC: Date: 8/28/2015 11:53:27 AM Subject: RE: For your review both are staff in . ugggh From: Morgan, Jodi [mailto:Jodi.Morgan@illinois.gov] Sent: Friday, August 28, 2015 12:51 PM To: Shay Drummond Subject: RE: For your review Is the one who is ⁷ employee? From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 12:46 PM To: Austin, Connie Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review We are reviewing we just got results for four more positive cases. One was previously a negative and they must have gotten two urines as one is now positive. That is in-patient and it is Staff is positive is positive is positive All in patient. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 12:41 PM To: Shay Drummond Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Okay, did the 2 non pneumonias have resp symptoms. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 12:32 PM To: Austin, Connie Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Update: Blessing has been discharging a few – they now have 20 patients (1 has been discharged, and 2 pending discharge) I have a conference call with them at 1:00pm Also it looks like we have pneumonia dx on all of our positives but two – that was first pass on our spreadsheet. Getting labs filed and reviewed with Jon. I also presented your questions to Cathy at IVH. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:45 AM To: Shay Drummond Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Okay I gave Melaney 23 and she seemed content with that, so if we get more questions I think I would give 23 lab confirmed, I didn’t check and should have, how many have pneumonia? Otherwise some may be Legionnaires’ disease and some may be Pontiac fever. If they ask, 12 of the 23 residents and one staff are hospitalized, 2 residents discharged and 8 residents are at IVH being treated. Onsets from July 24 through August 26. CDC’s questions for the day. What is the S. pneumo vaccination program at the facility (I think the thought there is to decrease respiratory illnesses that you can prevent) and also reduce risk of having Legionella affect someone who has S pneumo. Craig, any thoughts about influenza vaccination early? I will ask our intern to check on the next question which is how many of the negatives had urine antigens done within 48 hours of their onset, may need to be re-tested as it can take 48-72 hours for the test to be positive. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:11 AM To: Austin, Connie Subject: RE: For your review No there are currently 23 in Blessing With 12 of those being positive 6 negative and pending labs. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:07 AM To: Shay Drummond Subject: RE: For your review So 22 residents, 1 staff 12 of the 23 are currently hospitalized and 2 were discharged, so 9 never hospitalized? just want to make sure that is correct? Latest onset I saw was 8/26. We have a new intern do you want him to enter some of these in INEDSS? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:02 AM To: Austin, Connie Subject: For your review Illinois Veteran Home 23 Confirmed positive Urine antigens – all are residents and 1 staff 23 patients in Blessing from IVH with 12 confirmed urine antigen – and additional labs pending 1 patient is in ICU none are on vents 1 is in IMC IVH is monitoring approx.. 35 residents with 8 positives in that group. IVH has 2 residents that were hospitalized and have been discharged – both were urine positives Illinois Veterans Home Staff 5 with signs and symptoms one is hospitalized in ICU and is a positive. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Austin Connie CC: "Morgan, Jodi" "Conover, Craig" Date: 8/28/2015 11:32:03 AM Subject: RE: For your review Update: Blessing has been discharging a few – they now have 20 patients (1 has been discharged, and 2 pending discharge) I have a conference call with them at 1:00pm Also it looks like we have pneumonia dx on all of our positives but two – that was first pass on our spreadsheet. Getting labs filed and reviewed with Jon. I also presented your questions to Cathy at IVH. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:45 AM To: Shay Drummond Cc: Morgan, Jodi; Conover, Craig Subject: RE: For your review Okay I gave Melaney 23 and she seemed content with that, so if we get more questions I think I would give 23 lab confirmed, I didn’t check and should have, how many have pneumonia? Otherwise some may be Legionnaires’ disease and some may be Pontiac fever. If they ask, 12 of the 23 residents and one staff are hospitalized, 2 residents discharged and 8 residents are at IVH being treated. Onsets from July 24 through August 26. CDC’s questions for the day. What is the S. pneumo vaccination program at the facility (I think the thought there is to decrease respiratory illnesses that you can prevent) and also reduce risk of having Legionella affect someone who has S pneumo. Craig, any thoughts about influenza vaccination early? I will ask our intern to check on the next question which is how many of the negatives had urine antigens done within 48 hours of their onset, may need to be re-tested as it can take 48-72 hours for the test to be positive. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:11 AM To: Austin, Connie Subject: RE: For your review No there are currently 23 in Blessing With 12 of those being positive 6 negative and pending labs. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:07 AM To: Shay Drummond Subject: RE: For your review So 22 residents, 1 staff 12 of the 23 are currently hospitalized and 2 were discharged, so 9 never hospitalized? just want to make sure that is correct? Latest onset I saw was 8/26. We have a new intern do you want him to enter some of these in INEDSS? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:02 AM To: Austin, Connie Subject: For your review Illinois Veteran Home 23 Confirmed positive Urine antigens – all are residents and 1 staff 23 patients in Blessing from IVH with 12 confirmed urine antigen – and additional labs pending 1 patient is in ICU none are on vents 1 is in IMC IVH is monitoring approx.. 35 residents with 8 positives in that group. IVH has 2 residents that were hospitalized and have been discharged – both were urine positives Illinois Veterans Home Staff 5 with signs and symptoms one is hospitalized in ICU and is a positive. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Austin Connie CC: Date: 8/28/2015 10:10:43 AM Subject: RE: For your review No there are currently 23 in Blessing With 12 of those being positive 6 negative and pending labs. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 11:07 AM To: Shay Drummond Subject: RE: For your review So 22 residents, 1 staff 12 of the 23 are currently hospitalized and 2 were discharged, so 9 never hospitalized? just want to make sure that is correct? Latest onset I saw was 8/26. We have a new intern do you want him to enter some of these in INEDSS? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:02 AM To: Austin, Connie Subject: For your review Illinois Veteran Home 23 Confirmed positive Urine antigens – all are residents and 1 staff 23 patients in Blessing from IVH with 12 confirmed urine antigen – and additional labs pending 1 patient is in ICU none are on vents 1 is in IMC IVH is monitoring approx.. 35 residents with 8 positives in that group. IVH has 2 residents that were hospitalized and have been discharged – both were urine positives Illinois Veterans Home Staff 5 with signs and symptoms one is hospitalized in ICU and is a positive. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Yantis Ryan CC: Date: 8/28/2015 8:26:42 PM Subject: Re: IDVA/IDPH Press Release: Two Deaths at Illinois Veterans’ Home-Quincy (after-hours email list) Did this go out???? Sent from my iPhone On Aug 28, 2015, at 8:41 PM, Yantis, Ryan wrote: For Immediate Release Aug. 28, 2015 CONTACTS: See Below Two Deaths at Illinois Veterans’ Home-Quincy Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of two residents at the Illinois Veterans’ Home-Quincy. The two residents, both of whom had underlying medical conditions, were among the 23 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “The Illinois Department of Veterans’ Affairs (IDVA) and our Quincy Home staff are deeply saddened by the passing of these two veterans, just as we are when any of our residents pass. Our thoughts and prayers are with the family, friends, and caretakers of these residents.” said Erica Jeffries, Director, IDVA. “We are keenly focused on making all of our Homes places for residents to live and thrive, and we work very hard to provide the safest, most sanitary, and pleasant living arrangements for our heroes. We will continue to work closely with IDPH and the local healthcare providers to remediate these issues as quickly as possible to ensure the safety and well-being of all of our residents.” “Legionnaires’ disease can range from a mild respiratory illness to severe pneumonia and death,” said IDPH Director Nirav D. Shah, M.D., J.D. “It can take up to 14 days to become ill after exposure, so we could see additional cases. Because the elderly and those with underlying medical conditions are at greater risk of serious illness, we are working diligently to identify residents or staff who have respiratory illness and provide medical treatment to them as quickly as possible.” Names of the deceased are being withheld to allow families to notify other family and friends. We will work with the families and ask others to respect their privacy at this difficult time. IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. For more information about Legionnaires’ disease, visit the IDPH website. For media seeking additional information, please contact: IDVA / IVH-Quincy: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d)217-222-8440 x148 (c)217-316-2795 sdrummond@co.adams.il.us ### <2015-08-28 IDVA-IDPH Release Two Dead at IVH-Q FINAL R.docx> From: To: Conover . . a . Connie CC: "Morgan, Jodi" - - Date: 8/28/2015 5:02:09 PM Subject: RE: lab testing update Legionella pneumophila Urinary Antigen Test Number: 182246 CDT: 87449 Related Information Leamumeuamh?am . . Specimen Urine Volume 5 mL Container Sterile screw-cap container Storage Refrigerate. Instructions Causes for Swab specimen; inappropriate specimen transport device; unlabeled specimen or name discrepancy between specimen and request label; Rejection specimen received after prolonged delay (usually more than 72 hours); nonurine specimen Reference Interval No Legionella pneumophila serogroup 1 antigen detected Use Confirm the diagnosis of Legionella pneumophila serogroup 1 infection Limitations This test will not detect species or serogroups other than Legionella pneumophila serogroup 1. Methodology Enzyme immunoassay (EIA) Additional Legionella pneumophila has been estimated to cause 80% to 85% of Legionella infections, with serogroup 1 accounting for most of these. Information Current methods of diagnosis for Legionella infection include culture and DFA. All of these other tests require a high quality respiratory specimen to perform this test and, unfortunately, many patients with Legionella infection do not produce sputum. A number of investigators have shown that a specific soluble antigen was present in the urine of patients with Legionnaires' disease, which can be detected both early and late in the disease. References Berdal PP, Farshy CE, Feelley JC. Detection of Legionella pneumophila antigen in urine by enzyme-linked immunospecific assay. J Clin Microbiol. 1979 May; 9(5):575-578. PubMed 383744 Kohler RB, Zimmerman SE, Wilson E, et al. Rapid immunoassay diagnosis of Legionnaires' disease: Detection and partial characterization of urinary antigen. Ann Intern Med. 1981 May; 94(5):601-605. PubMed 7235392 Reingold AL, Thomason BM, Brake BJ, Thacker L, Wilkinson HW, Kuritsky JN. Legionellapneumonia in the United States: The distribution of serogroups and species causing human illness. J Infect Dis. 1984 May; 149(5):819. PubMed 6726009 From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Friday, August 28, 2015 5:47 PM To: Austin, Connie Cc: Shay Drummond; Echols, Fred; Morgan, Jodi; Kelly-Shannon, Kate D. Subject: Re: lab testing update False positives are very rare. How close to the facility does she live? iPhone. itypos. iapologize. On Aug 28, 2015, at 5:42 PM, "Austin, Connie" wrote: When I talked to CDC they said if the person has clinically compatible symptoms and is positive you would consider them a case. Do you know what test kit LabCorp uses? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 5:08 PM To: Austin, Connie Subject: RE: lab testing update Yes you should have her H&P we just faxed all info over. Presented to ambulatory with cough and fever was treated in ambulatory clinic and is at home. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 5:07 PM To: Shay Drummond; Conover, Craig Subject: RE: lab testing update Is she symptomatic? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 5:01 PM To: Austin, Connie; Conover, Craig; Shah, Nirav Subject: lab testing update Hi there. is being interviewed now and so far no connection to the IVH….What is the data on false positives? Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Austin Connie CC: Date: 8/28/2015 5:20:34 PM Subject: RE: lab testing update On phone with labCorps- she is looking up brand, she also wanted to know if we wanted to know machine From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 6:17 PM To: Shay Drummond Subject: RE: lab testing update I can tell you on the phone there is one that is better than another but this below doesn’t have the brand name. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 6:02 PM To: Conover, Craig; Austin, Connie Cc: Echols, Fred; Morgan, Jodi; Kelly-Shannon, Kate D. Subject: RE: lab testing update Printer Friendly Version Legionella pneumophila Urinary Antigen Test Number: 182246 CPT: 87449 Related Information Spechnen Volume Container Storage Instructions Causes for Rejection Reference Interval Use Limitations Methodology Additional Information References Urine 5mL Sterile screw-cap container Refrigerate. Swab specimen; inappropriate specimen transport device; unlabeled specimen or name discrepancy between specimen and request label; specimen received after prolonged delay (usually more than 72 hours); nonurine specimen No Legione/la pneumophila serogroup 1 antigen detected Confirm the diagnosis of Legione/Ia pneumophila serogroup 1 infection This test will not detect species or serogroups other than Legionel/a pneumophila serogroup 1. Enzyme immunoassay (EIA) Legionel/a pneumophila has been estimated to cause 80% to 85% of Legione/Ia infections, with serogroup 1 accounting for most of these. Current methods of diagnosis for Legione/la infection include culture and DFA. All of these other tests require a high quality respiratory specimen to perform this test and, unfortunately, many patients with Legionel/a infection do not produce sputum. A number of investigators have shown that a specific soluble antigen was present in the urine of patients with Legionnaires' disease, which can be detected both early and late in the disease. Berdal PP, Farshy CE, Feelley JC. Detection of Legionel/a pneumophila antigen in urine by enzyme-linked immunospecific assay. Clin Microbiol. 1979 May; 9(5):575-578. PubMed 383744 Kohler RB, Zimmerman SE, Wilson E, et al. Rapid immunoassay diagnosis of Legionnaires' disease: Detection and partial characterization of urinary antigen. Ann Intern Med. 1981 May; 94(5):601-605. PubMed 7235392 Reingold AL, Thomason BM, Brake BJ, Thacker L, Wilkinson HW, Kuritsky JN. Legionellapneumonia in the United States: The distribution of serogroups and species causing human illness. J Infect Dis. 1984 May; 149(5):819. PubMed 6726009 From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Friday, August 28, 2015 5:47 PM To: Austin, Connie Cc: Shay Drummond; Echols, Fred; Morgan, Jodi; Kelly-Shannon, Kate D. Subject: Re: lab testing update False positives are very rare. How close to the facility does she live? iPhone. itypos. iapologize. On Aug 28, 2015, at 5:42 PM, "Austin, Connie" wrote: When I talked to CDC they said if the person has clinically compatible symptoms and is positive you would consider them a case. Do you know what test kit LabCorp uses? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 5:08 PM To: Austin, Connie Subject: RE: lab testing update Yes you should have her H&P we just faxed all info over. Presented to ambulatory with cough and fever was treated in ambulatory clinic and is at home. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Friday, August 28, 2015 5:07 PM To: Shay Drummond; Conover, Craig Subject: RE: lab testing update Is she symptomatic? Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 5:01 PM To: Austin, Connie; Conover, Craig; Shah, Nirav Subject: lab testing update Hi there. is being interviewed now and so far no connection to the IVH….What is the data on false positives? Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: HOUSTON CATHY CC: Date: 8/28/2015 9:14:42 AM Subject: RE: Legionella Tracking Log - 8 28 15 - AM.xlsx Cathy this is great, thanks there are more labs coming in. From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Friday, August 28, 2015 9:26 AM To: Shay Drummond Subject: Legionella Tracking Log - 8 28 15 - AM.xlsx Updated as of 09:00. All residents that have not had a UA obtained yet at IVHQ on this listing are being done this am. From: "Shay Drummond" To: Clegg "Whitney ;Jon Campos" CC: Date: 8/28/2015 7:58:32 AM Subject: RE: Legionella Tracking Log (3).xlsx Thanks! From: Clegg, Whitney [mailto:Whitney.Clegg@illinois.gov] Sent: Friday, August 28, 2015 8:57 AM To: Shay Drummond; Jon Campos Subject: Re: Legionella Tracking Log (3).xlsx Whitney cell phone 952-994-3835 Justin cell phone 515-230-2870 Call anytime if you need us From: Shay Drummond Sent: Thursday, August 27, 2015 4:19:38 PM To: Clegg, Whitney Subject: Legionella Tracking Log (3).xlsx From: "Shay Drummond" To: Austin Connie CC: "Jerrod Welch" "Jon Campos" Date: 8/28/2015 8:21:03 PM Subject: Re: ppt. Thanks yes- vry helpful! Sent from my iPhone > On Aug 28, 2015, at 9:03 PM, Austin, Connie wrote: > > In case this is helpful. > We are missing a number of the pending cases and the 2 new community cases on the epi curve and the 2 food service employees on the map. > But this gives a general sense. > > Connie Austin > State public health veterinarian > Division of Infectious Disease > Illinois Department of Public Health > 525 W Jefferson St > WorK: 217-785-7165 > Fax: 217-557-4049 > Connie.austin@illinois.gov > > From: "Shay Drummond" To: Yantis Ryan CC: Date: 8/28/2015 3:27:44 PM Subject: RE: QHW - Matt Hopf on Increased Numbers at IVH-Q On phone with him now From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Friday, August 28, 2015 4:27 PM To: Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F Subject: QHW - Matt Hopf on Increased Numbers at IVH-Q - ​All Call from Matt Hopf, Quincy Herald Whig, on short deadline for reason for increase confirmed cases of legionellosis at the Home. A: Legionnaires’ disease is caused by the Legionella bacteria and symptoms can include fever, muscle aches, cough - common symptoms until such time that some develop pneumonia, and require hospitalization. Other symptoms may include headache, fatigue, loss of appetite, confusion, or diarrhea; again, fairly common symptoms for a wide variety of diseases. Symptoms may develop between 2 to 10 days after an exposure, but special laboratory testing is needed to confirm a diagnosis of Legionella. Antibiotics are used to treat Legionnaires’ disease, and those with Legionnaires’ disease often need to be hospitalized. Adults older than 50 with respiratory complications such as chronic lung diseases, people with weakened immune systems, people who take immune weakening medications (immunosuppressive medications), and smokers are at higher risk of Legionnaires’ disease. --Thoughts? Ryan From: "Shay Drummond" To: HOUSTON CATHY CC: Date: 8/28/2015 11:56:48 AM Subject: RE: Status Update I think we both need vacations, extended. Would it help for you to send the clinical case definition to VA – the urine test along with pneumonia meets the case def. sputums help to augment. If you need more clinical stuff from IDPH and CDC let me know. Thanks ⅛ From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Friday, August 28, 2015 12:54 PM To: Shay Drummond Subject: RE: Status Update Flu vaccine ordered not here yet. Pneumonia Vaccines—YES I sent you updated list of additional residents this am. None since that I am aware of. What else can you do for me?? Hum want a new job? Lol VA (not Illinois VA—that you have been on numerous calls with) the VA that we have to report to here in Quincy—Federal. They are concerned that only tests are urines that we are diagnosing with. (just between you and me for now) From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 12:28 PM To: HOUSTON, CATHY Subject: RE: Status Update Cathy no we don’t need any more, thanks! Urines continue. Are you seeing any more residents or staff with signs and symptoms? What other data or lab reports do we still need to get to you? Anything else I can help you with? Also do your residents get pneumonia vaccines? And one more question, do you have flu vaccine in for staff and residents, yet? From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Friday, August 28, 2015 12:14 PM To: Shay Drummond Subject: RE: Status Update We have not been collecting the NP/OP. We sent those back to you yesterday. Do you want us to still attempt to get those? From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:49 AM To: Manley, Linda (Linda.Manley@blessinghealthsystem.org); Roberts, Vickie; Merrick, Robert (Robert.Merrick@blessinghospital.com); Loyd, David (David.Loyd@blessinghealthsystem.org); HOUSTON, CATHY Cc: Jon Campos; Jerrod Welch Subject: Status Update Good morning, We currently have 23 lab confirmed cases. There are 23 cases hospitalized – of those we have 12 positives 6 negatives and 5 pending results IVH is currently caring for 35 residents with signs and symptoms and there are 8 positives in that group, and many labs pending IVH has two staff hospitalized with one in ICU who is pending labs and the other a positive. Labs: We want to continue to collect urines on all presenting with signs and symptoms and any that you can collect sputum’s. Also all urines can go through LabCorp’s at this point. We have gotten urines on all ill residents at the home and they will be sending any new labs through Blessing. Blood – we had sent an email a few days ago about lab holding blood for further testing. This was a CDC request – since then due to the large number of positive legionella – they do not need any blood specimens or NP/OP sent to CDC. We are working on getting all cases into INEDSS and updated. We do have two CSTE Fellows from the CDC who are conducting detailed epi interviews with patients to assist in the investigation. They are spending time at IVH this morning. Environmental controls have been ongoing since Monday at IVH. Please feel free to call or email if you have any questions or if you think we need a quick call today prior to the weekend. Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: HOUSTON CATHY CC: Date: 8/28/2015 11:28:29 AM Subject: RE: Status Update Cathy no we don’t need any more, thanks! Urines continue. Are you seeing any more residents or staff with signs and symptoms? What other data or lab reports do we still need to get to you? Anything else I can help you with? Also do your residents get pneumonia vaccines? And one more question, do you have flu vaccine in for staff and residents, yet? From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Friday, August 28, 2015 12:14 PM To: Shay Drummond Subject: RE: Status Update We have not been collecting the NP/OP. We sent those back to you yesterday. Do you want us to still attempt to get those? From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Friday, August 28, 2015 11:49 AM To: Manley, Linda (Linda.Manley@blessinghealthsystem.org); Roberts, Vickie; Merrick, Robert (Robert.Merrick@blessinghospital.com); Loyd, David (David.Loyd@blessinghealthsystem.org); HOUSTON, CATHY Cc: Jon Campos; Jerrod Welch Subject: Status Update Good morning, We currently have 23 lab confirmed cases. There are 23 cases hospitalized – of those we have 12 positives 6 negatives and 5 pending results IVH is currently caring for 35 residents with signs and symptoms and there are 8 positives in that group, and many labs pending IVH has two staff hospitalized with one in ICU who is pending labs and the other a positive. Labs: We want to continue to collect urines on all presenting with signs and symptoms and any that you can collect sputum’s. Also all urines can go through LabCorp’s at this point. We have gotten urines on all ill residents at the home and they will be sending any new labs through Blessing. Blood – we had sent an email a few days ago about lab holding blood for further testing. This was a CDC request – since then due to the large number of positive legionella – they do not need any blood specimens or NP/OP sent to CDC. We are working on getting all cases into INEDSS and updated. We do have two CSTE Fellows from the CDC who are conducting detailed epi interviews with patients to assist in the investigation. They are spending time at IVH this morning. Environmental controls have been ongoing since Monday at IVH. Please feel free to call or email if you have any questions or if you think we need a quick call today prior to the weekend. Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Arnold Melaney Ryan "LENARD F" "CATHY S" "Erica L" "HARRY H" Nirav CC: Date: 8/28/2015 11:19:43 AM Subject: RE: Updated TP/Q&A Melaney that is correct – and I was just getting ready to send this up. Thanks! From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Friday, August 28, 2015 12:19 PM To: Yantis, Ryan; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; SAWYER, HARRY H; Shah, Nirav Subject: RE: Updated TP/Q&A Thanks Ryan. I also updated some of the talking points, the main ones being that we don’t know if all 23 confirmed cases are Legionnaires’ disease or the milder form – so I changed it to say 23 cases of legionellosis. Shay – you may know more about this. Also – one staff member is now included in the cases. Q.6 A6. Are all 23 cases residents, or are staff members ill as well? Is staff at risk? All cases except for one, are residents. Some staff members have been at risk of exposure as well from aerosolized water sources. We are working diligently to make sure any place where Legionella bacteria could grow at the home is addressed – i.e. cleaned. And the CDC typically does not recommend moving long-term care residents. From: Yantis, Ryan Sent: Friday, August 28, 2015 12:01 PM To: Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; SAWYER, HARRY H; Shah, Nirav Subject: Updated TP/Q&A All - updated overall cases, added Q&A 7 from my ABC 7 query yesterday, added numbers to Q&A ​'s for easier tracking & updating, and updated "as of " date/time stamp Attached. From: "Shay Drummond" To: Manley "Linda <" "\(Linda.Manley@blessinghealthsystem.org\);Roberts>" Vickie "Robert\(Robert.Merrick@blessinghospital.com\);Loyd" "David <" "\(David.Loyd@blessinghealthsystem.org\);HOUSTON>" "CATHY\(CATHY.S.HOUSTON@illinois.gov\);" CC: "Jon Campos" "Jerrod Welch" Date: 8/28/2015 10:49:10 AM Subject: Status Update Good morning, We currently have 23 lab confirmed cases. There are 23 cases hospitalized – of those we have 12 positives 6 negatives and 5 pending results IVH is currently caring for 35 residents with signs and symptoms and there are 8 positives in that group, and many labs pending IVH has two staff hospitalized with one in ICU who is pending labs and the other a positive. Labs: We want to continue to collect urines on all presenting with signs and symptoms and any that you can collect sputum’s. Also all urines can go through LabCorp’s at this point. We have gotten urines on all ill residents at the home and they will be sending any new labs through Blessing. Blood – we had sent an email a few days ago about lab holding blood for further testing. This was a CDC request – since then due to the large number of positive legionella – they do not need any blood specimens or NP/OP sent to CDC. We are working on getting all cases into INEDSS and updated. We do have two CSTE Fellows from the CDC who are conducting detailed epi interviews with patients to assist in the investigation. They are spending time at IVH this morning. Environmental controls have been ongoing since Monday at IVH. Please feel free to call or email if you have any questions or if you think we need a quick call today prior to the weekend. Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Yantis, Ryan" To: "Shay Drummond" Melaney "LENARD F" "CATHY S" "Erica L" "HARRY H" Nirav CC: Date: 8/28/2015 1:13:07 PM Subject: Afternoon Media Sweep - IVH-Q ​All; so far reporting is fair, balanced (no naysayers) and accurate, largely from the original press release. New Case number 23 will drive more attention. Washington Times reported 30 minutes ago, based on WGEM's update, which they are feeding to the Associated Press. http://www.washingtontimes.com/news/2015/aug/28/confirmed-legionnaires-disease-cases-at-vets-home-/ ​ WGEM's update​ Confirmed Legionnaires' disease cases at vets home now at 23 Posted: Aug 28, 2015 1:15 PM CDTUpdated: Aug 28, 2015 1:15 PM CDT QUINCY, Ill. (AP) - A health official says the number of confirmed cases of Legionnaires' disease at the Illinois Veterans' Home in Quincy has nearly tripled to 23. Adams County Health Department Director of Clinical and Environmental Services Shay Drummond said lab tests confirmed the new total Friday, a day after state officials announced eight confirmed cases among residents of the home. Drummond tells WGEM-AM (http://bit.ly/1PXnoXE ) the health department is recommending elderly people and anyone who's sick or has immunity issues should not visit the home. Those groups are most vulnerable to the disease. Legionnaires' disease is caused when water tainted with Legionella bacteria is inhaled into the lungs. The source of the bacteria hasn't been determined, but Drummond said the health department is confident it's limited to the veterans home. Information from: WGEM-AM. Copyright 2015 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. From: "Yantis, Ryan" To: Arnold Melaney "CATHY S" "LENARD F" "BRUCE L" "GWEN G" "Erica L ;Shay Drummond" "HARRY H" CC: Date: 8/28/2015 10:06:41 AM S u b j e c t : Fw: Google Alert - Illinois department of Veterans' affairs Wonderful... we made the "Outbreak News" on LD at IVH-Q... but, it was FBA, largely from the release and our websources. By editor in chief, by Robert Herriman on August 28, 2015 http://outbreaknewstoday.com/legionnaires-disease-outbreak-at-illinois-veterans-home-quincy-81490/ Outbreak News Today is a new health and disease “magazine” news website focused on the latest news and information pertaining to infectious diseases. Non- communicable diseases and other health news is also covered. The website breaks down the latest news by area of the globe for easy searching. From: Google Alerts Sent: Friday, August 28, 2015 11:01 AM To: Yantis, Ryan Subject: Google Alert - Illinois department of Veterans' affairs Illinois department of Veterans' affairs Daily update August 28, 2015 NEWS Health officials say several cases of Legionnaires' disease confirmed in Illinois Veterans Home W GEM WGEM "Our Quincy Home staff and the Illinois Department of Veterans' Affairs leadership are taking this situation seriously, as we do with any other situation ... 8 Treated for Legionnaires' Disease at Illinois Veterans Home - WSIL TV Legionnaires' disease outbreak at Illinois Veterans' Home - Quincy - Outbreak News Today Legionnaires' disease outbreak at IL Vets Home - Quincy Journal Full Coverage Flag as irrelevant You have received this email because you have subscribed to Google Alerts. Unsubscribe Receive this alert as RSS feed Send Feedback From: "Yantis, Ryan" To: "CMS . IISNEWS" CC: Date: 8/28/2015 7:39:10 PM Subject: IDVA/IDPH Press Release: Two Deaths at Illinois Veterans’ Home-Quincy (after-hours email list) Attachments: 2015-08-28 IDVA-IDPH Release Two Dead at IVH-Q FINAL R.docx For Immediate Release Aug. 28, 2015 CONTACTS: See Below Two Deaths at Illinois Veterans’ Home-Quincy Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of two residents at the Illinois Veterans’ HomeQuincy. The two residents, both of whom had underlying medical conditions, were among the 23 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “The Illinois Department of Veterans’ Affairs (IDVA) and our Quincy Home staff are deeply saddened by the passing of these two veterans, just as we are when any of our residents pass. Our thoughts and prayers are with the family, friends, and caretakers of these residents.” said Erica Jeffries, Director, IDVA. “We are keenly focused on making all of our Homes places for residents to live and thrive, and we work very hard to provide the safest, most sanitary, and pleasant living arrangements for our heroes. We will continue to work closely with IDPH and the local healthcare providers to remediate these issues as quickly as possible to ensure the safety and well-being of all of our residents.” “Legionnaires’ disease can range from a mild respiratory illness to severe pneumonia and death,” said IDPH Director Nirav D. Shah, M.D., J.D. “It can take up to 14 days to become ill after exposure, so we could see additional cases. Because the elderly and those with underlying medical conditions are at greater risk of serious illness, we are working diligently to identify residents or staff who have respiratory illness and provide medical treatment to them as quickly as possible.” Names of the deceased are being withheld to allow families to notify other family and friends. We will work with the families and ask others to respect their privacy at this difficult time. IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. For more information about Legionnaires’ disease, visit the IDPH website. For media seeking additional information, please contact: IDVA / IVH-Quincy: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d)217-222-8440 x148 (c)217-316-2795 sdrummond@co.adams.il.us ### From: "Yantis, Ryan" To: HOUSTON "CATHY S" "LENARD F" CC: "Arnold, Melaney" "Jeffries, Erica L" "Shay Drummond" Date: 8/28/2015 3:44:09 PM S u b j e c t : Previous Cases Legionnaires at IVH-Q? Please note his query - he's also asked Shay and I (separately) why the spike in numbers. That Answer: Legionnaire's is a tough disease to diagnose due to symptoms common with other diseases, a long incubation period, and what can appear to be random selection of those afflicted as it is not transmitted person to person. Compounding these factors, a special lab test is needed to confirm the presence of the Legionella bacteria in a patient. That presence, combined with physical symptoms - which may take days or weeks to evolve, makes a rapid diagnosis difficult. Legionnaires’ disease is caused by the Legionella bacteria and symptoms can include fever, muscle aches, cough - common symptoms until such time that some develop pneumonia, and require hospitalization. Other symptoms may include headache, fatigue, loss of appetite, confusion, or diarrhea; again, fairly common symptoms for a wide variety of diseases. Symptoms may develop between 2 to 10 days after an exposure, but special laboratory testing is needed to confirm a diagnosis ofLegionella . Antibiotics are used to treat Legionnaires’ disease, and those with Legionnaires’ disease often need to be hospitalized. Adults older than 50 with respiratory complications such as chronic lung diseases, people with weakened immune systems, people who take immune weakening medications (immunosuppressive medications), and smokers are at higher risk of Legionnaires’ disease. From: Matthew Hopf Sent: Friday, August 28, 2015 4:38 PM To: Yantis, Ryan Subject: Illinois Veterans Home RyanAny chance you could find out if there there were ever cases of Legionnaires' disease at the Illinois Veterans Home previously? Thanks. -Matt Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Yantis, Ryan" To: Arnold "Melaney ;Shay Drummond" "LENARD F" CC: Date: 8/28/2015 3:27:03 PM Subject: QHW - Matt Hopf on Increased Numbers at IVH-Q ​All Call from Matt Hopf, Quincy Herald Whig, on short deadline for reason for increase confirmed cases of legionellosis at the Home. A: Legionnaires’ disease is caused by the Legionella bacteria and symptoms can include fever, muscle aches, cough - common symptoms until such time that some develop pneumonia, and require hospitalization. Other symptoms may include headache, fatigue, loss of appetite, confusion, or diarrhea; again, fairly common symptoms for a wide variety of diseases. Symptoms may develop between 2 to 10 days after an exposure, but special laboratory testing is needed to confirm a diagnosis of Legionella. Antibiotics are used to treat Legionnaires’ disease, and those with Legionnaires’ disease often need to be hospitalized. Adults older than 50 with respiratory complications such as chronic lung diseases, people with weakened immune systems, people who take immune weakening medications (immunosuppressive medications), and smokers are at higher risk of Legionnaires’ disease. --Thoughts? Ryan From: "Yantis, Ryan" To: "Shay Drummond" CC: Date: 8/28/2015 8:28:18 PM Subject: Re: IDVA/IDPH Press Release: Two Deaths at Illinois Veterans’ Home-Quincy (after-hours email list) ​Yes - From: Shay Drummond Sent: Friday, August 28, 2015 9:26 PM To: Yantis, Ryan Subject: Re: IDVA/IDPH Press Release: Two Deaths at Illinois Veterans’ Home-Quincy (after-hours email list) Did this go out???? Sent from my iPhone On Aug 28, 2015, at 8:41 PM, Yantis, Ryan wrote: For Immediate Release Aug. 28, 2015 CONTACTS: See Below Two Deaths at Illinois Veterans’ Home-Quincy Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of two residents at the Illinois Veterans’ Home-Quincy. The two residents, both of whom had underlying medical conditions, were among the 23 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “The Illinois Department of Veterans’ Affairs (IDVA) and our Quincy Home staff are deeply saddened by the passing of these two veterans, just as we are when any of our residents pass. Our thoughts and prayers are with the family, friends, and caretakers of these residents.” said Erica Jeffries, Director, IDVA. “We are keenly focused on making all of our Homes places for residents to live and thrive, and we work very hard to provide the safest, most sanitary, and pleasant living arrangements for our heroes. We will continue to work closely with IDPH and the local healthcare providers to remediate these issues as quickly as possible to ensure the safety and well-being of all of our residents.” “Legionnaires’ disease can range from a mild respiratory illness to severe pneumonia and death,” said IDPH Director Nirav D. Shah, M.D., J.D. “It can take up to 14 days to become ill after exposure, so we could see additional cases. Because the elderly and those with underlying medical conditions are at greater risk of serious illness, we are working diligently to identify residents or staff who have respiratory illness and provide medical treatment to them as quickly as possible.” Names of the deceased are being withheld to allow families to notify other family and friends. We will work with the families and ask others to respect their privacy at this difficult time. IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. For more information about Legionnaires’ disease, visit the IDPH website. For media seeking additional information, please contact: IDVA / IVH-Quincy: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d)217-222-8440 x148 (c)217-316-2795 sdrummond@co.adams.il.us ### <2015-08-28 IDVA-IDPH Release Two Dead at IVH-Q FINAL R.docx> From: "Yantis, Ryan" To: "Matthew Hopf" CC: Date: 8/28/2015 3:51:11 PM Subject: Re: Illinois Veterans Home ​Working it. Did you get an answer from Shay Drummond on the reason for the increase of cases at the Home? I'm still working the response with the Home's leadership Ryan From: Matthew Hopf Sent: Friday, August 28, 2015 4:38 PM To: Yantis, Ryan Subject: Illinois Veterans Home RyanAny chance you could find out if there there were ever cases of Legionnaires' disease at the Illinois Veterans Home previously? Thanks. -Matt Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Yantis, Ryan" To: Arnold "Melaney ;Shay Drummond" "LENARD F" CC: "Little, Divya Mohan" Date: 8/28/2015 9:35:22 AM Subject: Re: Media strategy ​Concur. Just now looking at the numbers to get perspective. We also need to have a timeline prepared for RTQ. Next potential media triggers​? Death of a resident/staff, with concerns that it is related to legionella Residents being moved by family/at own request to other home with concerns/complaints "whistleblowers" from staff / residents purporting insider info on how IVH-Q and others screwed this up From: Arnold, Melaney Sent: Friday, August 28, 2015 10:30 AM To: Yantis, Ryan; Shay Drummond; WINNICKI, LENARD F Cc: Little, Divya Mohan Subject: Media strategy Morning ~ IDPH’s thoughts on media strategy. It looks like we’re going to see a pretty big jump in numbers today. And some of the cases are not doing well. However, we do not propose a news release today. The only new thing we would have is the updated numbers. IDPH is working to update our website, we’ll have a banner on the home page for Legionnaires’ disease that will link directly to our Legionnaires’ info page. On that page we plan on posting the daily numbers. We’re being transparent, but not continuing to put this in the media’s eye. If/when we see deaths – at that time I think we’ll need a news release, possibly even a news conference if all administrators agree. Thoughts? Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: "Yantis, Ryan" To: Smith Mitch CC: "Shay Drummond" "Arnold, Melaney" Date: 8/28/2015 3:44:40 PM Subject: Re: New York Times request ​ From: Smith, Mitch Sent: Friday, August 28, 2015 4:38 PM To: Yantis, Ryan Subject: New York Times request Hi Ryan, I'm a Chicago-based New York Times reporter following the Legionnaires' cases in Quincy. Can you please send me the most recent press release, and include me on the distribution list for any updates? Thanks for your help. -Mitch Smith Mitch Smith The New York Times, Chicago bureau mitch.smith@nytimes.com O: 312-552-7209 C: 913-568-8847 From: "Yantis, Ryan" To: "Shay Drummond" CC: "Arnold, Melaney" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Jeffries, Erica L" "SAWYER, HARRY H" "Shah, Nirav" Date: 8/28/2015 11:36:39 AM S u b j e c t : Re: Updated TP/Q&A Great. Thanks Sent from my iPhone On Aug 28, 2015, at 12:19 PM, Shay Drummond wrote: Melaney that is correct – and I was just getting ready to send this up. Thanks! From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Friday, August 28, 2015 12:19 PM To: Yantis, Ryan; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; SAWYER, HARRY H; Shah, Nirav Subject: RE: Updated TP/Q&A Thanks Ryan. I also updated some of the talking points, the main ones being that we don’t know if all 23 confirmed cases are Legionnaires’ disease or the milder form – so I changed it to say 23 cases of legionellosis. Shay – you may know more about this. Also – one staff member is now included in the cases. Q.6 A6. Are all 23 cases residents, or are staff members ill as well? Is staff at risk? All cases except for one, are residents. Some staff members have been at risk of exposure as well from aerosolized water sources. We are working diligently to make sure any place where Legionella bacteria could grow at the home is addressed – i.e. cleaned. And the CDC typically does not recommend moving long-term care residents. From: Yantis, Ryan Sent: Friday, August 28, 2015 12:01 PM To: Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; SAWYER, HARRY H; Shah, Nirav Subject: Updated TP/Q&A All - updated overall cases, added Q&A 7 from my ABC 7 query yesterday, added numbers to Attached. Q&A ​'s for easier tracking & updating, and updated "as of " date/time stamp From: "Yantis, Ryan" To: Arnold "Melaney ;Shay Drummond" "LENARD F" "CATHY S" "Erica L" "HARRY H" Nirav CC: Date: 8/28/2015 11:00:47 AM Subject: Updated TP/Q&A Attachments: Legionella TP & Q&A 2015-08-28 1150am.docx All - updated overall cases, added Q&A 7 from my ABC 7 query yesterday, added numbers to Q&A​'s for easier tracking & updating, and updated "as of " date/time stamp Attached. From: "Arnold, Melaney" To: Yantis "Ryan ;Shay Drummond" CC: "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Jeffries, Erica L" "Shah, Nirav" Date: 8/29/2015 5:22:16 PM Subject: RE: DRAFT - IVH Quincy update for QHW and others Attachments: Legionella TP QA 2015-08-29_600 PM.docx From: Yantis, Ryan Sent: Saturday, August 29, 2015 6:00 PM To: Arnold, Melaney; Shay Drummond Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; Shah, Nirav Subject: DRAFT - IVH Quincy update for QHW and others For response to the Quincy Herald Whig via email from me, once we have numbers...highlighted below. Q: Will there be any update today (Sat. Aug 28 at 6 pm.) on the Legionnaires' disease outbreak at the Illinois Veterans Home? ​ A: Our thoughts and prayers go to those two heroes who passed yesterday, and we offer our sincere condolences to their loved ones. There have been no additional deaths believed to be related to legionella in the past 24 hours, and while this is certainly welcome news, much remains to be done. The only numbers I would provide would be 28 individuals associated with the home –. If pressed I would be willing to say 23 residents and 3 staff, plus 2 resident deaths. Providing the number of people in care, treated in the hospital or home, and those with respiratory illness is going to fluctuate GREATLY over the next several days and getting into the numbers game never goes well. There are too many variables that change – someone dies, but does not test positive for Legionnaires’, someone has pneumonia but it’s due to another bacteria, a resident being treated at the facility goes home with family, etc. This is just my experience. We have ### residents in care in local or regional health care providing facilities, ### treated and in the Home, and ### with respiratory illness symptoms. We are continuing to work closely with our partners - the Adams County Health Dept., the Illinois Dept. of Public Health, and local care providers focusing on our residents, their health, and to getting through this tough situation. ​ I updated the talking points a bit. Thanks From: Arnold, Melaney Sent: Saturday, August 29, 2015 5:50 PM To: Yantis, Ryan Subject: Re: IVH Quincy update What numbers do you need? On Aug 29, 2015, at 5:45 PM, Yantis, Ryan wrote: ​Matt Working on it and waiting on numbers from the Home and local health care providers. Hopefully soon. Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 5:31 PM To: Yantis, Ryan Subject: Re: IVH Quincy update ETA on an update? From: "Yantis, Ryan" Date: Saturday, August 29, 2015 9:54 AM To: Quincy Herald-Whig Subject: Re: IVH Quincy update ​Matt We're working on it. Will let you know. Thanks Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 9:54 AM To: Yantis, Ryan Subject: IVH Quincy update RyanWill there be any update today on the Legionnaires' disease outbreak at the Illinois Veterans Home? Thanks. -Matt Hopf The Herald-Whig Sent from Outlook Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Arnold, Melaney" To: "Shay Drummond" Ryan CC: Date: 8/29/2015 3:03:21 PM Subject: RE: FYI Definitely vigilant about what info and when. I’m not sure I understand when he says names mentioned – have any names been mentioned? It is understandable how upsetting this is, but for talking points – if pressed – testing/diagnosis for Legionnaires’ disease takes time. As soon as we knew a diagnosis, we shared the info. Also, I believe the treatment would have remained the same – correct? Emotion is going to start driving the news stories, so I envision things getting much more difficult moving forward. Thank you Shay From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Saturday, August 29, 2015 3:45 PM To: A rnold, Melaney; Yantis, Ryan Subject: FYI Importance: High Melaney and Ryan, See the message below that messaged me on FB today. This certainly brings it all home for me and why I want to be very diligent on when we release info and what info we release. I have not yet responded to this,….but I needed to share.. “My father is one of the two who passed away at the vets home. I know you are not responsible with how they handle things but it’s been really devastating to know that our choices for my dad’s care would have been different if we knew about the legionnaires We did not find out about or that my dad had it until 4 hours before he died. Now myself and my family instead of burying our father have to wait. Now we have to deal with the fact that maybe we did not do all we could have. The situation was handled badly to say the least but the lack of communication in mind killed my father a hero who served his country only to die in its care. We knew nothing about this and we had serval conversations with the vets home trying to make the very best choices we could for my dad this is more than inexcusable considering we had him at the ER on Tuesday and not one person mentioned anything including the nurses who were caring for him. It would be nice before names are mentioned that my family should be told about any further information especially when it comes to releasing names. I have no doubt everyone working very hard to get this under control but we ask ourselves why was no one working hard for my dad. Why did it take his death and another’s before the severity of this horrible disease was brought to the public attention. I hope no other families have to sit and watch their loved one die in the same way we did and then to find out it may have all been prevented…Sincerely the family US Army Vet.” Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Arnold, Melaney" To: Yantis Ryan CC: "Shay Drummond" "Shah, Nirav" "Jeffries, Erica L" "Neisen, Lisa \(PR\)" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "DIEHL, GWEN G" "SAWYER, HARRY H" "McGill, Patricia O" Date: 8/29/2015 9:50:40 AM Subject: Re: Press Release Commentary This is a technicality the media /public may not seize on, but it is Legionella (italicized) bacteria. But when referring to the illness - I think we should go with Legionnaires' disease. I can't open the document right now except on my phone, but will be able to later On Aug 29, 2015, at 10:28 AM, Yantis, Ryan wrote: All - Please find attached the current Talking Points and Q&A (Legionella TP QA 2015-08-29 1015 AM.docx​) for staffing. All changes have been highlighted. If there are changes offered, please also summarize in the message. There are some data points we need to update. I attempted to answer Shay's questions: What is being done? Is it safe for residents to return to home from hospital? I also updated the deaths question, but we need our 1130 update to confirm today's numbers. Thanks Ryan From: "Arnold, Melaney" To: Austin Connie CC: "Shah, Nirav" "Shay Drummond" "Conover, Craig" Date: 8/29/2015 9:54:03 AM Subject: Re: Press Release Commentary At this time, I don't think we should be telling people there are cases in the community. That being said, yes, we need to have a response ready if asked. On Aug 29, 2015, at 10:50 AM, Austin, Connie wrote: Both have been exposed to 2 different decorative fountains. Shay what did you find out about the other ltc resident. Had he been outside the facility? Any other pneumonia cases in the facility int the last month Spoke to cdc about this with increased testing we may be finding sporadic cases we wouldn't have found without heightened awareness Unfortunately no way to look at strains with urine antigen Sent from my iPhone On Aug 29, 2015, at 11:04 AM, Shah, Nirav wrote: Thanks. I am growing concerned about the unaffiliated positive cases. Dr. Conover/Austin: what is our best guess as to the transmission route of the community cases? Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 10:02 AM To: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary I am having a status update with Blessing and IVH this morning and should have current numbers by 11 or so. We also have some outliers testing positive from the community – we need to address that in the talking points – these are patients that have no tie to IVH. This is where is will start to get dicey. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Saturday, August 29, 2015 9:55 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Arnold, Melaney; WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All - Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ <8583DF30-92C8-4590-83CE-4FE4BB4C51B6[4].png> <6FDB29A3-6052-417A-8D97-0D61EDD16A5D[4].png> From: "Arnold, Melaney" To: "Shay Drummond" CC: "Jerrod Welch" "Shah, Nirav" "Austin, Connie" "Conover, Craig" "Echols, Fred" "Jon Campos" Date: 8/29/2015 10:16:16 AM Subject: Re: Update 12:30 would be better for me, but others are more vital to this call. I may be a bit late. Thanks On Aug 29, 2015, at 11:13 AM, Shay Drummond wrote: Does noon work for everyone? We need clarification on the coroners – issues. From: Jerrod Welch Sent: Saturday, August 29, 2015 10:27 AM To: Shah, Nirav; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: RE: Update How about a call at 12:00 I will wait for the confirmation on that time, but if it works, we can invite the coroner and get this issue addressed. I have a call in number, but I’ll defer to DPH if you wish to utilize the call number you have previously used. Just let me know, and thanks for the response. I think this will go a long way in getting his concerns addressed. JCW From: Shah, Nirav Sent: Saturday, August 29, 2015 10:10 AM To: Jerrod Welch; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: Re: Update Thanks, Jerrod. This is a good question and I think we have contemplated this with CDC. I?m available for a call anytime other than 11AM today. Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Spring?eld, IL 62761 (217) 557-2556 n From: Jerrod Welch Date: Saturday, August 29, 2015 at 9:47 AM To: Shay Drummond Nirav Shah "Austin, Connie" "Conover, Craig" Fred" "Arnold, Cc: Jon Campos Subject: RE: Update To compound this, the Coroner is wanting to speak through this with DPH today if possible. Outside of a tissue sample of the lung, are there any other samples he should be collecting for a current epi investigation or future research on the disease. He is speaking with another pathologist who has made this suggestion, though I?m not sure who it is. He has placed a hold on all of the bodies and is trying to determine which ones they will perform an autopsy on and which ones they will simply collect the requested tissue from. Last night we had informally decided that he?d do autopsies on those without a lab positive urine, and tissues only on those with positives. I think after speaking with families, he?s changing his mind on who to autopsy. I think that we should coordinate a call that he can be on to ask questions to one of your experts who might help him make his decisions during this. He has some other general thoughts/concerns that I also think could benefit from a conversation with Connie or someone else who is you guys think fits this line of info. Thoughs? JCW From: Shay Drummond Sent: Saturday, August 29, 2015 9:23 AM To: Shah, Nirav (Nirav.Shah@illinois.gov); Austin, Connie (Connie.Austin@Illinois.gov); Craig.Conover@illinois.gov; Echols, Fred (Fred.Echols@Illinois.gov); Arnold, Melaney (Melaney.Arnold@Illinois.gov) Cc: Jon Campos; Jerrod Welch Subject: Update Importance: High All, the day is not starting well as I just found out that we lost another veterans home resident that was positive. He was being cared for on site. Blessing update: as of 0800 22 In house 2 admits overnight – was a re admit – both IVH residents. IVH Psychological care for staff and residents: IVH has counselors on staff that are tending to their needs, no additional resources needed at this time. Blessing is going to collect urine antigens on the 3 in house patients that have discordant labs. Will collect today and send to IDPH lab Springfield. Is there restrictions on times over weekend? Will have a solid update on numbers by 10:30 this morning. Thanks, Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 Publich CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and con?dential use of the designated recipients named above. The documents accompanying this transmission may contain con?dential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been ful?lled. If the reader of this message is not the intended recipient, you are hereby noti?ed that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: Shah Nirav CC: "Shay Drummond" "Arnold, Melaney" "Conover, Craig" Date: 8/29/2015 9:50:06 AM Subject: Re: Press Release Commentary Both have been exposed to 2 different decorative fountains. Shay what did you find out about the other ltc resident. Had he been outside the facility? Any other pneumonia cases in the facility int the last month Spoke to cdc about this with increased testing we may be finding sporadic cases we wouldn't have found without heightened awareness Unfortunately no way to look at strains with urine antigen Sent from my iPhone On Aug 29, 2015, at 11:04 AM, Shah, Nirav wrote: Thanks. I am growing concerned about the unaffiliated positive cases. Dr. Conover/Austin: what is our best guess as to the transmission route of the community cases? Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 10:02 AM To: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary I am having a status update with Blessing and IVH this morning and should have current numbers by 11 or so. We also have some outliers testing positive from the community – we need to address that in the talking points – these are patients that have no tie to IVH. This is where is will start to get dicey. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Saturday, August 29, 2015 9:55 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Arnold, Melaney; WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All - Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Austin, Connie" To: Conover Craig CC: "Shah, Nirav" "Shay Drummond" "Arnold, Melaney" Date: 8/29/2015 10:25:03 AM Subject: Re: Press Release Commentary We can do on Monday. I'm not sure how far blessing is and I think her home is at least 4 miles. I think sunset home was more than a mile for the second one Sent from my iPhone On Aug 29, 2015, at 12:15 PM, Conover, Craig wrote: Community cases should be mapped-- I believe the one we were alerted to yesterday lives a little over a mile from the facility as the crow flies. From: Austin, Connie Sent: Saturday, August 29, 2015 10:50 AM To: Shah, Nirav Cc: Shay Drummond; Arnold, Melaney; Conover, Craig Subject: Re: Press Release Commentary Both have been exposed to 2 different decorative fountains. Shay what did you find out about the other ltc resident. Had he been outside the facility? Any other pneumonia cases in the facility int the last month Spoke to cdc about this with increased testing we may be finding sporadic cases we wouldn't have found without heightened awareness Unfortunately no way to look at strains with urine antigen Sent from my iPhone On Aug 29, 2015, at 11:04 AM, Shah, Nirav wrote: Thanks. I am growing concerned about the unaffiliated positive cases. Dr. Conover/Austin: what is our best guess as to the transmission route of the community cases? Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 10:02 AM To: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary I am having a status update with Blessing and IVH this morning and should have current numbers by 11 or so. We also have some outliers testing positive from the community – we need to address that in the talking points – these are patients that have no tie to IVH. This is where is will start to get dicey. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Saturday, August 29, 2015 9:55 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Arnold, Melaney; WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All - Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Conover, Craig" To: Shah Nirav "Melaney ;Shay Drummond" CC: Date: 8/29/2015 3:09:56 PM Subject: quincy water testing http://www.quincyil.gov/files/documents/document/000/000/705.2014WaterQualityReport.pdf background info on testing done by quincy/IL EPA: http://www.quincyil.gov/files/documents/document/000/000/705.2014WaterQualityReport.pdf From: Shah, Nirav Sent: Saturday, August 29, 2015 3:45 PM To: Shay Drummond; Austin, Connie; Conover, Craig Cc: Arnold, Melaney Subject: Re: Press Release Commentary Hi Shay, Do you happen to know if the City is testing its water supply for evidence of Legionella? Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 11:42 AM To: "Austin, Connie" , "Conover, Craig" Cc: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary Connie, Jon is sending the addresses, distance from IVH etc. to you. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Saturday, August 29, 2015 11:25 AM To: Conover, Craig Cc: Shah, Nirav; Shay Drummond; Arnold, Melaney Subject: Re: Press Release Commentary We can do on Monday. I'm not sure how far blessing is and I think her home is at least 4 miles. I think sunset home was more than a mile for the second one Sent from my iPhone On Aug 29, 2015, at 12:15 PM, Conover, Craig wrote: Community cases should be mapped-- I believe the one we were alerted to yesterday lives a little over a mile from the facility as the crow flies. From: Austin, Connie Sent: Saturday, August 29, 2015 10:50 AM To: Shah, Nirav Cc: Shay Drummond; Arnold, Melaney; Conover, Craig Subject: Re: Press Release Commentary Both have been exposed to 2 different decorative fountains. Shay what did you find out about the other ltc resident. Had he been outside the facility? Any other pneumonia cases in the facility int the last month Spoke to cdc about this with increased testing we may be finding sporadic cases we wouldn't have found without heightened awareness Unfortunately no way to look at strains with urine antigen Sent from my iPhone On Aug 29, 2015, at 11:04 AM, Shah, Nirav wrote: Thanks. I am growing concerned about the unaffiliated positive cases. Dr. Conover/Austin: what is our best guess as to the transmission route of the community cases? Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 10:02 AM To: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary I am having a status update with Blessing and IVH this morning and should have current numbers by 11 or so. We also have some outliers testing positive from the community – we need to address that in the talking points – these are patients that have no tie to IVH. This is where is will start to get dicey. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Saturday, August 29, 2015 9:55 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Arnold, Melaney; WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Conover, Craig" To: "Shay Drummond" Nirav CC: "Austin, Connie" "Arnold, Melaney" Date: 8/29/2015 3:26:08 PM Subject: Re: monday draft plan Shay --Are they testing for Legionella on Monday? At first pass, I don't think I would recommend this based on the current situation--if you look hard enough you will usually find Legionella as it is ubiquitous and finding it will raise questions about elimination, additional testing, etc. CC From: Shay Drummond Sent: Saturday, August 29, 2015 4:05 PM To: Shah, Nirav Cc: Austin, Connie; Conover, Craig; Arnold, Melaney Subject: Re: Press Release Commentary They are testing Monday and have not done so in the past. They will be available also on Monday to visit with IDPH EH staff. Thanks, Shay Sent from my iPhone On Aug 29, 2015, at 3:46 PM, Shah, Nirav wrote: Hi Shay, Do you happen to know if the City is testing its water supply for evidence of Legionella? Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 <6FDB29A3-6052-417A-8D97-0D61EDD16A5D[17].png> From: Shay Drummond Date: Saturday, August 29, 2015 at 11:42 AM To: "Austin, Connie" , "Conover, Craig" Cc: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary Connie, Jon is sending the addresses, distance from IVH etc. to you. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Saturday, August 29, 2015 11:25 AM To: Conover, Craig Cc: Shah, Nirav; Shay Drummond; Arnold, Melaney Subject: Re: Press Release Commentary We can do on Monday. I'm not sure how far blessing is and I think her home is at least 4 miles. I think sunset home was more than a mile for the second one Sent from my iPhone On Aug 29, 2015, at 12:15 PM, Conover, Craig wrote: Community cases should be mapped-- I believe the one we were alerted to yesterday lives a little over a mile from the facility as the crow flies. From: Austin, Connie Sent: Saturday, August 29, 2015 10:50 AM To: Shah, Nirav Cc: Shay Drummond; Arnold, Melaney; Conover, Craig Subject: Re: Press Release Commentary Both have been exposed to 2 different decorative fountains. Shay what did you find out about the other ltc resident. Had he been outside the facility? Any other pneumonia cases in the facility int the last month Spoke to cdc about this with increased testing we may be finding sporadic cases we wouldn't have found without heightened awareness Unfortunately no way to look at strains with urine antigen Sent from my iPhone On Aug 29, 2015, at 11:04 AM, Shah, Nirav wrote: Thanks. I am growing concerned about the unaffiliated positive cases. Dr. Conover/Austin: what is our best guess as to the transmission route of the community cases? Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 10:02 AM To: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary I am having a status update with Blessing and IVH this morning and should have current numbers by 11 or so. We also have some outliers testing positive from the community – we need to address that in the talking points – these are patients that have no tie to IVH. This is where is will start to get dicey. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Saturday, August 29, 2015 9:55 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Arnold, Melaney; WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Conover, Craig" To: "Shay Drummond" CC: "Austin, Connie" Date: 8/29/2015 1:07:39 PM Subject: Re: Press Release Commentary Please send to Whitney and Justin also. From: Shay Drummond Sent: Saturday, August 29, 2015 11:42 AM To: Austin, Connie; Conover, Craig Cc: Shah, Nirav; Arnold, Melaney Subject: RE: Press Release Commentary Connie, Jon is sending the addresses, distance from IVH etc. to you. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Saturday, August 29, 2015 11:25 AM To: Conover, Craig Cc: Shah, Nirav; Shay Drummond; Arnold, Melaney Subject: Re: Press Release Commentary We can do on Monday. I'm not sure how far blessing is and I think her home is at least 4 miles. I think sunset home was more than a mile for the second one Sent from my iPhone On Aug 29, 2015, at 12:15 PM, Conover, Craig wrote: Community cases should be mapped-- I believe the one we were alerted to yesterday lives a little over a mile from the facility as the crow flies. From: Austin, Connie Sent: Saturday, August 29, 2015 10:50 AM To: Shah, Nirav Cc: Shay Drummond; Arnold, Melaney; Conover, Craig Subject: Re: Press Release Commentary Both have been exposed to 2 different decorative fountains. Shay what did you find out about the other ltc resident. Had he been outside the facility? Any other pneumonia cases in the facility int the last month Spoke to cdc about this with increased testing we may be finding sporadic cases we wouldn't have found without heightened awareness Unfortunately no way to look at strains with urine antigen Sent from my iPhone On Aug 29, 2015, at 11:04 AM, Shah, Nirav wrote: Thanks. I am growing concerned about the unaffiliated positive cases. Dr. Conover/Austin: what is our best guess as to the transmission route of the community cases? Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 10:02 AM To: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary I am having a status update with Blessing and IVH this morning and should have current numbers by 11 or so. We also have some outliers testing positive from the community – we need to address that in the talking points – these are patients that have no tie to IVH. This is where is will start to get dicey. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Saturday, August 29, 2015 9:55 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Arnold, Melaney; WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Conover, Craig" To: Austin Connie Nirav CC: "Shay Drummond" "Arnold, Melaney" Date: 8/29/2015 10:15:21 AM Subject: Re: Press Release Commentary Community cases should be mapped-- I believe the one we were alerted to yesterday lives a little over a mile from the facility as the crow flies. From: Austin, Connie Sent: Saturday, August 29, 2015 10:50 AM To: Shah, Nirav Cc: Shay Drummond; Arnold, Melaney; Conover, Craig Subject: Re: Press Release Commentary Both have been exposed to 2 different decorative fountains. Shay what did you find out about the other ltc resident. Had he been outside the facility? Any other pneumonia cases in the facility int the last month Spoke to cdc about this with increased testing we may be finding sporadic cases we wouldn't have found without heightened awareness Unfortunately no way to look at strains with urine antigen Sent from my iPhone On Aug 29, 2015, at 11:04 AM, Shah, Nirav wrote: Thanks. I am growing concerned about the unaffiliated positive cases. Dr. Conover/Austin: what is our best guess as to the transmission route of the community cases? Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 10:02 AM To: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary I am having a status update with Blessing and IVH this morning and should have current numbers by 11 or so. We also have some outliers testing positive from the community – we need to address that in the talking points – these are patients that have no tie to IVH. This is where is will start to get dicey. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Saturday, August 29, 2015 9:55 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Arnold, Melaney; WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Conover, Craig" To: "Jerrod Welch" "Fred ;Shay Drummond" Nirav Connie Melaney CC: "Jon Campos" Date: 8/29/2015 10:43:56 AM Subject: Re: Update Is there a medical examiner involved? I can connect the medical examiner directly with the CDC pathology staff for guidance. From: Jerrod Welch Sent: Saturday, August 29, 2015 11:23 AM To: Echols, Fred; Shay Drummond; Shah, Nirav; Austin, Connie; Conover, Craig; Arnold, Melaney Cc: Jon Campos Subject: RE: Update Fred, will we plan to use your conference number? I’ll reach back out to the coroner with the info if that’s the case. JCW From: Echols, Fred [mailto:Fred.Echols@Illinois.gov] Sent: Saturday, August 29, 2015 11:23 AM To: Shay Drummond; Jerrod Welch; Shah, Nirav; Austin, Connie; Conover, Craig; Arnold, Melaney Cc: Jon Campos Subject: RE: Update Shay, I have reached out to CDC staff and am hoping they will be available for the call. -Fred PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Saturday, August 29, 2015 11:14 AM To: Jerrod Welch; Shah, Nirav; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: RE: Update Does noon work for everyone? We need clarification on the coroners – issues. From: Jerrod Welch Sent: Saturday, August 29, 2015 10:27 AM To: Shah, Nirav; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: RE: Update How about a call at 12:00 I will wait for the confirmation on that time, but if it works, we can invite the coroner and get this issue addressed. I have a call in number, but I’ll defer to DPH if you wish to utilize the call number you have previously used. Just let me know, and thanks for the response. I think this will go a long way in getting his concerns addressed. JCW From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 10:10 AM To: Jerrod Welch; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: Re: Update Thanks, Jerrod. This is a good question and I think we have contemplated this with CDC. I’m available for a call anytime other than 11AM today. _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Jerrod Welch Date: Saturday, August 29, 2015 at 9:47 AM To: Shay Drummond , Nirav Shah , "Austin, Connie" , "Conover, Craig" , "Echols, Fred" , "Arnold, Melaney" Cc: Jon Campos Subject: RE: Update To compound this, the Coroner is wanting to speak through this with DPH today if possible. Outside of a tissue sample of the lung, are there any other samples he should be collecting for a current epi investigation or future research on the disease. He is speaking with another pathologist who has made this suggestion, though I’m not sure who it is. He has placed a hold on all of the bodies and is trying to determine which ones they will perform an autopsy on and which ones they will simply collect the requested tissue from. Last night we had informally decided that he’d do autopsies on those without a lab positive urine, and tissues only on those with positives. I think after speaking with families, he’s changing his mind on who to autopsy. I think that we should coordinate a call that he can be on to ask questions to one of your experts who might help him make his decisions during this. He has some other general thoughts/concerns that I also think could benefit from a conversation with Connie or someone else who is you guys think fits this line of info. Thoughs? JCW From: Shay Drummond Sent: Saturday, August 29, 2015 9:23 AM To: Shah, Nirav (Nirav.Shah@illinois.gov); Austin, Connie (Connie.Austin@Illinois.gov); Craig.Conover@illinois.gov; Echols, Fred (Fred.Echols@Illinois.gov); Arnold, Melaney (Melaney.Arnold@Illinois.gov) Cc: Jon Campos; Jerrod Welch Subject: Update Importance: High All, the day is not starting well as I just found out that we lost another veterans home resident that was positive. He was being cared for on site. Blessing update: as of 0800 22 In house 2 admits overnight – LV was a re admit – both IVH residents. IVH Psychological care for staff and residents: IVH has counselors on staff that are tending to their needs, no additional resources needed at this time. Blessing is going to collect urine antigens on the 3 in house patients that have discordant labs. Will collect today and send to IDPH lab Springfield. Is there restrictions on times over weekend? Will have a solid update on numbers by 10:30 this morning. Thanks, Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Conover, Craig" To: "Jerrod Welch" "Fred ;Shay Drummond" Nirav Connie Melaney CC: "Jon Campos" Date: 8/29/2015 11:26:58 AM Subject: Re: Update CDC tells me they were invited to the call at 1230 so they can provide input then re autopsy issues. From: Jerrod Welch Sent: Saturday, August 29, 2015 11:46 AM To: Conover, Craig; Echols, Fred; Shay Drummond; Shah, Nirav; Austin, Connie; Arnold, Melaney Cc: Jon Campos Subject: RE: Update Coroner is checking his availability but does indeed want him to join us on the call, and probably then have your contact with CDC pathology staff as well. From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Saturday, August 29, 2015 11:44 AM To: Jerrod Welch; Echols, Fred; Shay Drummond; Shah, Nirav; Austin, Connie; Arnold, Melaney Cc: Jon Campos Subject: Re: Update Is there a medical examiner involved? I can connect the medical examiner directly with the CDC pathology staff for guidance. From: Jerrod Welch Sent: Saturday, August 29, 2015 11:23 AM To: Echols, Fred; Shay Drummond; Shah, Nirav; Austin, Connie; Conover, Craig; Arnold, Melaney Cc: Jon Campos Subject: RE: Update Fred, will we plan to use your conference number? I’ll reach back out to the coroner with the info if that’s the case. JCW From: Echols, Fred [mailto:Fred.Echols@Illinois.gov] Sent: Saturday, August 29, 2015 11:23 AM To: Shay Drummond; Jerrod Welch; Shah, Nirav; Austin, Connie; Conover, Craig; Arnold, Melaney Cc: Jon Campos Subject: RE: Update Shay, I have reached out to CDC staff and am hoping they will be available for the call. -Fred PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Saturday, August 29, 2015 11:14 AM To: Jerrod Welch; Shah, Nirav; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: RE: Update Does noon work for everyone? We need clarification on the coroners – issues. From: Jerrod Welch Sent: Saturday, August 29, 2015 10:27 AM To: Shah, Nirav; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: RE: Update How about a call at 12:00 I will wait for the confirmation on that time, but if it works, we can invite the coroner and get this issue addressed. I have a call in number, but I’ll defer to DPH if you wish to utilize the call number you have previously used. Just let me know, and thanks for the response. I think this will go a long way in getting his concerns addressed. JCW From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 10:10 AM To: Jerrod Welch; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: Re: Update Thanks, Jerrod. This is a good question and I think we have contemplated this with CDC. I’m available for a call anytime other than 11AM today. _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Jerrod Welch Date: Saturday, August 29, 2015 at 9:47 AM To: Shay Drummond , Nirav Shah , "Austin, Connie" , "Conover, Craig" , "Echols, Fred" , "Arnold, Melaney" Cc: Jon Campos Subject: RE: Update To compound this, the Coroner is wanting to speak through this with DPH today if possible. Outside of a tissue sample of the lung, are there any other samples he should be collecting for a current epi investigation or future research on the disease. He is speaking with another pathologist who has made this suggestion, though I’m not sure who it is. He has placed a hold on all of the bodies and is trying to determine which ones they will perform an autopsy on and which ones they will simply collect the requested tissue from. Last night we had informally decided that he’d do autopsies on those without a lab positive urine, and tissues only on those with positives. I think after speaking with families, he’s changing his mind on who to autopsy. I think that we should coordinate a call that he can be on to ask questions to one of your experts who might help him make his decisions during this. He has some other general thoughts/concerns that I also think could benefit from a conversation with Connie or someone else who is you guys think fits this line of info. Thoughs? JCW From: Shay Drummond Sent: Saturday, August 29, 2015 9:23 AM To: Shah, Nirav (Nirav.Shah@illinois.gov); Austin, Connie (Connie.Austin@Illinois.gov); Craig.Conover@illinois.gov; Echols, Fred (Fred.Echols@Illinois.gov); Arnold, Melaney (Melaney.Arnold@Illinois.gov) Cc: Jon Campos; Jerrod Welch Subject: Update Importance: High All, the day is not starting well as I just found out that we lost another veterans home resident that was positive. He was being cared for on site. Blessing update: as of 0800 22 In house 2 admits overnight – LV was a re admit – both IVH residents. IVH Psychological care for staff and residents: IVH has counselors on staff that are tending to their needs, no additional resources needed at this time. Blessing is going to collect urine antigens on the 3 in house patients that have discordant labs. Will collect today and send to IDPH lab Springfield. Is there restrictions on times over weekend? Will have a solid update on numbers by 10:30 this morning. Thanks, Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Echols, Fred" To: "Shay Drummond" Nirav Connie Craig "Melaney ;;Kelly-Shannon>" "Kate D." Tal David Jodi CC: Date: 8/29/2015 10:43:08 AM Subject: Legionellosis Outbreak- Adams Co. Attachments: attachment.ics When: Saturday, August 29, 2015 12:30 PM-1:30 PM (UTC-06:00) Central Time (US & Canada). Where: Teleconference Note: The GMT offset above does not reflect daylight saving time adjustments. *~*~*~*~*~*~*~*~*~* The call-in information for today’s conference call is provided below: Call in: 1-888-494-4032 Passcode: 6575947859 From: "Echols, Fred" To: sdrummond@co.adams.il.us jcampos@co.adams.il.us CC: "Austin, Connie" Date: 8/29/2015 1:31:44 PM Subject: Questions Regarding the Hotel Shay, The veterans’ affairs staff was supposed to alert family members of IVH residents. However, we (IDPH DID staff) don't know what information was relayed to the family members staying on the grounds. Have people staying overnight on the grounds been told to see medical provider if they become ill. Overnight visitors could become ill in other states and not know about legionella risk. It is important that family members are aware of the risk and know what to do if they become ill. Can you reach out to the Veterans’ Affairs representatives and ask about what information has been provided to family members? If information has been provided to family member, IDPH CDCS staff would like to receive a copy of the document(s). Please let me know if you have any questions or concerns. Respectfully Yours, Fredrick L. Echols, MD Chief,Communicable Diseases Illinois Department of Public Health Phone: 217-782-2016 Fax: 217-524-0962 Email: Fred.Echols@Illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "Echols, Fred" To: sdrummond@co.adams.il.us CC: Date: 8/29/2015 3:41:46 PM Subject: RE: Legionella Tracking Log - 8 29-15 1400.xlsx Shay, Thanks so much for sending the information. To ensure HIPAA compliance please password-protect any documents you send via email that contain patient information. Again, thank you all for all that you are doing. We sincerely appreciate your efforts to protect the residents in your jurisdiction. -Fred PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Saturday, August 29, 2015 4:19 PM To: Austin, Connie; Echols, Fred; Conover, Craig; Clegg, Whitney Subject: Fwd: Legionella Tracking Log - 8 29-15 1400.xlsx Most recent IVH data. Sent from my iPhone Begin forwarded message: From: "HOUSTON, CATHY" Date: August 29, 2015 at 4:14:13 PM CDT To: Shay Drummond Subject: Legionella Tracking Log - 8 29-15 1400.xlsx From: "Echols, Fred" To: sdrummond@co.adams.il.us CC: Date: 8/29/2015 1:36:47 PM S u b j e c t : RE: Questions Regarding the Hotel Wonderful! Thank you. -Fred PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Saturday, A ugust 29, 2015 2:36 PM T o: Echols, Fred Subject: RE: Questions Regarding the Hotel Hi – the hotels now all make sense. We did have a call from a family that was similar to your scenario. I will find out what guidance they have given and try to get copies. Thanks, Shay From: Echols, Fred [mailto:Fred.Echols@Illinois.gov] Sent: Saturday, A ugust 29, 2015 2:32 PM T o: Shay Drummond; Jon Campos Cc: Austin, C onnie Subject: Questions Regarding the Hotel Shay, The veterans’ affairs staff was supposed to alert family members of IVH residents. However, we (IDPH DID staff) don't know what information was relayed to the family members staying on the grounds. Have people staying overnight on the grounds been told to see medical provider if they become ill. Overnight visitors could become ill in other states and not know about legionella risk. It is important that family members are aware of the risk and know what to do if they become ill. Can you reach out to the Veterans’ Affairs representatives and ask about what information has been provided to family members? If information has been provided to family member, IDPH CDCS staff would like to receive a copy of the document(s). Please let me know if you have any questions or concerns. Respectfully Yours, Fredrick L. Echols, MD Chief,Communicable Diseases Illinois Department of Public Health Phone: 217-782-2016 Fax: 217-524-0962 Email: Fred.Echols@Illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: To: H. (H. El Ii?. . Connie . . am. . Melaney CC: Wm Date: 8/29/2015 10:22:46 AM Subject: RE: Update Shay, have reached out to CDC staff and am hoping they will be available for the call. -FRED 1 ONFIDENTLALI NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify: the sender by telephone to arrange for the secure return of the document. From: Shay Drummond Sent: Saturday, August 29, 2015 11:14 AM To: Jerrod Welch; Shah, Nirav; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: RE: Update Does noon work for everyone? We need clarification on the coroners - issues. From: Jerrod Welch Sent: Saturday, August 29, 2015 10:27 AM To: Shah, Nirav; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: RE: Update How about a call at 12:00 I will wait for the confirmation on that time, but if it works, we can invite the coroner and get this issue addressed. I have a call in number, but I?ll defer to DPH if you wish to utilize the call number you have previously used. Just let me know, and thanks for the response. I think this will go a long way in getting his concerns addressed. JCW From: Shah, Nirav Sent: Saturday, August 29, 2015 10:10 AM To: Jerrod Welch; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: Re: Update Thanks, Jerrod. This is a good question and I think we have contemplated this with CDC. I?m available for a call anytime other than 11AM today. Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Spring?eld, IL 62761 (217) 557-2556 to From: Jerrod Welch Date: Saturday, August 29, 2015 at 9:47 AM To: Shay Drummond Nirav Shah , "Austin, Connie" "Conover, Craig" "Echo S, Fred" "Arnold, Melaney" Cc: Jon Campos Subject: RE: Update To compound this, the Coroner is wanting to speak through this with DPH today if possible. Outside of a tissue sample of the lung, are there any other samples he should be collecting for a current epi investigation or future research on the disease. He is speaking with another pathologist who has made this suggestion, though I’m not sure who it is. He has placed a hold on all of the bodies and is trying to determine which ones they will perform an autopsy on and which ones they will simply collect the requested tissue from. Last night we had informally decided that he’d do autopsies on those without a lab positive urine, and tissues only on those with positives. I think after speaking with families, he’s changing his mind on who to autopsy. I think that we should coordinate a call that he can be on to ask questions to one of your experts who might help him make his decisions during this. He has some other general thoughts/concerns that I also think could benefit from a conversation with Connie or someone else who is you guys think fits this line of info. Thoughs? JCW From: Shay Drummond Sent: Saturday, August 29, 2015 9:23 AM To: Shah, Nirav (Nirav.Shah@illinois.gov); Austin, Connie (Connie.Austin@Illinois.gov); Craig.Conover@illinois.gov; Echols, Fred (Fred.Echols@Illinois.gov); Arnold, Melaney (Melaney.Arnold@Illinois.gov) Cc: Jon Campos; Jerrod Welch Subject: Update Importance: High All, the day is not starting well as I just found out that we lost another veterans home resident that was positive. He was being cared for on site. Blessing update: as of 0800 22 In house 2 admits overnight – was a re admit – both IVH residents. IVH Psychological care for staff and residents: IVH has counselors on staff that are tending to their needs, no additional resources needed at this time. Blessing is going to collect urine antigens on the 3 in house patients that have discordant labs. Will collect today and send to IDPH lab Springfield. Is there restrictions on times over weekend? Will have a solid update on numbers by 10:30 this morning. Thanks, Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. 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From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/29/2015 3:14:13 PM Subject: Legionella Tracking Log - 8 29-15 1400.xlsx Attachments: Legionella Tracking Log - 8 29-15 1400.xlsx From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/29/2015 3:26:00 PM Subject: RE: Legionella Tracking Log - 8 29-15 1400.xlsx We have just found out we have another employee who was tested. This is what she reported. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Saturday, August 29, 2015 4:17 PM To: HOUSTON, CATHY Subject: Re: Legionella Tracking Log - 8 29-15 1400.xlsx Thanks- i appreciate it! Sent from my iPhone On Aug 29, 2015, at 4:14 PM, HOUSTON, CATHY wrote: she currently has diagnosis of mycoplasma pneumonia. From: "HOUSTON, CATHY" To: Yantis Ryan "LENARD F." CC: "Jeffries, Erica L" "Arnold, Melaney" "Shay Drummond" Date: 8/29/2015 12:52:59 PM Subject: RE: WGEM Interview and Home Campus B-Roll Whenever. I am here for the day. From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Saturday, August 29, 2015 1:45 PM To: WINNICKI, LENARD F. Cc: HOUSTON, CATHY; Jeffries, Erica L; Arnold, Melaney; Shay Drummond Subject: Re: WGEM Interview and Home Campus B-Roll ​Cathy is good to go when she's ready. I can call/email Chad to coordinate. We have confirmation from the Gov's Press Office on this interview as well, so that base is covered. Standing By Ryan From: WINNICKI, LENARD F. Sent: Saturday, August 29, 2015 1:22 PM To: Yantis, Ryan Cc: HOUSTON, CATHY S; Jeffries, Erica L Subject: Re: WGEM Interview and Home Campus B-Roll Cathy is gonna have a bite of lunch now and will be ready to go. I would like her to confirm when ready, though Len Winnicki, MSHS, LNHA Senior Nursing Home Administrator Illinois Department of Veteran Affairs One Veterans Drive Manteno, IL. 60950 Ph: (815) 468-6581 x210 Lenard.Winnicki@illinois.gov This e-mail and any attachments are intended solely for the person or entity to which addressed and may contain confidential information. Any copy or distribution of this information by person or entities other than the addressee is prohibited by law. If you have received this message in error, please contact the sender and delete this message along with any attachments. On Aug 29, 2015, at 12:58 PM, "Yantis, Ryan" wrote: ​Cathy & Len The camera will likely be from waist up, and more on face than on attire. I know this is a burden, but it's important. Again, happy to prep or talk either of you through it. Relax, be yourself, talk from knowledge, and BIFF (brief, informative, friendly, factual) Ryan From: HOUSTON, CATHY Sent: Saturday, August 29, 2015 12:55 PM To: Jeffries, Erica L; Yantis, Ryan; WINNICKI, LENARD F Subject: RE: WGEM Interview and Home Campus B-Roll I am in blue jeans. From: Jeffries, Erica L Sent: Saturday, August 29, 2015 12:49 PM To: HOUSTON, CATHY; Yantis, Ryan; WINNICKI, LENARD F. Subject: Fwd: WGEM Interview and Home Campus B-Roll Cathy, Would you be willing to do another interview? You'll be the biggest local celebrity Quincy has had in years! Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 Begin forwarded message: From: "Shah, Nirav" Date: August 29, 2015 at 12:37:33 CDT To: "Yantis, Ryan" , "Jeffries, Erica L" , "WINNICKI, LENARD F." , "HOUSTON, CATHY" , Shay Drummond , "Neisen, Lisa (PR)" , "Arnold, Melaney" Cc: "VACA, BRUCE" , "Ray, Jaimee M." Subject: Re: WGEM Interview and Home Campus B-Roll This is, of course, an IDVA decision. But Ryan, your analysis seems completely right to me. Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 IDPH_Logo1_blk_only <8583DF30-92C8-4590-83CE-4FE4BB4C51B6[13].png> From: , Ryan Date: Saturday, August 29, 2015 at 12:25 PM To: "Jeffries, Erica L" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" , Shay Drummond , "Neisen, Lisa (PR)" , "Arnold, Melaney" , Nirav Shah Cc: "VACA, BRUCE L" , "Ray, Jaimee M" Subject: WGEM Interview and Home Campus B-Roll ​ ll A Per previous email, Chad Mahoney, WGEM TV remains interested in an on-camera, on-IVH-Q grounds interview with someone from the Home, or IDVA. My instinct says yes - give the interview. We are working to a solution and have nothing to hide. We have great working relationship with are partners on this - IDPH, ACDH, Blessing, others - and they are offering knowledge, skills, and abilities to help the Home meet this challenge. Saying no to an interview can undermine public support (which has been neutral-positive so far) and create the impression we have something to hide. He also asked to visit the home to get b-roll... I approved that. As with the previous, I am happy to help/standing by for a prep session on a call with a selects spokesperson at Quincy. Thanks - Ryan From: "Jeffries, Erica L" To: Yantis Ryan CC: "Arnold, Melaney" "Shay Drummond" "WINNICKI, LENARD F." "HOUSTON, CATHY" "Shah, Nirav" Date: 8/29/2015 5:51:30 PM Subject: Re: DRAFT - IVH Quincy update for QHW and others, based onUpdated TPs I think this is a comprehensive response, Ryan. Thanks. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 18:31, Yantis, Ryan wrote: Thanks Melaney - So, another version of the email to the Quincy Herald Whig in RTQ: · Our thoughts and prayers go to those two heroes who passed yesterday, and we offer our sincere condolences to their loved ones.​ There have been no additional deaths believed to be related to legionella in the past 24 hours, and while this is certainly welcome news, much remains to be done. ​ Currently 28 individuals from the Veterans’ Home in Quincy have tested positive for Legionnaires’ disease; this includes the two residents who died yesterday. · The Adams County Health Department, the Illinois Department of Public Health, the Illinois Department of Veterans’ Affairs, Quincy Veterans’ Home, Blessing Hospital, and other medical providers, with guidance from the Centers for Disease Control and Prevention, are working together very closely to track patients with respiratory illness who have a connection with the home. · Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires’ disease and are making sure residents receive prompt medical attention if needed. · Compounding the challenge of identifying and treating individuals with Legionnaires’ disease is that we typically see other respiratory issues in residents this time of year. Therefore, all residents presenting any Legionnaires’ disease–type symptoms will be treated as if they have Legionnaires’ disease until lab results confirm the individual is negative for the bacteria. · Environmental health and infectious disease staff continue to visit the home to investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources. · The Illinois Veterans’ Home-Quincy has established a remediation plan including: Cleaning hot water tanks Cleaning the cooling tower – completed Friday, August 28. Using bottled water for residents and staff Using a temporary chiller so the facility chiller can be certified by outside experts Keeping fountains and other potential sources of aerosolized water turned off Removing possible/suspected Legionella-infected systems/devices from use until they can be specially treated and tested before use. Working with IDPH and other experts to clean and certify systems. We will update as the situation warrants. Our From: Arnold, Melaney Sent: Saturday, August 29, 2015 6:22 PM To: Yantis, Ryan; Shay Drummond Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; Shah, Nirav Subject: RE: DRAFT - IVH Quincy update for QHW and others From: Yantis, Ryan Sent: Saturday, August 29, 2015 6:00 PM To: Arnold, Melaney; Shay Drummond Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; Shah, Nirav Subject: DRAFT - IVH Quincy update for QHW and others For response to the Quincy Herald Whig via email from me, once we have numbers...highlighted below. Q: Will there be any update today (Sat. Aug 28 at 6 pm.) on the Legionnaires' disease outbreak at the Illinois Veterans Home? ​ A: Our thoughts and prayers go to those two heroes who passed yesterday, and we offer our sincere condolences to their loved ones. There have been no additional deaths believed to be related to legionella in the past 24 hours, and while this is certainly welcome news, much remains to be done. The only numbers I would provide would be 28 individuals associated with the home –. If pressed I would be willing to say 23 residents and 3 staff, plus 2 resident deaths. Providing the number of people in care, treated in the hospital or home, and those with respiratory illness is going to fluctuate GREATLY over the next several days and getting into the numbers game never goes well. There are too many variables that change – someone dies, but does not test positive for Legionnaires’, someone has pneumonia but it’s due to another bacteria, a resident being treated at the facility goes home with family, etc. This is just my experience. We have ### residents in care in local or regional health care providing facilities, ### treated and in the Home, and ### with respiratory illness symptoms. We are continuing to work closely with our partners - the Adams County Health Dept., the Illinois Dept. of Public Health, and local care providers - focusing on our residents, their health, and to getting through this tough situation. ​ I updated the talking points a bit. Thanks From: Arnold, Melaney Sent: Saturday, August 29, 2015 5:50 PM To: Yantis, Ryan Subject: Re: IVH Quincy update What numbers do you need? On Aug 29, 2015, at 5:45 PM, Yantis, Ryan wrote: ​Matt - Working on it and waiting on numbers from the Home and local health care providers. Hopefully soon. Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 5:31 PM To: Yantis, Ryan Subject: Re: IVH Quincy update ETA on an update? From: "Yantis, Ryan" Date: Saturday, August 29, 2015 9:54 AM To: Quincy Herald-Whig Subject: Re: IVH Quincy update ​Matt - We're working on it. Will let you know. Thanks Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 9:54 AM To: Yantis, Ryan Subject: IVH Quincy update Ryan- Will there be any update today on the Legionnaires' disease outbreak at the Illinois Veterans Home? Thanks. -Matt Hopf The Herald-Whig Sent from Outlook Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Jeffries, Erica L" To: Shah Nirav CC: "Arnold, Melaney" "Yantis, Ryan" "Shay Drummond" "WINNICKI, LENARD F." "HOUSTON, CATHY" Date: 8/29/2015 5:28:26 PM Subject: Re: DRAFT - IVH Quincy update for QHW and others I agree as well, however, I do think we need to be transparent about the number of deaths. I would not mention "in hospital" or "in home", but certainly, I think we should give the death count. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 18:26, Shah, Nirav wrote: I wanted to chime in on the numbers issue. I agree with Melaney. This can quickly become a numbers game. And when the media senses discrepancies or does not understand fluctuations, they are quick to paint us as disorganized. I would keep the count as simple as possible to avoid those complexities. Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 <6FDB29A3-6052-417A-8D97-0D61EDD16A5D[25].png> From: , Melaney Date: Saturday, August 29, 2015 at 6:22 PM To: "Yantis, Ryan" , Shay Drummond Cc: "WINNICKI, LENARD F" , "HOUSTON, CATHY S" , "Jeffries, Erica L" , Nirav Shah Subject: RE: DRAFT - IVH Quincy update for QHW and others From: Yantis, Ryan Sent: Saturday, August 29, 2015 6:00 PM To: Arnold, Melaney; Shay Drummond Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; Shah, Nirav Subject: DRAFT - IVH Quincy update for QHW and others For response to the Quincy Herald Whig via email from me, once we have numbers...highlighted below. Q: Will there be any update today (Sat. Aug 28 at 6 pm.) on the Legionnaires' disease outbreak at the Illinois Veterans Home? ​ A: Our thoughts and prayers go to those two heroes who passed yesterday, and we offer our sincere condolences to their loved ones. There have been no additional deaths believed to be related to legionella in the past 24 hours, and while this is certainly welcome news, much remains to be done. The only numbers I would provide would be 28 individuals associated with the home –. If pressed I would be willing to say 23 residents and 3 staff, plus 2 resident deaths. Providing the number of people in care, treated in the hospital or home, and those with respiratory illness is going to fluctuate GREATLY over the next several days and getting into the numbers game never goes well. There are too many variables that change – someone dies, but does not test positive for Legionnaires’, someone has pneumonia but it’s due to another bacteria, a resident being treated at the facility goes home with family, etc. This is just my experience. We have ### residents in care in local or regional health care providing facilities, ### treated and in the Home, and ### with respiratory illness symptoms. We are continuing to work closely with our partners - the Adams County Health Dept., the Illinois Dept. of Public Health, and local care providers - focusing on our residents, their health, and to getting through this tough situation. ​ I updated the talking points a bit. Thanks From: Arnold, Melaney Sent: Saturday, August 29, 2015 5:50 PM To: Yantis, Ryan Subject: Re: IVH Quincy update What numbers do you need? On Aug 29, 2015, at 5:45 PM, Yantis, Ryan wrote: ​Matt Working on it and waiting on numbers from the Home and local health care providers. Hopefully soon. Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 5:31 PM To: Yantis, Ryan Subject: Re: IVH Quincy update ETA on an update? From: "Yantis, Ryan" Date: Saturday, August 29, 2015 9:54 AM To: Quincy Herald-Whig Subject: Re: IVH Quincy update ​Matt We're working on it. Will let you know. Thanks Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 9:54 AM To: Yantis, Ryan Subject: IVH Quincy update RyanWill there be any update today on the Legionnaires' disease outbreak at the Illinois Veterans Home? Thanks. -Matt Hopf The Herald-Whig Sent from Outlook Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Jeffries, Erica L" To: Yantis "Ryan ;Shay Drummond" Nirav "Lisa \(PR\)" "LENARD F." CATHY Melaney CC: "DIEHL, GWEN" "SAWYER, HARRY" "McGill, Trish" Date: 8/29/2015 9:30:32 AM S u b j e c t : RE: Press Release Commentary Thanks so much, Ryan. EJeffries Director, IDVA 217-785-4114 From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Saturday, August 29, 2015 10:28 AM To: Shay Drummond; Shah, Nirav; Jeffries, Erica L; Neisen, Lisa (PR); WINNICKI, LENARD F.; HOUSTON, CATHY; Arnold, Melaney Cc: DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary All Please find attached the current Talking Points and Q&A (Legionella TP QA 2015-08-29 1015 AM.docx​) for staffing. All changes have been highlighted. If there are changes offered, please also summarize in the message. There are some data points we need to update. I attempted to answer Shay's questions: What is being done? Is it safe for residents to return to home from hospital? I also updated the deaths question, but we need our 1130 update to confirm today's numbers. Thanks Ryan From: "Jeffries, Erica L" To: "Shay Drummond" Ryan Melaney CC: "Shah, Nirav" "Neisen, Lisa \(PR\)" "WINNICKI, LENARD F." "HOUSTON, CATHY" "DIEHL, GWEN" "SAWYER, HARRY" "McGill, Trish" Date: 8/29/2015 10:55:52 AM Subject: RE: Press Release Commentary Thank you, Shay – are they still looking for an interview from someone from the Home staff? EJeffries Director, IDVA 217-785-4114 From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Saturday, August 29, 2015 11:54 AM To: Yantis, Ryan; Arnold, Melaney Cc: Shah, Nirav; Jeffries, Erica L; Neisen, Lisa (PR); WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: RE: Press Release Commentary I did an interview at 11 – expressed our condolences to the families, staff and community. Held with our numbers from yesterday and asked that persons in the county experiencing signs and symptoms with concerns please contact their family physician and follow their guidance – we are seeing an influx to the ED. Kept it very factual to signs and symptoms, the vulnerable population. Thanks, Shay From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Saturday, August 29, 2015 11:51 AM To: Arnold, Melaney Cc: Shay Drummond; Shah, Nirav; Jeffries, Erica L; Neisen, Lisa (PR); WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary All WGEM Chad Mahoney called asking for an update and requesting someone from the Home/IDVA for an on-camera interview, citing the deaths and the emotional tie Quincy has to the Home. He confirmed we are providing info, and complimented Shay on her availability and willingness to share info. No other updated or new queries to me as of this email. ​ From: Arnold, Melaney Sent: Saturday, August 29, 2015 10:50 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Jeffries, Erica L; Neisen, Lisa (PR); WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary This is a technicality the media /public may not seize on, but it is Legionella (italicized) bacteria. But when referring to the illness - I think we should go with Legionnaires' disease. I can't open the document right now except on my phone, but will be able to later On Aug 29, 2015, at 10:28 AM, Yantis, Ryan wrote: All Please find attached the current Talking Points and Q&A (Legionella TP QA 2015-08-29 1015 AM.docx​) for staffing. All changes have been highlighted. If there are changes offered, please also summarize in the message. There are some data points we need to update. I attempted to answer Shay's questions: What is being done? Is it safe for residents to return to home from hospital? I also updated the deaths question, but we need our 1130 update to confirm today's numbers. Thanks Ryan From: "Jeffries, Erica L" To: Yantis Ryan CC: "Shay Drummond" "Shah, Nirav" "Arnold, Melaney" "WINNICKI, LENARD F." "HOUSTON, CATHY" "DIEHL, GWEN" "SAWYER, HARRY" "McGill, Trish" Date: 8/29/2015 8:54:50 AM Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All - Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Jeffries, Erica L" To: Yantis Ryan CC: "Shah, Nirav" "Arnold, Melaney" "Shay Drummond" "WINNICKI, LENARD F." "HOUSTON, CATHY" "DIEHL, GWEN" "SAWYER, HARRY" "McGill, Trish" Date: 8/29/2015 8:42:19 AM Subject: Re: Press Release Commentary Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All - Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Jeffries, Erica L" To: Yantis Ryan CATHY "LENARD F." CC: "Arnold, Melaney" "Shay Drummond" Date: 8/29/2015 12:59:03 PM Subject: RE: WGEM Interview and Home Campus B-Roll You’re gonna be great, Cathy – thank you again! EJeffries Director, IDVA 217-785-4114 From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Saturday, August 29, 2015 1:58 PM To: HOUSTON, CATHY; WINNICKI, LENARD F. Cc: Jeffries, Erica L; Arnold, Melaney; Shay Drummond Subject: Re: WGEM Interview and Home Campus B-Roll ​OK - WGEM Shavon Anderson, 20 minutes or so, meet at the Admin Building. ​Shavon was the young lady who interviewed Cathy the other night. From: HOUSTON, CATHY Sent: Saturday, August 29, 2015 1:52 PM To: Yantis, Ryan; WINNICKI, LENARD F Cc: Jeffries, Erica L; Arnold, Melaney; Shay Drummond Subject: RE: WGEM Interview and Home Campus B-Roll Whenever. I am here for the day. From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Saturday, August 29, 2015 1:45 PM To: WINNICKI, LENARD F. Cc: HOUSTON, CATHY; Jeffries, Erica L; Arnold, Melaney; Shay Drummond Subject: Re: WGEM Interview and Home Campus B-Roll ​Cathy is good to go when she's ready. I can call/email Chad to coordinate. We have confirmation from the Gov's Press Office on this interview as well, so that base is covered. Standing By Ryan From: WINNICKI, LENARD F. Sent: Saturday, August 29, 2015 1:22 PM To: Yantis, Ryan Cc: HOUSTON, CATHY S; Jeffries, Erica L Subject: Re: WGEM Interview and Home Campus B-Roll Cathy is gonna have a bite of lunch now and will be ready to go. I would like her to confirm when ready, though Len Winnicki, MSHS, LNHA Senior Nursing Home Administrator Illinois Department of Veteran Affairs One Veterans Drive Manteno, IL. 60950 Ph: (815) 468-6581 x210 Lenard.Winnicki@illinois.gov This e-mail and any attachments are intended solely for the person or entity to which addressed and may contain confidential information. Any copy or distribution of this information by person or entities other than the addressee is prohibited by law. If you have received this message in error, please contact the sender and delete this message along with any attachments. On Aug 29, 2015, at 12:58 PM, "Yantis, Ryan" wrote: ​Cathy & Len The camera will likely be from waist up, and more on face than on attire. I know this is a burden, but it's important. Again, happy to prep or talk either of you through it. Relax, be yourself, talk from knowledge, and BIFF (brief, informative, friendly, factual) Ryan From: HOUSTON, CATHY Sent: Saturday, August 29, 2015 12:55 PM To: Jeffries, Erica L; Yantis, Ryan; WINNICKI, LENARD F Subject: RE: WGEM Interview and Home Campus B-Roll I am in blue jeans. From: Jeffries, Erica L Sent: Saturday, August 29, 2015 12:49 PM To: HOUSTON, CATHY; Yantis, Ryan; WINNICKI, LENARD F. Subject: Fwd: WGEM Interview and Home Campus B-Roll Cathy, Would you be willing to do another interview? You'll be the biggest local celebrity Quincy has had in years! Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 Begin forwarded message: From: "Shah, Nirav" Date: August 29, 2015 at 12:37:33 CDT To: "Yantis, Ryan" , "Jeffries, Erica L" , "WINNICKI, LENARD F." , "HOUSTON, CATHY" , Shay Drummond , "Neisen, Lisa (PR)" , "Arnold, Melaney" Cc: "VACA, BRUCE" , "Ray, Jaimee M." Subject: Re: WGEM Interview and Home Campus B-Roll This is, of course, an IDVA decision. But Ryan, your analysis seems completely right to me. Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 IDPH_Logo1_blk_only <8583DF30-92C8-4590-83CE-4FE4BB4C51B6[13].png> From: , Ryan Date: Saturday, August 29, 2015 at 12:25 PM To: "Jeffries, Erica L" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" , Shay Drummond , "Neisen, Lisa (PR)" , "Arnold, Melaney" , Nirav Shah Cc: "VACA, BRUCE L" , "Ray, Jaimee M" Subject: WGEM Interview and Home Campus B-Roll ​All Per previous email, Chad Mahoney, WGEM TV remains interested in an on-camera, on-IVH-Q grounds interview with someone from the Home, or IDVA. My instinct says yes - give the interview. We are working to a solution and have nothing to hide. We have great working relationship with are partners on this - IDPH, ACDH, Blessing, others - and they are offering knowledge, skills, and abilities to help the Home meet this challenge. Saying no to an interview can undermine public support (which has been neutral-positive so far) and create the impression we have something to hide. He also asked to visit the home to get b-roll... I approved that. As with the previous, I am happy to help/standing by for a prep session on a call with a selects spokesperson at Quincy. Thanks - Ryan From: "Jerrod Welch" To: Fred.Echols@Illinois.gov CC: Date: 8/29/2015 11:07:48 AM Subject: Accepted: FW: Legionellosis Outbreak- Adams Co. Attachments: attachment.ics -----Original Appointment----From: Echols, Fred [mailto:Fred.Echols@Illinois.gov] Sent: Saturday, August 29, 2015 11:43 AM To: Echols, Fred; Shay Drummond; Shah, Nirav; Austin, Connie; Conover, Craig; Arnold, Melaney; Jon Campos; Kelly-Shannon, Kate D.; Holmes, Tal; Culp, David; Morgan, Jodi Subject: Legionellosis Outbreak- Adams Co. When: Saturday, August 29, 2015 12:30 PM-1:30 PM (UTC-06:00) Central Time (US & Canada). Where: Teleconference When: Saturday, August 29, 2015 12:30 PM-1:30 PM (UTC-06:00) Central Time (US & Canada). Where: Teleconference Note: The GMT offset above does not reflect daylight saving time adjustments. +~+~+~+~+~+~+~+~+~+ The call-in information for today’s conference call is provided below: Call in: 1-888-494-4032 Passcode: 6575947859 From: "Jerrod Welch" To: Conover Craig "Fred ;Shay Drummond" Nirav Connie Melaney CC: "Jon Campos" Date: 8/29/2015 10:46:03 AM Subject: RE: Update Coroner is checking his availability but does indeed want him to join us on the call, and probably then have your contact with CDC pathology staff as well. From: Conover, Craig [mailto:Craig.Conover@Illinois.gov] Sent: Saturday, August 29, 2015 11:44 AM To: Jerrod Welch; Echols, Fred; Shay Drummond; Shah, Nirav; Austin, Connie; Arnold, Melaney Cc: Jon Campos Subject: Re: Update Is there a medical examiner involved? I can connect the medical examiner directly with the CDC pathology staff for guidance. From: Jerrod Welch Sent: Saturday, August 29, 2015 11:23 AM To: Echols, Fred; Shay Drummond; Shah, Nirav; Austin, Connie; Conover, Craig; Arnold, Melaney Cc: Jon Campos Subject: RE: Update Fred, will we plan to use your conference number? I’ll reach back out to the coroner with the info if that’s the case. JCW From: Echols, Fred [mailto:Fred.Echols@Illinois.gov] Sent: Saturday, August 29, 2015 11:23 AM To: Shay Drummond; Jerrod Welch; Shah, Nirav; Austin, Connie; Conover, Craig; Arnold, Melaney Cc: Jon Campos Subject: RE: Update Shay, I have reached out to CDC staff and am hoping they will be available for the call. -FRED NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond Sent: Saturday, August 29, 2015 11:14 AM To: Jerrod Welch; Shah, Nirav; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: RE: Update Does noon work for everyone? We need clarification on the coroners - issues. From: Jerrod Welch Sent: Saturday, August 29, 2015 10:27 AM To: Shah, Nirav; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: RE: Update How about a call at 12:00 I will wait for the confirmation on that time, but if it works, we can invite the coroner and get this issue addressed. I have a call in number, but I?ll defer to DPH if you wish to utilize the call number you have previously used. Just let me know, and thanks for the response. I think this will go a long way in getting his concerns addressed. JCW From: Shah, Nirav Sent: Saturday, August 29, 2015 10:10 AM To: Jerrod Welch; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: Re: Update Thanks, Jerrod. This is a good question and I think we have contemplated this with CDC. I?m available for a call anytime other than 11AM today. Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Spring?eld, IL 62761 (217) 557-2556 9 From: Jerrod Welch <'we ch co.adams.il.us> Date: Saturday, August 29, 2015 at 9:47 AM To: Shay Drummond Nirav Shah , "Austin, Connie" , "Conover, Craig" , "Echols, Fred" , "Arnold, Melaney" Cczlon Campos Subject: RE: Update To compound this, the Coroner is wanting to speak through this with DPH today if possible. Outside of a tissue sample of the lung, are there any other samples he should be collecting for a current epi investigation or future research on the disease. He is speaking with another pathologist who has made this suggestion, though I?m not sure who it is. He has placed a hold on all of the bodies and is trying to determine which ones they will perform an autopsy on and which ones they will simply collect the requested tissue from. Last night we had informally decided that he?d do autopsies on those without a lab positive urine, and tissues only on those with positives. I think after speaking with families, he?s changing his mind on who to autopsy. I think that we should coordinate a call that he can be on to ask questions to one of your experts who might help him make his decisions during this. He has some other general thoughts/concerns that I also think could benefit from a conversation with Connie or someone else who is you guys think fits this line of info. Thoughs? JCW From: Shay Sent: Saturday, August 29, 2015 9:23 AM To: Shah, Nirav Austin, Connie Crai .Conover illinois. ov; Echols, Fred Arnold, Melaney (Melanev.Amold@Illinois.gov) Cc: Jon Campos; Jerrod Welch Subject: Update Importance: High All, the clay is not starting well as just found out that we lost another veterans home resident that was positive. He was being cared for on site. Blessing update: as of 0800 22 In house 2 admits overnight -. was a re admit - both IVH residents. IVH care for staff and residents: IVH has counselors on staff that are tending to their needs, no additional resources needed at this time. Blessing is going to collect urine antigens on the 3 in house patients that have discordant labs. Will collect today and send to IDPH lab Springfield. Is there restrictions on times over weekend? Will have a solid update on numbers by 10:30 this morning. Thanks, Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Of?ce: 217-222-8440 x148 Cell: 217-316-2795 Publicme CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and con?dential use of the designated recipients named above. The documents accompanying this transmission may contain con?dential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been ful?lled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Jerrod Welch" To: "Shay Drummond" "Nirav\(Nirav.Shah@illinois.gov\);Austin" "Connie\(Connie.Austin@Illinois.gov\);;Echols" "Fred\(Fred.Echols@Illinois.gov\);Arnold" "Melaney <" "\(Melaney.Arnold@Illinois.gov\);>" CC: "Jon Campos" Date: 8/29/2015 8:47:56 AM Subject: RE: Update To compound this, the Coroner is wanting to speak through this with DPH today if possible. Outside of a tissue sample of the lung, are there any other samples he should be collecting for a current epi investigation or future research on the disease. He is speaking with another pathologist who has made this suggestion, though I’m not sure who it is. He has placed a hold on all of the bodies and is trying to determine which ones they will perform an autopsy on and which ones they will simply collect the requested tissue from. Last night we had informally decided that he’d do autopsies on those without a lab positive urine, and tissues only on those with positives. I think after speaking with families, he’s changing his mind on who to autopsy. I think that we should coordinate a call that he can be on to ask questions to one of your experts who might help him make his decisions during this. He has some other general thoughts/concerns that I also think could benefit from a conversation with Connie or someone else who is you guys think fits this line of info. Thoughs? JCW From: Shay Drummond Sent: Saturday, August 29, 2015 9:23 AM To: Shah, Nirav (Nirav.Shah@illinois.gov); Austin, Connie (Connie.Austin@Illinois.gov); Craig.Conover@illinois.gov; Echols, Fred (Fred.Echols@Illinois.gov); Arnold, Melaney (Melaney.Arnold@Illinois.gov) Cc: Jon Campos; Jerrod Welch Subject: Update Importance: High All, the day is not starting well as I just found out that we lost another veterans home resident that was positive. He was being cared for on site. Blessing update: as of 0800 22 In house 2 admits overnight – was a re admit – both IVH residents. IVH Psychological care for staff and residents: IVH has counselors on staff that are tending to their needs, no additional resources needed at this time. Blessing is going to collect urine antigens on the 3 in house patients that have discordant labs. Will collect today and send to IDPH lab Springfield. Is there restrictions on times over weekend? Will have a solid update on numbers by 10:30 this morning. Thanks, Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: Echols Nirav Crai CC: "Jon Campos" Date: 8/29/2015 10:23:52 AM Subject: RE: Update Fred, will we plan to use your conference number? I?ll reach back out to the coroner with the info if that?s the case. JCW From: Echols, Fred Sent: Saturday, August 29, 2015 11:23 AM To: Shay Drummond; Jerrod Welch; Shah, Nirav; Austin, Connie; Conover, Craig; Arnold, Melaney Cc: Jon Campos Subject: RE: Update Shay, have reached out to CDC staff and am hoping they will be available for the call. -FRED .. .. [i WBHONFIDENTMLIT NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is in use of the individual or entity above. If you are not the named or intended recipient, you are hereby noti?ed that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond Sent: Saturday, August 29, 2015 11:14 AM To: Jerrod Welch; Shah, Nirav; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: RE: Update Does noon work for everyone? We need clarification on the coroners – issues. From: Jerrod Welch Sent: Saturday, August 29, 2015 10:27 AM To: Shah, Nirav; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: RE: Update How about a call at 12:00 I will wait for the confirmation on that time, but if it works, we can invite the coroner and get this issue addressed. I have a call in number, but I’ll defer to DPH if you wish to utilize the call number you have previously used. Just let me know, and thanks for the response. I think this will go a long way in getting his concerns addressed. JCW From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 10:10 AM To: Jerrod Welch; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: Re: Update Thanks, Jerrod. This is a good question and I think we have contemplated this with CDC. I’m available for a call anytime other than 11AM today. _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 [i L: From: Jerrod Welch Date: Saturday, August 29, 2015 at 9:47 AM To: Shay Drummond Nirav Shah "Austin, Connie" "Conover, Craig" "Echo 5, Melaney" Cc: Jon Campos Subject: RE: Update To compound this, the Coroner is wanting to speak through this with DPH today if possible. Outside of a tissue sample of the lung, are there any other samples he should be collecting for a current epi investigation or future research on the disease. He is speaking with another pathologist who has made this suggestion, though I?m not sure who it is. He has placed a hold on all of the bodies and is trying to determine which ones they will perform an autopsy on and which ones they will simply collect the requested tissue from. Last night we had informally decided that he?d do autopsies on those without a lab positive urine, and tissues only on those with positives. I think after speaking with families, he?s changing his mind on who to autopsy. I think that we should coordinate a call that he can be on to ask questions to one of your experts who might help him make his decisions during this. He has some other general thoughts/concerns that I also think could benefit from a conversation with Connie or someone else who is you guys think fits this line of info. Thoughs? JCW From: Shay Sent: Saturday, August 29, 2015 9:23 AM To: Shah. Austin, Connie Echols, Fred (ELedEchQISQIl?mismx); Arnold, Melaney (Wham Cc: Jon Campos; Jerrod Welch Subject: Update Importance: High All, the day is not starting well as just found out that we lost another veterans home resident that was positive. He was being cared for on site. Blessing update: as of 0800 22 In house 2 admits overnight – was a re admit – both IVH residents. IVH Psychological care for staff and residents: IVH has counselors on staff that are tending to their needs, no additional resources needed at this time. Blessing is going to collect urine antigens on the 3 in house patients that have discordant labs. Will collect today and send to IDPH lab Springfield. Is there restrictions on times over weekend? Will have a solid update on numbers by 10:30 this morning. Thanks, Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Jerrod Welch" To: Shah "Nirav ;Shay Drummond" Connie Craig Fred Melaney CC: "Jon Campos" Date: 8/29/2015 9:26:34 AM Subject: RE: Update How about a call at 12:00 I will wait for the confirmation on that time, but if it works, we can invite the coroner and get this issue addressed. I have a call in number, but I’ll defer to DPH if you wish to utilize the call number you have previously used. Just let me know, and thanks for the response. I think this will go a long way in getting his concerns addressed. JCW From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 10:10 AM To: Jerrod Welch; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: Re: Update Thanks, Jerrod. This is a good question and I think we have contemplated this with CDC. I’m available for a call anytime other than 11AM today. _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Spring?eld, IL 62761 (217) 557-2556 9 [i From: Jerrod Welch Date: Saturday, August 29, 2015 at 9:47 AM To: Shay Drummond Nirav Shah "Austin, Connie" "Conover, Craig" "Echo 5, Melaney" Cc: Jon Campos Subject: RE: Update To compound this, the Coroner is wanting to speak through this with DPH today if possible. Outside of a tissue sample of the lung, are there any other samples he should be collecting for a current epi investigation or future research on the disease. He is speaking with another pathologist who has made this suggestion, though I?m not sure who it is. He has placed a hold on all of the bodies and is trying to determine which ones they will perform an autopsy on and which ones they will simply collect the requested tissue from. Last night we had informally decided that he?d do autopsies on those without a lab positive urine, and tissues only on those with positives. I think after speaking with families, he?s changing his mind on who to autopsy. I think that we should coordinate a call that he can be on to ask questions to one of your experts who might help him make his decisions during this. He has some other general thoughts/concerns that I also think could benefit from a conversation with Connie or someone else who is you guys think fits this line of info. Thoughs? JCW From: Shay Drummond Sent: Saturday, August 29, 2015 9:23 AM To: Shah. Austin, Connie Echols, Fred Arnold, Melaney To: "Shay Drummond" CC: "Austin, Connie" "Conover, Craig" "Echols, Fred" "Arnold, Melaney" "Jon Campos" "Jerrod Welch" "Culp, David" "Gentry-Wiseman, Michelle" "Shah, Nirav" Date: 8/29/2015 9:47:14 AM Subject: Re: Update Shay: Thank you for returning my call so quickly. As we discussed, LabCorp will be used for further urine antigen tests; LabCorp turnarounds are now better. With respect to the urine specimens with discrepant results between Memorial and LabCorp, 3 specimens will be re-taken this weekend for shipment Monday to CDC from the IDPH Springfield lab to resolve their status. The urine specimens can be stored in a refrigerator (2 - 8 degree C) for up to 14 days so storage should be no problem with respect to acceptability of the specimens when CDC receives them. If other needs or questions arise, please call me at 309 222 1312. I will be watching emails, also. Tom From: Johnson, Bernard T. Sent: Saturday, August 29, 2015 10:19 AM To: Shah, Nirav Cc: Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney; Jon Campos; Jerrod Welch; Culp, David; Gentry-Wiseman, Michelle Subject: Re: Update Shay, the lab we were using is almost out of supplies for the test and we were not expecting more. Can you please call me to discuss? 309 222 1312 Bernard (Tom) Johnson Chief, Division of Laboratories Illinois Department of Public Health Phone: 217.782.6572 Cell: 309.222.1312 Email: Bernard.Johnson@Illinois.gov On Aug 29, 2015, at 9:42 AM, Shah, Nirav wrote: Thank you, Shay. Very sad. Dave/Tom: could you take a look at Shay's inquiry re: lab timing and let us know what is possible? Thanks, -Nirav On Aug 29, 2015, at 9:23 AM, Shay Drummond wrote: All, the day is not starting well as I just found out that we lost another veterans home resident that was positive. He was being cared for on site. Blessing update: as of 0800 22 In house 2 admits overnight – was a re admit – both IVH residents. IVH Psychological care for staff and residents: IVH has counselors on staff that are tending to their needs, no additional resources needed at this time. Blessing is going to collect urine antigens on the 3 in house patients that have discordant labs. Will collect today and send to IDPH lab Springfield. Is there restrictions on times over weekend? Will have a solid update on numbers by 10:30 this morning. Thanks, Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Johnson, Bernard T." To: Shah Nirav CC: "Shay Drummond" "Austin, Connie" "Conover, Craig" "Echols, Fred" "Arnold, Melaney" "Jon Campos" "Jerrod Welch" "Culp, David" "Gentry-Wiseman, Michelle" Date: 8/29/2015 9:19:55 AM Subject: Re: Update Shay, the lab we were using is almost out of supplies for the test and we were not expecting more. Can you please call me to discuss? 309 222 1312 Bernard (Tom) Johnson Chief, Division of Laboratories Illinois Department of Public Health Phone: 217.782.6572 Cell: 309.222.1312 Email: Bernard.Johnson@Illinois.gov On Aug 29, 2015, at 9:42 AM, Shah, Nirav wrote: Thank you, Shay. Very sad. Dave/Tom: could you take a look at Shay's inquiry re: lab timing and let us know what is possible? Thanks, -Nirav On Aug 29, 2015, at 9:23 AM, Shay Drummond wrote: All, the day is not starting well as I just found out that we lost another veterans home resident that was positive. He was being cared for on site. Blessing update: as of 0800 22 In house 2 admits overnight – was a re admit – both IVH residents. IVH Psychological care for staff and residents: IVH has counselors on staff that are tending to their needs, no additional resources needed at this time. Blessing is going to collect urine antigens on the 3 in house patients that have discordant labs. Will collect today and send to IDPH lab Springfield. Is there restrictions on times over weekend? Will have a solid update on numbers by 10:30 this morning. Thanks, Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Martin, Aaron" To: sdrummond@co.adams.il.us CC: Date: 8/29/2015 10:55:07 AM Subject: IVHQ Shay, Connie Austin requested that someone from IDPH environmental health contact Adams County HD today regarding the hospital worker diagnosed with legionella and possibly exposed to an outdoor fountain at a friend's house. Just touching base to see if you need anything from us (EH) or want to discuss this case's exposures. I am available if so at 217-306-5656. Sent from my iPhone From: "Shah, Nirav" To: "Shay Drummond" Ryan CC: "Arnold, Melaney" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Jeffries, Erica L" Date: 8/29/2015 6:16:02 PM Subject: Re: DRAFT - IVH Quincy update for QHW and others, based onUpdated TPs Thanks, Shay. Yes, we all are in agreement that the public case count will consist of confirmed cases and deaths. No hospitalizations, etc. Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 7:01 PM To: "Yantis, Ryan" Cc: "Arnold, Melaney" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" , "Jeffries, Erica L" , Nirav Shah Subject: Re: DRAFT - IVH Quincy update for QHW and others, based on Updated TPs Hi agree with keeping the numbers as simple as possible and making sure we're all on the same page with what the numbers included don't include Sent from my iPhone On Aug 29, 2015, at 6:31 PM, Yantis, Ryan wrote: Thanks Melaney - So, another version of the email to the Quincy Herald Whig in RTQ: · Our thoughts and prayers go to those two heroes who passed yesterday, and we offer our sincere condolences to their loved ones.​ There have been no additional deaths believed to be related to legionella in the past 24 hours, and while this is certainly welcome news, much remains to be done. ​ Currently 28 individuals from the Veterans’ Home in Quincy have tested positive for Legionnaires’ disease; this includes the two residents who died yesterday. · The Adams County Health Department, the Illinois Department of Public Health, the Illinois Department of Veterans’ Affairs, Quincy Veterans’ Home, Blessing Hospital, and other medical providers, with guidance from the Centers for Disease Control and Prevention, are working together very closely to track patients with respiratory illness who have a connection with the home. · Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires’ disease and are making sure residents receive prompt medical attention if needed. · Compounding the challenge of identifying and treating individuals with Legionnaires’ disease is that we typically see other respiratory issues in residents this time of year. Therefore, all residents presenting any Legionnaires’ disease–type symptoms will be treated as if they have Legionnaires’ disease until lab results confirm the individual is negative for the bacteria. · Environmental health and infectious disease staff continue to visit the home to investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources. · The Illinois Veterans’ Home-Quincy has established a remediation plan including: Cleaning hot water tanks Cleaning the cooling tower – completed Friday, August 28. Using bottled water for residents and staff Using a temporary chiller so the facility chiller can be certified by outside experts Keeping fountains and other potential sources of aerosolized water turned off Removing possible/suspected Legionella-infected systems/devices from use until they can be specially treated and tested before use. Working with IDPH and other experts to clean and certify systems. We will update as the situation warrants. Our From: Arnold, Melaney Sent: Saturday, August 29, 2015 6:22 PM To: Yantis, Ryan; Shay Drummond Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; Shah, Nirav Subject: RE: DRAFT - IVH Quincy update for QHW and others From: Yantis, Ryan Sent: Saturday, August 29, 2015 6:00 PM To: Arnold, Melaney; Shay Drummond Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; Shah, Nirav Subject: DRAFT - IVH Quincy update for QHW and others For response to the Quincy Herald Whig via email from me, once we have numbers...highlighted below. Q: Will there be any update today (Sat. Aug 28 at 6 pm.) on the Legionnaires' disease outbreak at the Illinois Veterans Home? ​ A: Our thoughts and prayers go to those two heroes who passed yesterday, and we offer our sincere condolences to their loved ones. There have been no additional deaths believed to be related to legionella in the past 24 hours, and while this is certainly welcome news, much remains to be done. The only numbers I would provide would be 28 individuals associated with the home –. If pressed I would be willing to say 23 residents and 3 staff, plus 2 resident deaths. Providing the number of people in care, treated in the hospital or home, and those with respiratory illness is going to fluctuate GREATLY over the next several days and getting into the numbers game never goes well. There are too many variables that change – someone dies, but does not test positive for Legionnaires’, someone has pneumonia but it’s due to another bacteria, a resident being treated at the facility goes home with family, etc. This is just my experience. We have ### residents in care in local or regional health care providing facilities, ### treated and in the Home, and ### with respiratory illness symptoms. ​ We are continuing to work closely with our partners - the Adams County Health Dept., the Illinois Dept. of Public Health, and local care providers - focusing on our residents, their health, and to getting through this tough situation. I updated the talking points a bit. Thanks From: Arnold, Melaney Sent: Saturday, August 29, 2015 5:50 PM To: Yantis, Ryan Subject: Re: IVH Quincy update What numbers do you need? On Aug 29, 2015, at 5:45 PM, Yantis, Ryan wrote: ​Matt - Working on it and waiting on numbers from the Home and local health care providers. Hopefully soon. Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 5:31 PM To: Yantis, Ryan Subject: Re: IVH Quincy update ETA on an update? From: "Yantis, Ryan" Date: Saturday, August 29, 2015 9:54 AM To: Quincy Herald-Whig Subject: Re: IVH Quincy update ​Matt - We're working on it. Will let you know. Thanks Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 9:54 AM To: Yantis, Ryan Subject: IVH Quincy update Ryan- Will there be any update today on the Legionnaires' disease outbreak at the Illinois Veterans Home? Thanks. -Matt Hopf The Herald-Whig Sent from Outlook Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Shah, Nirav" To: Arnold Melaney "Ryan ;Shay Drummond" CC: "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Jeffries, Erica L" Date: 8/29/2015 5:26:39 PM Subject: Re: DRAFT - IVH Quincy update for QHW and others I wanted to chime in on the numbers issue. I agree with Melaney. This can quickly become a numbers game. And when the media senses discrepancies or does not understand fluctuations, they are quick to paint us as disorganized. I would keep the count as simple as possible to avoid those complexities. Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Melaney Date: Saturday, August 29, 2015 at 6:22 PM To: "Yantis, Ryan" , Shay Drummond Cc: "WINNICKI, LENARD F" , "HOUSTON, CATHY S" , "Jeffries, Erica L" , Nirav Shah Subject: RE: DRAFT - IVH Quincy update for QHW and others From: Yantis, Ryan Sent: Saturday, August 29, 2015 6:00 PM To: Arnold, Melaney; Shay Drummond Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; Shah, Nirav Subject: DRAFT - IVH Quincy update for QHW and others For response to the Quincy Herald Whig via email from me, once we have numbers...highlighted below. Q: Will there be any update today (Sat. Aug 28 at 6 pm.) on the Legionnaires' disease outbreak at the Illinois Veterans Home? ​ A: Our thoughts and prayers go to those two heroes who passed yesterday, and we offer our sincere condolences to their loved ones. There have been no additional deaths believed to be related to legionella in the past 24 hours, and while this is certainly welcome news, much remains to be done. The only numbers I would provide would be 28 individuals associated with the home –. If pressed I would be willing to say 23 residents and 3 staff, plus 2 resident deaths. Providing the number of people in care, treated in the hospital or home, and those with respiratory illness is going to fluctuate GREATLY over the next several days and getting into the numbers game never goes well. There are too many variables that change – someone dies, but does not test positive for Legionnaires’, someone has pneumonia but it’s due to another bacteria, a resident being treated at the facility goes home with family, etc. This is just my experience. We have ### residents in care in local or regional health care providing facilities, ### treated and in the Home, and ### with respiratory illness symptoms. We are continuing to work closely with our partners - the Adams County Health Dept., the Illinois Dept. of Public Health, and local care providers focusing on our residents, their health, and to getting through this tough situation. ​ I updated the talking points a bit. Thanks From: Arnold, Melaney Sent: Saturday, August 29, 2015 5:50 PM To: Yantis, Ryan Subject: Re: IVH Quincy update What numbers do you need? On Aug 29, 2015, at 5:45 PM, Yantis, Ryan wrote: ​Matt Working on it and waiting on numbers from the Home and local health care providers. Hopefully soon. Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 5:31 PM To: Yantis, Ryan Subject: Re: IVH Quincy update ETA on an update? From: "Yantis, Ryan" Date: Saturday, August 29, 2015 9:54 AM To: Quincy Herald-Whig Subject: Re: IVH Quincy update ​Matt We're working on it. Will let you know. Thanks Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 9:54 AM To: Yantis, Ryan Subject: IVH Quincy update RyanWill there be any update today on the Legionnaires' disease outbreak at the Illinois Veterans Home? Thanks. -Matt Hopf The Herald-Whig Sent from Outlook Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Shah, Nirav" To: "Shay Drummond" Craig CC: "Austin, Connie" "Arnold, Melaney" Date: 8/29/2015 3:32:12 PM Subject: Re: monday draft plan Given where we are, I think we should plan to test it—recognizing that the test may saddle us with information we don’t want. But the risks of not testing are greater than testing at this point. We’ll prepare our environmental team to have the discussion and make a more formal recommendation. Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 4:28 PM To: "Conover, Craig" Cc: Nirav Shah , "Austin, Connie" , "Arnold, Melaney" Subject: Re: monday draft plan Jeff Conte our city engineer had put that on the radar to do on Monday and light of the community situation, and he is also talking with EPA regarding guidance. Would you like me to ask him to defer the testing? Thanks! Sent from my iPhone On Aug 29, 2015, at 4:26 PM, Conover, Craig wrote: Shay --Are they testing for Legionella on Monday? At first pass, I don't think I would recommend this based on the current situation--if you look hard enough you will usually find Legionella as it is ubiquitous and finding it will raise questions about elimination, additional testing, etc. CC From: Shay Drummond Sent: Saturday, August 29, 2015 4:05 PM To: Shah, Nirav Cc: Austin, Connie; Conover, Craig; Arnold, Melaney Subject: Re: Press Release Commentary They are testing Monday and have not done so in the past. They will be available also on Monday to visit with IDPH EH staff. Thanks, Shay Sent from my iPhone On Aug 29, 2015, at 3:46 PM, Shah, Nirav wrote: Hi Shay, Do you happen to know if the City is testing its water supply for evidence of Legionella? Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 <6FDB29A3-6052-417A-8D97-0D61EDD16A5D[17].png> From: Shay Drummond Date: Saturday, August 29, 2015 at 11:42 AM To: "Austin, Connie" , "Conover, Craig" Cc: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary Connie, Jon is sending the addresses, distance from IVH etc. to you. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Saturday, August 29, 2015 11:25 AM To: Conover, Craig Cc: Shah, Nirav; Shay Drummond; Arnold, Melaney Subject: Re: Press Release Commentary We can do on Monday. I'm not sure how far blessing is and I think her home is at least 4 miles. I think sunset home was more than a mile for the second one Sent from my iPhone On Aug 29, 2015, at 12:15 PM, Conover, Craig wrote: Community cases should be mapped-- I believe the one we were alerted to yesterday lives a little over a mile from the facility as the crow flies. From: Austin, Connie Sent: Saturday, August 29, 2015 10:50 AM To: Shah, Nirav Cc: Shay Drummond; Arnold, Melaney; Conover, Craig Subject: Re: Press Release Commentary Both have been exposed to 2 different decorative fountains. Shay what did you find out about the other ltc resident. Had he been outside the facility? Any other pneumonia cases in the facility int the last month Spoke to cdc about this with increased testing we may be finding sporadic cases we wouldn't have found without heightened awareness Unfortunately no way to look at strains with urine antigen Sent from my iPhone On Aug 29, 2015, at 11:04 AM, Shah, Nirav wrote: Thanks. I am growing concerned about the unaffiliated positive cases. Dr. Conover/Austin: what is our best guess as to the transmission route of the community cases? Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 10:02 AM To: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary I am having a status update with Blessing and IVH this morning and should have current numbers by 11 or so. We also have some outliers testing positive from the community – we need to address that in the talking points – these are patients that have no tie to IVH. This is where is will start to get dicey. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Saturday, August 29, 2015 9:55 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Arnold, Melaney; WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All - Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Shah, Nirav" To: Jeffries "Erica L" CC: "Yantis, Ryan" "Arnold, Melaney" "Shay Drummond" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "DIEHL, GWEN G" "SAWYER, HARRY H" "McGill, Patricia O" Date: 8/29/2015 8:43:57 AM Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All - Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Shah, Nirav" To: "Shay Drummond" Melaney CC: "Conover, Craig" "Austin, Connie" Date: 8/29/2015 9:04:42 AM Subject: Re: Press Release Commentary Thanks. I am growing concerned about the unaffiliated positive cases. Dr. Conover/Austin: what is our best guess as to the transmission route of the community cases? Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 10:02 AM To: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary I am having a status update with Blessing and IVH this morning and should have current numbers by 11 or so. We also have some outliers testing positive from the community – we need to address that in the talking points – these are patients that have no tie to IVH. This is where is will start to get dicey. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Saturday, August 29, 2015 9:55 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Arnold, Melaney; WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All - Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Shah, Nirav" To: "Shay Drummond" Connie Craig CC: "Arnold, Melaney" Date: 8/29/2015 2:45:58 PM Subject: Re: Press Release Commentary Hi Shay, Do you happen to know if the City is testing its water supply for evidence of Legionella? Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 11:42 AM To: "Austin, Connie" , "Conover, Craig" Cc: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary Connie, Jon is sending the addresses, distance from IVH etc. to you. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Saturday, August 29, 2015 11:25 AM To: Conover, Craig Cc: Shah, Nirav; Shay Drummond; Arnold, Melaney Subject: Re: Press Release Commentary We can do on Monday. I'm not sure how far blessing is and I think her home is at least 4 miles. I think sunset home was more than a mile for the second one Sent from my iPhone On Aug 29, 2015, at 12:15 PM, Conover, Craig wrote: Community cases should be mapped-- I believe the one we were alerted to yesterday lives a little over a mile from the facility as the crow flies. From: Austin, Connie Sent: Saturday, August 29, 2015 10:50 AM To: Shah, Nirav Cc: Shay Drummond; Arnold, Melaney; Conover, Craig Subject: Re: Press Release Commentary Both have been exposed to 2 different decorative fountains. Shay what did you find out about the other ltc resident. Had he been outside the facility? Any other pneumonia cases in the facility int the last month Spoke to cdc about this with increased testing we may be finding sporadic cases we wouldn't have found without heightened awareness Unfortunately no way to look at strains with urine antigen Sent from my iPhone On Aug 29, 2015, at 11:04 AM, Shah, Nirav wrote: Thanks. I am growing concerned about the unaffiliated positive cases. Dr. Conover/Austin: what is our best guess as to the transmission route of the community cases? Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 10:02 AM To: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary I am having a status update with Blessing and IVH this morning and should have current numbers by 11 or so. We also have some outliers testing positive from the community – we need to address that in the talking points – these are patients that have no tie to IVH. This is where is will start to get dicey. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Saturday, August 29, 2015 9:55 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Arnold, Melaney; WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All - Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Shah, Nirav" To: "Shay Drummond" CC: "Austin, Connie" "Conover, Craig" "Echols, Fred" "Arnold, Melaney" "Jon Campos" "Jerrod Welch" "Culp, David" "Johnson, Bernard T." "Gentry-Wiseman, Michelle" Date: 8/29/2015 8:42:55 AM Subject: Re: Update Thank you, Shay. Very sad. Dave/Tom: could you take a look at Shay's inquiry re: lab timing and let us know what is possible? Thanks, -Nirav On Aug 29, 2015, at 9:23 AM, Shay Drummond wrote: All, the day is not starting well as I just found out that we lost another veterans home resident that was positive. He was being cared for on site. Blessing update: as of 0800 22 In house 2 admits overnight – was a re admit – both IVH residents. IVH Psychological care for staff and residents: IVH has counselors on staff that are tending to their needs, no additional resources needed at this time. Blessing is going to collect urine antigens on the 3 in house patients that have discordant labs. Will collect today and send to IDPH lab Springfield. Is there restrictions on times over weekend? Will have a solid update on numbers by 10:30 this morning. Thanks, Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: "Jerrod Welch Drummond" . . . am. . Crai WW Melaney CC: Date: 8/29/2015 9:10:06 AM Subject: Re: Update Thanks, Jerrod. This is a good question and I think we have contemplated this with CDC. I?m available for a call anytime other than 11AM today. Nirav D. Shah, MD, JD. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Spring?eld, IL 62761 (217) 557-2556 "u From: Jerrod Welch Date: Saturday, August 29, 2015 at 9:47 AM To: Shay Drummond , Nirav Shah , "Austin, Connie" , "Conover, Craig" , "Echols, Fred" , "Arnold, Melaney" Cc: Jon Campos Subject: RE: Update To compound this, the Coroner is wanting to speak through this with DPH today if possible. Outside of a tissue sample of the lung, are there any other samples he should be collecting for a current epi investigation or future research on the disease. He is speaking with another pathologist who has made this suggestion, though I’m not sure who it is. He has placed a hold on all of the bodies and is trying to determine which ones they will perform an autopsy on and which ones they will simply collect the requested tissue from. Last night we had informally decided that he’d do autopsies on those without a lab positive urine, and tissues only on those with positives. I think after speaking with families, he’s changing his mind on who to autopsy. I think that we should coordinate a call that he can be on to ask questions to one of your experts who might help him make his decisions during this. He has some other general thoughts/concerns that I also think could benefit from a conversation with Connie or someone else who is you guys think fits this line of info. Thoughs? JCW From: Shay Drummond Sent: Saturday, August 29, 2015 9:23 AM To: Shah, Nirav (Nirav.Shah@illinois.gov); Austin, Connie (Connie.Austin@Illinois.gov); Craig.Conover@illinois.gov; Echols, Fred (Fred.Echols@Illinois.gov); Arnold, Melaney (Melaney.Arnold@Illinois.gov) Cc: Jon Campos; Jerrod Welch Subject: Update Importance: High All, the day is not starting well as I just found out that we lost another veterans home resident that was positive. He was being cared for on site. Blessing update: as of 0800 22 In house 2 admits overnight – was a re admit – both IVH residents. IVH Psychological care for staff and residents: IVH has counselors on staff that are tending to their needs, no additional resources needed at this time. Blessing is going to collect urine antigens on the 3 in house patients that have discordant labs. Will collect today and send to IDPH lab Springfield. Is there restrictions on times over weekend? Will have a solid update on numbers by 10:30 this morning. Thanks, Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: "Connie Austin" "Fred Echols" Craig.Conover@illinois.gov "Whitney Clegg" CC: Date: 8/29/2015 3:18:36 PM Subject: Fwd: Legionella Tracking Log - 8 29-15 1400.xlsx Attachments: Legionella Tracking Log - 8 29-15 1400.xlsx ATT00001.htm Most recent IVH data. Sent from my iPhone Begin forwarded message: From: "HOUSTON, CATHY" Date: August 29, 2015 at 4:14:13 PM CDT To: Shay Drummond Subject: Legionella Tracking Log - 8 29-15 1400.xlsx From: "Shay Drummond" To: Yantis Ryan CC: "Arnold, Melaney" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Jeffries, Erica L" "Shah, Nirav" Date: 8/29/2015 6:01:43 PM Subject: Re: DRAFT - IVH Quincy update for QHW and others, based onUpdated TPs Hi agree with keeping the numbers as simple as possible and making sure we're all on the same page with what the numbers included don't include Sent from my iPhone On Aug 29, 2015, at 6:31 PM, Yantis, Ryan wrote: Thanks Melaney - So, another version of the email to the Quincy Herald Whig in RTQ: · Our thoughts and prayers go to those two heroes who passed yesterday, and we offer our sincere condolences to their loved ones.​ There have been no additional deaths believed to be related to legionella in the past 24 hours, and while this is certainly welcome news, much remains to be done. ​ Currently 28 individuals from the Veterans’ Home in Quincy have tested positive for Legionnaires’ disease; this includes the two residents who died yesterday. · The Adams County Health Department, the Illinois Department of Public Health, the Illinois Department of Veterans’ Affairs, Quincy Veterans’ Home, Blessing Hospital, and other medical providers, with guidance from the Centers for Disease Control and Prevention, are working together very closely to track patients with respiratory illness who have a connection with the home. · Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires’ disease and are making sure residents receive prompt medical attention if needed. · Compounding the challenge of identifying and treating individuals with Legionnaires’ disease is that we typically see other respiratory issues in residents this time of year. Therefore, all residents presenting any Legionnaires’ disease–type symptoms will be treated as if they have Legionnaires’ disease until lab results confirm the individual is negative for the bacteria. · Environmental health and infectious disease staff continue to visit the home to investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources. · The Illinois Veterans’ Home-Quincy has established a remediation plan including: Cleaning hot water tanks Cleaning the cooling tower – completed Friday, August 28. Using bottled water for residents and staff Using a temporary chiller so the facility chiller can be certified by outside experts Keeping fountains and other potential sources of aerosolized water turned off Removing possible/suspected Legionella-infected systems/devices from use until they can be specially treated and tested before use. Working with IDPH and other experts to clean and certify systems. We will update as the situation warrants. Our From: Arnold, Melaney Sent: Saturday, August 29, 2015 6:22 PM To: Yantis, Ryan; Shay Drummond Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; Shah, Nirav Subject: RE: DRAFT - IVH Quincy update for QHW and others From: Yantis, Ryan Sent: Saturday, August 29, 2015 6:00 PM To: Arnold, Melaney; Shay Drummond Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; Shah, Nirav Subject: DRAFT - IVH Quincy update for QHW and others For response to the Quincy Herald Whig via email from me, once we have numbers...highlighted below. Q: Will there be any update today (Sat. Aug 28 at 6 pm.) on the Legionnaires' disease outbreak at the Illinois Veterans Home? ​ A: Our thoughts and prayers go to those two heroes who passed yesterday, and we offer our sincere condolences to their loved ones. There have been no additional deaths believed to be related to legionella in the past 24 hours, and while this is certainly welcome news, much remains to be done. The only numbers I would provide would be 28 individuals associated with the home –. If pressed I would be willing to say 23 residents and 3 staff, plus 2 resident deaths. Providing the number of people in care, treated in the hospital or home, and those with respiratory illness is going to fluctuate GREATLY over the next several days and getting into the numbers game never goes well. There are too many variables that change – someone dies, but does not test positive for Legionnaires’, someone has pneumonia but it’s due to another bacteria, a resident being treated at the facility goes home with family, etc. This is just my experience. We have ### residents in care in local or regional health care providing facilities, ### treated and in the Home, and ### with respiratory illness symptoms. We are continuing to work closely with our partners - the Adams County Health Dept., the Illinois Dept. of Public Health, and local care providers - focusing on our residents, their health, and to getting through this tough situation. ​ I updated the talking points a bit. Thanks From: Arnold, Melaney Sent: Saturday, August 29, 2015 5:50 PM To: Yantis, Ryan Subject: Re: IVH Quincy update What numbers do you need? On Aug 29, 2015, at 5:45 PM, Yantis, Ryan wrote: ​Matt - Working on it and waiting on numbers from the Home and local health care providers. Hopefully soon. Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 5:31 PM To: Yantis, Ryan Subject: Re: IVH Quincy update ETA on an update? From: "Yantis, Ryan" Date: Saturday, August 29, 2015 9:54 AM To: Quincy Herald-Whig Subject: Re: IVH Quincy update ​Matt - We're working on it. Will let you know. Thanks Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 9:54 AM To: Yantis, Ryan Subject: IVH Quincy update Ryan- Will there be any update today on the Legionnaires' disease outbreak at the Illinois Veterans Home? Thanks. -Matt Hopf The Herald-Whig Sent from Outlook Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. Matt anf Hepunat 130 3. 51h Quincy. 1L 52-3-3? ?lfi?E: 21 FEES-3391 Email: mhamn??whigmm Twitter: HERALD-WHIG It?s Knnw! @m HF. i-a i-"i From: "Shay Drummond" To: Yantis Ryan CC: "Arnold, Melaney" Date: 8/29/2015 7:02:41 PM Subject: Re: FYI Ryan, Thanks for sharing your experience in this area. My practices to not respond and these situations in our local level, I have staff that I asked to look at the social media to get a pulse on what is going on but I find I do better if I just don't even read it. Thanks for all of your word smithing. Shay Sent from my iPhone On Aug 29, 2015, at 4:36 PM, Yantis, Ryan wrote: Shay & Melaney - No release of names from me/IDVA. I don't even have them. Previous professional life experience for me was handling death notifications for the Army. Army-wide. In the Pentagon, the uniformed and civilian folks who died on 9/11. I do not release info without giving families/next-of-kin time. Very, very serious subject for me. That said, the gent is grieving, and while some of his anger is justified, his father, his medical treatment was out of our hands. There's going to be a certain amount of lashout and anger. The Home, Blessing, and others need to step us and talk to people. And yes there will be lawsuits. We've faced many with the Homes in the 30 months I've been with IDVA. It's part of doing business. We just need to be consistent and do the right things. Ryan From: Shay Drummond Sent: Saturday, August 29, 2015 4:15 PM To: Arnold, Melaney Cc: Yantis, Ryan Subject: Re: FYI Agree on all points. I had not heard names mentioned at all. I am sure the questions are going to get more difficult. Thanks.... Sent from my iPhone On Aug 29, 2015, at 4:03 PM, Arnold, Melaney wrote: Definitely vigilant about what info and when. I’m not sure I understand when he says names mentioned – have any names been mentioned? It is understandable how upsetting this is, but for talking points – if pressed – testing/diagnosis for Legionnaires’ disease takes time. As soon as we knew a diagnosis, we shared the info. Also, I believe the treatment would have remained the same – correct? Emotion is going to start driving the news stories, so I envision things getting much more difficult moving forward. Thank you Shay From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Saturday, August 29, 2015 3:45 PM To: Arnold, Melaney; Yantis, Ryan Subject: FYI Importance: High Melaney and Ryan, See the message below that messaged me on FB today. This certainly brings it all home for me and why I want to be very diligent on when we release info and what info we release. I have not yet responded to this,….but I needed to share.. “My father is one of the two who passed away at the vets home. I know you are not responsible with how they handle things but it’s been really devastating to know that our choices for my dad’s care would have been different if we knew about the legionnaires We did not find out about or that my dad had it until 4 hours before he died. Now myself and my family instead of burying our father have to wait. Now we have to deal with the fact that maybe we did not do all we could have. The situation was handled badly to say the least but the lack of communication in mind killed my father a hero who served his country only to die in its care. We knew nothing about this and we had serval conversations with the vets home trying to make the very best choices we could for my dad this is more than inexcusable considering we had him at the ER on Tuesday and not one person mentioned anything including the nurses who were caring for him. It would be nice before names are mentioned that my family should be told about any further information especially when it comes to releasing names. I have no doubt everyone working very hard to get this under control but we ask ourselves why was no one working hard for my dad. Why did it take his death and another’s before the severity of this horrible disease was brought to the public attention. I hope no other families have to sit and watch their loved one die in the same way we did and then to find out it may have all been prevented…Sincerely the family US Army Vet.” Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Yantis Ryan CC: Date: 8/29/2015 4:46:59 PM Subject: RE: IVH Quincy update Ryan – were you wanting to get info out tonight or are you waiting until the AM? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Saturday, August 29, 2015 5:46 PM To: Matthew Hopf Subject: Re: IVH Quincy update ​Matt Working on it and waiting on numbers from the Home and local health care providers. Hopefully soon. Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 5:31 PM To: Yantis, Ryan Subject: Re: IVH Quincy update ETA on an update? From: "Yantis, Ryan" Date: Saturday, August 29, 2015 9:54 AM To: Quincy Herald-Whig Subject: Re: IVH Quincy update ​Matt We're working on it. Will let you know. Thanks Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 9:54 AM To: Yantis, Ryan Subject: IVH Quincy update RyanWill there be any update today on the Legionnaires' disease outbreak at the Illinois Veterans Home? Thanks. -Matt Hopf The Herald-Whig Sent from Outlook Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Shay Drummond" To: HOUSTON CATHY CC: Date: 8/29/2015 3:17:28 PM Subject: Re: Legionella Tracking Log - 8 29-15 1400.xlsx Thanks- i appreciate it! Sent from my iPhone On Aug 29, 2015, at 4:14 PM, HOUSTON, CATHY wrote: From : "Shay Drummond" To: Echols Fred CC: Date: 8/29/2015 3:48:13 PM Subject: Re: Legionella Tracking Log - 8 29-15 1400.xlsx Thanks - will do! Sent from my iPhone On Aug 29, 2015, at 4:41 PM, Echols, Fred wrote: Shay, Thanks so much for sending the information. To ensure HIPAA compliance please password-protect any documents you send via email that contain patient information. Again, thank you all for all that you are doing. We sincerely appreciate your efforts to protect the residents in your jurisdiction. -Fred PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Saturday, August 29, 2015 4:19 PM To: Austin, Connie; Echols, Fred; Conover, Craig; Clegg, Whitney Subject: Fwd: Legionella Tracking Log - 8 29-15 1400.xlsx Most recent IVH data. Sent from my iPhone Begin forwarded message: From: "HOUSTON, CATHY" Date: August 29, 2015 at 4:14:13 PM CDT To: Shay Drummond Subject: Legionella Tracking Log - 8 29-15 1400.xlsx From: "Shay Drummond" To: Conover Craig CC: "Shah, Nirav" "Austin, Connie" "Arnold, Melaney" Date: 8/29/2015 3:28:28 PM Subject: Re: monday draft plan Jeff Conte our city engineer had put that on the radar to do on Monday and light of the community situation, and he is also talking with EPA regarding guidance. Would you like me to ask him to defer the testing? Thanks! Sent from my iPhone On Aug 29, 2015, at 4:26 PM, Conover, Craig wrote: Shay --Are they testing for Legionella on Monday? At first pass, I don't think I would recommend this based on the current situation--if you look hard enough you will usually find Legionella as it is ubiquitous and finding it will raise questions about elimination, additional testing, etc. CC From: Shay Drummond Sent: Saturday, August 29, 2015 4:05 PM To: Shah, Nirav Cc: Austin, Connie; Conover, Craig; Arnold, Melaney Subject: Re: Press Release Commentary They are testing Monday and have not done so in the past. They will be available also on Monday to visit with IDPH EH staff. Thanks, Shay Sent from my iPhone On Aug 29, 2015, at 3:46 PM, Shah, Nirav wrote: Hi Shay, Do you happen to know if the City is testing its water supply for evidence of Legionella? Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 <6FDB29A3-6052-417A-8D97-0D61EDD16A5D[17].png> From: Shay Drummond Date: Saturday, August 29, 2015 at 11:42 AM To: "Austin, Connie" , "Conover, Craig" Cc: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary Connie, Jon is sending the addresses, distance from IVH etc. to you. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Saturday, August 29, 2015 11:25 AM To: Conover, Craig Cc: Shah, Nirav; Shay Drummond; Arnold, Melaney Subject: Re: Press Release Commentary We can do on Monday. I'm not sure how far blessing is and I think her home is at least 4 miles. I think sunset home was more than a mile for the second one Sent from my iPhone On Aug 29, 2015, at 12:15 PM, Conover, Craig wrote: Community cases should be mapped-- I believe the one we were alerted to yesterday lives a little over a mile from the facility as the crow flies. From: Austin, Connie Sent: Saturday, August 29, 2015 10:50 AM To: Shah, Nirav Cc: Shay Drummond; Arnold, Melaney; Conover, Craig Subject: Re: Press Release Commentary Both have been exposed to 2 different decorative fountains. Shay what did you find out about the other ltc resident. Had he been outside the facility? Any other pneumonia cases in the facility int the last month Spoke to cdc about this with increased testing we may be finding sporadic cases we wouldn't have found without heightened awareness Unfortunately no way to look at strains with urine antigen Sent from my iPhone On Aug 29, 2015, at 11:04 AM, Shah, Nirav wrote: Thanks. I am growing concerned about the unaffiliated positive cases. Dr. Conover/Austin: what is our best guess as to the transmission route of the community cases? Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 10:02 AM To: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary I am having a status update with Blessing and IVH this morning and should have current numbers by 11 or so. We also have some outliers testing positive from the community – we need to address that in the talking points – these are patients that have no tie to IVH. This is where is will start to get dicey. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Saturday, August 29, 2015 9:55 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Arnold, Melaney; WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All - Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Shay Drummond" To: Shah Nirav CC: "Austin, Connie" "Conover, Craig" "Arnold, Melaney" Date: 8/29/2015 3:05:08 PM Subject: Re: Press Release Commentary They are testing Monday and have not done so in the past. They will be available also on Monday to visit with IDPH EH staff. Thanks, Shay Sent from my iPhone On Aug 29, 2015, at 3:46 PM, Shah, Nirav wrote: Hi Shay, Do you happen to know if the City is testing its water supply for evidence of Legionella? Thanks, Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 <6FDB29A3-6052-417A-8D97-0D61EDD16A5D[17].png> From: Shay Drummond Date: Saturday, August 29, 2015 at 11:42 AM To: "Austin, Connie" , "Conover, Craig" Cc: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary Connie, Jon is sending the addresses, distance from IVH etc. to you. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Saturday, August 29, 2015 11:25 AM To: Conover, Craig Cc: Shah, Nirav; Shay Drummond; Arnold, Melaney Subject: Re: Press Release Commentary We can do on Monday. I'm not sure how far blessing is and I think her home is at least 4 miles. I think sunset home was more than a mile for the second one Sent from my iPhone On Aug 29, 2015, at 12:15 PM, Conover, Craig wrote: Community cases should be mapped-- I believe the one we were alerted to yesterday lives a little over a mile from the facility as the crow flies. From: Austin, Connie Sent: Saturday, August 29, 2015 10:50 AM To: Shah, Nirav Cc: Shay Drummond; Arnold, Melaney; Conover, Craig Subject: Re: Press Release Commentary Both have been exposed to 2 different decorative fountains. Shay what did you find out about the other ltc resident. Had he been outside the facility? Any other pneumonia cases in the facility int the last month Spoke to cdc about this with increased testing we may be finding sporadic cases we wouldn't have found without heightened awareness Unfortunately no way to look at strains with urine antigen Sent from my iPhone On Aug 29, 2015, at 11:04 AM, Shah, Nirav wrote: Thanks. I am growing concerned about the unaffiliated positive cases. Dr. Conover/Austin: what is our best guess as to the transmission route of the community cases? Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 10:02 AM To: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary I am having a status update with Blessing and IVH this morning and should have current numbers by 11 or so. We also have some outliers testing positive from the community – we need to address that in the talking points – these are patients that have no tie to IVH. This is where is will start to get dicey. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Saturday, August 29, 2015 9:55 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Arnold, Melaney; WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All - Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Shay Drummond" To: Shah "Nirav <" "\(Nirav.Shah@illinois.gov\);>" "Melaney <" "\(Melaney.Arnold@Illinois.gov\)>" CC: Date: 8/29/2015 9:02:18 AM Subject: RE: Press Release Commentary I am having a status update with Blessing and IVH this morning and should have current numbers by 11 or so. We also have some outliers testing positive from the community – we need to address that in the talking points – these are patients that have no tie to IVH. This is where is will start to get dicey. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Saturday, August 29, 2015 9:55 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Arnold, Melaney; WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All - Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Shay Drummond" To: Yantis Ryan Melaney CC: "Shah, Nirav" "Jeffries, Erica L" "Neisen, Lisa \(PR\)" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "DIEHL, GWEN G" "SAWYER, HARRY H" "McGill, Patricia O" Date: 8/29/2015 10:54:25 AM Subject: RE: Press Release Commentary I did an interview at 11 – expressed our condolences to the families, staff and community. Held with our numbers from yesterday and asked that persons in the county experiencing signs and symptoms with concerns please contact their family physician and follow their guidance – we are seeing an influx to the ED. Kept it very factual to signs and symptoms, the vulnerable population. Thanks, Shay From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Saturday, August 29, 2015 11:51 AM To: Arnold, Melaney Cc: Shay Drummond; Shah, Nirav; Jeffries, Erica L; Neisen, Lisa (PR); WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary All WGEM Chad Mahoney called asking for an update and requesting someone from the Home/IDVA for an on-camera interview, citing the deaths and the emotional tie Quincy has to the Home. He confirmed we are providing info, and complimented Shay on her availability and willingness to share info. No other updated or new queries to me as of this email. ​ From: Arnold, Melaney Sent: Saturday, August 29, 2015 10:50 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Jeffries, Erica L; Neisen, Lisa (PR); WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary This is a technicality the media /public may not seize on, but it is Legionella (italicized) bacteria. But when referring to the illness - I think we should go with Legionnaires' disease. I can't open the document right now except on my phone, but will be able to later On Aug 29, 2015, at 10:28 AM, Yantis, Ryan wrote: All Please find attached the current Talking Points and Q&A (Legionella TP QA 2015-08-29 1015 AM.docx​) for staffing. All changes have been highlighted. If there are changes offered, please also summarize in the message. There are some data points we need to update. I attempted to answer Shay's questions: What is being done? Is it safe for residents to return to home from hospital? I also updated the deaths question, but we need our 1130 update to confirm today's numbers. Thanks Ryan To: Shah Nirav "Erica L" CC: "Yantis, Ryan" "Arnold, Melaney" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "DIEHL, GWEN G" "SAWYER, HARRY H" "McGill, Patricia O" Date: 8/29/2015 8:47:59 AM Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All - Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Shay Drummond" To: Austin Connie Craig CC: "Shah, Nirav" "Arnold, Melaney" Date: 8/29/2015 10:42:02 AM Subject: RE: Press Release Commentary Connie, Jon is sending the addresses, distance from IVH etc. to you. From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Saturday, August 29, 2015 11:25 AM To: Conover, Craig Cc: Shah, Nirav; Shay Drummond; Arnold, Melaney Subject: Re: Press Release Commentary We can do on Monday. I'm not sure how far blessing is and I think her home is at least 4 miles. I think sunset home was more than a mile for the second one Sent from my iPhone On Aug 29, 2015, at 12:15 PM, Conover, Craig wrote: Community cases should be mapped-- I believe the one we were alerted to yesterday lives a little over a mile from the facility as the crow flies. From: Austin, Connie Sent: Saturday, August 29, 2015 10:50 AM To: Shah, Nirav Cc: Shay Drummond; Arnold, Melaney; Conover, Craig Subject: Re: Press Release Commentary Both have been exposed to 2 different decorative fountains. Shay what did you find out about the other ltc resident. Had he been outside the facility? Any other pneumonia cases in the facility int the last month Spoke to cdc about this with increased testing we may be finding sporadic cases we wouldn't have found without heightened awareness Unfortunately no way to look at strains with urine antigen Sent from my iPhone On Aug 29, 2015, at 11:04 AM, Shah, Nirav wrote: Thanks. I am growing concerned about the unaffiliated positive cases. Dr. Conover/Austin: what is our best guess as to the transmission route of the community cases? Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 10:02 AM To: Nirav Shah , "Arnold, Melaney" Subject: RE: Press Release Commentary I am having a status update with Blessing and IVH this morning and should have current numbers by 11 or so. We also have some outliers testing positive from the community – we need to address that in the talking points – these are patients that have no tie to IVH. This is where is will start to get dicey. From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Saturday, August 29, 2015 9:55 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Arnold, Melaney; WINNICKI, LENARD F.; HOUSTON, CATHY; DIEHL, GWEN; SAWYER, HARRY; McGill, Trish Subject: Re: Press Release Commentary Roger - thanks, Ryan. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:54, Yantis, Ryan wrote: Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All - Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Shay Drummond" To: Echols Fred CC: Date: 8/29/2015 1:35:51 PM Subject: RE: Questions Regarding the Hotel Hi – the hotels now all make sense. We did have a call from a family that was similar to your scenario. I will find out what guidance they have given and try to get copies. Thanks, Shay From: Echols, Fred [mailto:Fred.Echols@Illinois.gov] Sent: Saturday, August 29, 2015 2:32 PM To: Shay Drummond; Jon Campos Cc: Austin, Connie Subject: Questions Regarding the Hotel Shay, The veterans’ affairs staff was supposed to alert family members of IVH residents. However, we (IDPH DID staff) don't know what information was relayed to the family members staying on the grounds. Have people staying overnight on the grounds been told to see medical provider if they become ill. Overnight visitors could become ill in other states and not know about legionella risk. It is important that family members are aware of the risk and know what to do if they become ill. Can you reach out to the Veterans’ Affairs representatives and ask about what information has been provided to family members? If information has been provided to family member, IDPH CDCS staff would like to receive a copy of the document(s). Please let me know if you have any questions or concerns. Respectfully Yours, Fredrick L. Echols, MD Chief,Communicable Diseases Illinois Department of Public Health Phone: 217-782-2016 Fax: 217-524-0962 Email: Fred.Echols@Illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "Shay Drummond" To: "Jerrod Welch" Nirav Connie Craig Fred Melaney CC: "Jon Campos" Date: 8/29/2015 10:13:37 AM Subject: RE: Update Does noon work for everyone? We need clarification on the coroners – issues. From: Jerrod Welch Sent: Saturday, August 29, 2015 10:27 AM To: Shah, Nirav; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: RE: Update How about a call at 12:00 I will wait for the confirmation on that time, but if it works, we can invite the coroner and get this issue addressed. I have a call in number, but I’ll defer to DPH if you wish to utilize the call number you have previously used. Just let me know, and thanks for the response. I think this will go a long way in getting his concerns addressed. JCW From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 10:10 AM To: Jerrod Welch; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: Re: Update Thanks, Jerrod. This is a good question and I think we have contemplated this with CDC. I’m available for a call anytime other than 11AM today. Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Spring?eld, IL 62761 (217) 557-2556 [3 L3 From: Jerrod Welch <'we ch co.adams.il.us> Date: Saturday, August 29, 2015 at 9:47 AM To: Shay Drummond Nirav Shah , "Austin, Connie" , "Conover, Craig" , "Echols, Fred" , "Arnold, Melaney" Cchon Campos Subject: RE: Update To compound this, the Coroner is wanting to speak through this with DPH today if possible. Outside of a tissue sample of the lung, are there any other samples he should be collecting for a current epi investigation or future research on the disease. He is speaking with another pathologist who has made this suggestion, though I?m not sure who it is. He has placed a hold on all of the bodies and is trying to determine which ones they will perform an autopsy on and which ones they will simply collect the requested tissue from. Last night we had informally decided that he?d do autopsies on those without a lab positive urine, and tissues only on those with positives. I think after speaking with families, he?s changing his mind on who to autopsy. I think that we should coordinate a call that he can be on to ask questions to one of your experts who might help him make his decisions during this. He has some other general thoughts/concerns that I also think could benefit from a conversation with Connie or someone else who is you guys think fits this line of info. Thoughs? JCW From: Shay Drummond Sent: Saturday, August 29, 2015 9:23 AM To: Shah, Nirav Austin, Connie Craig.Conover@illinois.gov; Echols, Fred Arnold, Melaney (Melaney.Arnold@Illinois.gov) Cc: Jon Campos; Jerrod Welch Subject: Update Importance: High All, the day is not starting well as I just found out that we lost another veterans home resident that was positive. He was being cared for on site. Blessing update: as of 0800 22 In house 2 admits overnight – was a re admit – both IVH residents. IVH Psychological care for staff and residents: IVH has counselors on staff that are tending to their needs, no additional resources needed at this time. Blessing is going to collect urine antigens on the 3 in house patients that have discordant labs. Will collect today and send to IDPH lab Springfield. Is there restrictions on times over weekend? Will have a solid update on numbers by 10:30 this morning. Thanks, Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Arnold Melaney CC: "Jerrod Welch" "Shah, Nirav" "Austin, Connie" "Conover, Craig" "Echols, Fred" "Jon Campos" Date: 8/29/2015 10:17:11 AM Subject: RE: Update 1230 is good for us too! From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Saturday, August 29, 2015 11:16 AM To: Shay Drummond Cc: Jerrod Welch; Shah, Nirav; Austin, Connie; Conover, Craig; Echols, Fred; Jon Campos Subject: Re: Update 12:30 would be better for me, but others are more vital to this call. I may be a bit late. Thanks On Aug 29, 2015, at 11:13 AM, Shay Drummond wrote: Does noon work for everyone? We need clarification on the coroners – issues. From: Jerrod Welch Sent: Saturday, August 29, 2015 10:27 AM To: Shah, Nirav; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: RE: Update How about a call at 12:00 I will wait for the confirmation on that time, but if it works, we can invite the coroner and get this issue addressed. I have a call in number, but I?ll defer to DPH if you wish to utilize the call number you have previously used. Just let me know, and thanks for the response. I think this will go a long way in getting his concerns addressed. JCW From: Shah, Nirav Sent: Saturday, August 29, 2015 10:10 AM To: Jerrod Welch; Shay Drummond; Austin, Connie; Conover, Craig; Echols, Fred; Arnold, Melaney Cc: Jon Campos Subject: Re: Update Thanks, Jerrod. This is a good question and I think we have contemplated this with CDC. I?m available for a call anytime other than 11AM today. Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Spring?eld, IL 62761 (217) 557-2556 From: Jerrod Welch Date: Saturday, August 29, 2015 at 9:47 AM To: Shay Drummond Nirav Shah "Austin, Connie" , "Conover, Craig" "Echols, Fred" "Arnold, Melaney" Cc: Jon Campos Subject: RE: Update To compound this, the Coroner is wanting to speak through this with DPH today if possible. Outside of a tissue sample of the lung, are there any other samples he should be collecting for a current epi investigation or future research on the disease. He is speaking with another pathologist who has made this suggestion, though I’m not sure who it is. He has placed a hold on all of the bodies and is trying to determine which ones they will perform an autopsy on and which ones they will simply collect the requested tissue from. Last night we had informally decided that he’d do autopsies on those without a lab positive urine, and tissues only on those with positives. I think after speaking with families, he’s changing his mind on who to autopsy. I think that we should coordinate a call that he can be on to ask questions to one of your experts who might help him make his decisions during this. He has some other general thoughts/concerns that I also think could benefit from a conversation with Connie or someone else who is you guys think fits this line of info. Thoughs? JCW From: Shay Drummond Sent: Saturday, August 29, 2015 9:23 AM To: Shah, Nirav (Nirav.Shah@illinois.gov); Austin, Connie (Connie.Austin@Illinois.gov); Craig.Conover@illinois.gov; Echols, Fred (Fred.Echols@Illinois.gov); Arnold, Melaney (Melaney.Arnold@Illinois.gov) Cc: Jon Campos; Jerrod Welch Subject: Update Importance: High All, the day is not starting well as I just found out that we lost another veterans home resident that was positive. He was being cared for on site. Blessing update: as of 0800 22 In house 2 admits overnight – was a re admit – both IVH residents. IVH Psychological care for staff and residents: IVH has counselors on staff that are tending to their needs, no additional resources needed at this time. Blessing is going to collect urine antigens on the 3 in house patients that have discordant labs. Will collect today and send to IDPH lab Springfield. Is there restrictions on times over weekend? Will have a solid update on numbers by 10:30 this morning. Thanks, Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Shah "Nirav <" "\(Nirav.Shah@illinois.gov\);>" "Connie \(Connie.Austin@Illinois.gov\);" "Fred\(Fred.Echols@Illinois.gov\);" "Melaney <" "\(Melaney.Arnold@Illinois.gov\)>" CC: "Jon Campos" "Jerrod Welch" Date: 8/29/2015 8:22:59 AM Subject: Update All, the day is not starting well as I just found out that we lost another veterans home resident that was positive. He was being cared for on site. Blessing update: as of 0800 22 In house 2 admits overnight – LV was a re admit – both IVH residents. IVH Psychological care for staff and residents: IVH has counselors on staff that are tending to their needs, no additional resources needed at this time. Blessing is going to collect urine antigens on the 3 in house patients that have discordant labs. Will collect today and send to IDPH lab Springfield. Is there restrictions on times over weekend? Will have a solid update on numbers by 10:30 this morning. Thanks, Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "WINNICKI, LENARD F." To: Yantis Ryan CC: "Shay Drummond" "Shah, Nirav" "Jeffries, Erica L" "HOUSTON, CATHY" "Ray, Jaimee M." "McGill, Trish" "Arnold, Melaney" Date: 8/29/2015 4:08:21 PM Subject: Re: On Cam Interview with KHQA News in Quincy, IL FYSA. Quincy does have a marketing/PR guy who is used to these and is known in community and by media, Rick Geckenbacker. (I know I just butchered his name) Len Winnicki, MSHS, LNHA Senior Nursing Home Administrator Illinois Department of Veteran Affairs One Veterans Drive Manteno, IL. 60950 Ph: (815) 468-6581 x210 Lenard.Winnicki@illinois.gov This e-mail and any attachments are intended solely for the person or entity to which addressed and may contain confidential information. Any copy or distribution of this information by person or entities other than the addressee is prohibited by law. If you have received this message in error, please contact the sender and delete this message along with any attachments. On Aug 29, 2015, at 4:37 PM, "Yantis, Ryan" wrote: ​All - Another on-camera request. In speaking with him, I said tomorrow was the soonest. Comments? Ryan From: David P. Amelotti Sent: Saturday, August 29, 2015 4:33 PM To: Yantis, Ryan Subject: On Cam Interview with KHQA News in Quincy, IL Ryan, Following up on our phone call. I would like to do an interview with someone from the Quincy Veteran’s Home to discuss the Legionnaires Disease. Discuss the current situation, and how to move forward. Discuss preventative measures being taken to put general public mind at peace. As always, I appreciate your time. David Amelotti KHQA News Anchor/Reporter 217-242-3282 From: "Yantis, Ryan" To: Arnold "Melaney ;Shay Drummond" CC: "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Jeffries, Erica L" "Shah, Nirav" Date: 8/29/2015 5:00:02 PM Subject: DRAFT - IVH Quincy update for QHW and others For response to the Quincy Herald Whig via email from me, once we have numbers...highlighted below. Q: Will there be any update today (Sat. Aug 28 at 6 pm.) on the Legionnaires' disease outbreak at the Illinois Veterans Home? ​ A: Our thoughts and prayers go to those two heroes who passed yesterday, and we offer our sincere condolences to their loved ones. There have been no additional deaths believed to be related to legionella in the past 24 hours, and while this is certainly welcome news, much remains to be done. We have ### residents in care in local or regional health care providing facilities, ### treated and in the Home, and ### with respiratory illness symptoms. We are continuing to work closely with our partners - the Adams County Health Dept., the Illinois Dept. of Public Health, and local care providers focusing on our residents, their health, and to getting through this tough situation. ​ From: Arnold, Melaney Sent: Saturday, August 29, 2015 5:50 PM To: Yantis, Ryan Subject: Re: IVH Quincy update What numbers do you need? On Aug 29, 2015, at 5:45 PM, Yantis, Ryan wrote: ​Matt Working on it and waiting on numbers from the Home and local health care providers. Hopefully soon. Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 5:31 PM To: Yantis, Ryan Subject: Re: IVH Quincy update ETA on an update? From: "Yantis, Ryan" Date: Saturday, August 29, 2015 9:54 AM To: Quincy Herald-Whig Subject: Re: IVH Quincy update ​Matt We're working on it. Will let you know. Thanks Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 9:54 AM To: Yantis, Ryan Subject: IVH Quincy update RyanWill there be any update today on the Legionnaires' disease outbreak at the Illinois Veterans Home? Thanks. -Matt Hopf The Herald-Whig Sent from Outlook Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Yantis, Ryan" To: "Shay Drummond" Nirav "Erica L" "CATHY S" "LENARD F" "Jaimee M" "Patricia O" Melaney CC: Date: 8/29/2015 3:37:09 PM Subject: Fw: On Cam Interview with KHQA News in Quincy, IL ​All Another on-camera request. In speaking with him, I said tomorrow was the soonest. Comments? Ryan From: David P. Amelotti Sent: Saturday, August 29, 2015 4:33 PM To: Yantis, Ryan Subject: On Cam Interview with KHQA News in Quincy, IL Ryan, Following up on our phone call. I would like to do an interview with someone from the Quincy Veteran’s Home to discuss the Legionnaires Disease. Discuss the current situation, and how to move forward. Discuss preventative measures being taken to put general public mind at peace. As always, I appreciate your time. David Amelotti KHQA News Anchor/Reporter 217-242-3282 From: "Yantis, Ryan" To: Shah Nirav "Erica L" "Melaney ;Shay Drummond" "LENARD F" "CATHY S" "GWEN G" "HARRY H" "Patricia O" "Lisa \(PR\)" CC: Date: 8/29/2015 8:39:04 AM Subject: Press Release Commentary ​All Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Yantis, Ryan" To: Arnold "Melaney ;Shay Drummond" CC: "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Jeffries, Erica L" "Shah, Nirav" Date: 8/29/2015 5:31:30 PM Subject: Re: DRAFT - IVH Quincy update for QHW and others, based onUpdated TPs Thanks Melaney So, another version of the email to the Quincy Herald Whig in RTQ: · Our thoughts and prayers go to those two heroes who passed yesterday, and we offer our sincere condolences to their loved ones.​ There have been no additional deaths believed to be related to legionella in the past 24 hours, and while this is certainly welcome news, much remains to be done. ​ Currently 28 individuals from the Veterans’ Home in Quincy have tested positive for Legionnaires’ disease; this includes the two residents who died yesterday. · The Adams County Health Department, the Illinois Department of Public Health, the Illinois Department of Veterans’ Affairs, Quincy Veterans’ Home, Blessing Hospital, and other medical providers, with guidance from the Centers for Disease Control and Prevention, are working together very closely to track patients with respiratory illness who have a connection with the home. · Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires’ disease and are making sure residents receive prompt medical attention if needed. · Compounding the challenge of identifying and treating individuals with Legionnaires’ disease is that we typically see other respiratory issues in residents this time of year. Therefore, all residents presenting any Legionnaires’ disease–type symptoms will be treated as if they have Legionnaires’ disease until lab results confirm the individual is negative for the bacteria. · Environmental health and infectious disease staff continue to visit the home to investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources. · The Illinois Veterans’ Home-Quincy has established a remediation plan including: Cleaning hot water tanks Cleaning the cooling tower – completed Friday, August 28. Using bottled water for residents and staff Using a temporary chiller so the facility chiller can be certified by outside experts Keeping fountains and other potential sources of aerosolized water turned off Removing possible/suspected Legionella-infected systems/devices from use until they can be specially treated and tested before use. Working with IDPH and other experts to clean and certify systems. We will update as the situation warrants. Our From: Arnold, Melaney Sent: Saturday, August 29, 2015 6:22 PM To: Yantis, Ryan; Shay Drummond Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; Shah, Nirav Subject: RE: DRAFT - IVH Quincy update for QHW and others From: Yantis, Ryan Sent: Saturday, August 29, 2015 6:00 PM To: Arnold, Melaney; Shay Drummond Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; Shah, Nirav Subject: DRAFT - IVH Quincy update for QHW and others For response to the Quincy Herald Whig via email from me, once we have numbers...highlighted below. Q: Will there be any update today (Sat. Aug 28 at 6 pm.) on the Legionnaires' disease outbreak at the Illinois Veterans Home? ​ A: Our thoughts and prayers go to those two heroes who passed yesterday, and we offer our sincere condolences to their loved ones. There have been no additional deaths believed to be related to legionella in the past 24 hours, and while this is certainly welcome news, much remains to be done. The only numbers I would provide would be 28 individuals associated with the home –. If pressed I would be willing to say 23 residents and 3 staff, plus 2 resident deaths. Providing the number of people in care, treated in the hospital or home, and those with respiratory illness is going to fluctuate GREATLY over the next several days and getting into the numbers game never goes well. There are too many variables that change – someone dies, but does not test positive for Legionnaires’, someone has pneumonia but it’s due to another bacteria, a resident being treated at the facility goes home with family, etc. This is just my experience. We have ### residents in care in local or regional health care providing facilities, ### treated and in the Home, and ### with respiratory illness symptoms. We are continuing to work closely with our partners - the Adams County Health Dept., the Illinois Dept. of Public Health, and local care providers focusing on our residents, their health, and to getting through this tough situation. ​ I updated the talking points a bit. Thanks From: Arnold, Melaney Sent: Saturday, August 29, 2015 5:50 PM To: Yantis, Ryan Subject: Re: IVH Quincy update What numbers do you need? On Aug 29, 2015, at 5:45 PM, Yantis, Ryan wrote: ​Matt Working on it and waiting on numbers from the Home and local health care providers. Hopefully soon. Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 5:31 PM To: Yantis, Ryan Subject: Re: IVH Quincy update ETA on an update? From: "Yantis, Ryan" Date: Saturday, August 29, 2015 9:54 AM To: Quincy Herald-Whig Subject: Re: IVH Quincy update ​Matt We're working on it. Will let you know. Thanks Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 9:54 AM To: Yantis, Ryan Subject: IVH Quincy update RyanWill there be any update today on the Legionnaires' disease outbreak at the Illinois Veterans Home? Thanks. -Matt Hopf The Herald-Whig Sent from Outlook Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Yantis, Ryan" To: Shah "Nirav ;Shay Drummond" CC: "Arnold, Melaney" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "Jeffries, Erica L" Date: 8/29/2015 6:16:30 PM Subject: Re: DRAFT - IVH Quincy update for QHW and others, based onUpdated TPs ​Concur. Thanks From: Shah, Nirav Sent: Saturday, August 29, 2015 7:16 PM To: Shay Drummond; Yantis, Ryan Cc: Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L Subject: Re: DRAFT - IVH Quincy update for QHW and others, based on Updated TPs Thanks, Shay. Yes, we all are in agreement that the public case count will consist of confirmed cases and deaths. No hospitalizations, etc. Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: Shay Drummond Date: Saturday, August 29, 2015 at 7:01 PM To: "Yantis, Ryan" Cc: "Arnold, Melaney" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" , "Jeffries, Erica L" , Nirav Shah Subject: Re: DRAFT - IVH Quincy update for QHW and others, based on Updated TPs Hi agree with keeping the numbers as simple as possible and making sure we're all on the same page with what the numbers included don't include Sent from my iPhone On Aug 29, 2015, at 6:31 PM, Yantis, Ryan wrote: Thanks Melaney So, another version of the email to the Quincy Herald Whig in RTQ: Our thoughts and prayers go to those two heroes who passed yesterday, and we offer our sincere condolences to their loved ones.​ There have been no additional deaths believed to be related to legionella in the past 24 hours, and while this is certainly welcome news, much remains to be done. ​ · Currently 28 individuals from the Veterans’ Home in Quincy have tested positive for Legionnaires’ disease; this includes the two residents who died yesterday. · The Adams County Health Department, the Illinois Department of Public Health, the Illinois Department of Veterans’ Affairs, Quincy Veterans’ Home, Blessing Hospital, and other medical providers, with guidance from the Centers for Disease Control and Prevention, are working together very closely to track patients with respiratory illness who have a connection with the home. · Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires’ disease and are making sure residents receive prompt medical attention if needed. · Compounding the challenge of identifying and treating individuals with Legionnaires’ disease is that we typically see other respiratory issues in residents this time of year. Therefore, all residents presenting any Legionnaires’ disease–type symptoms will be treated as if they have Legionnaires’ disease until lab results confirm the individual is negative for the bacteria. · Environmental health and infectious disease staff continue to visit the home to investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources. · The Illinois Veterans’ Home-Quincy has established a remediation plan including: Cleaning hot water tanks Cleaning the cooling tower – completed Friday, August 28. Using bottled water for residents and staff Using a temporary chiller so the facility chiller can be certified by outside experts Keeping fountains and other potential sources of aerosolized water turned off Removing possible/suspected Legionella-infected systems/devices from use until they can be specially treated and tested before use. Working with IDPH and other experts to clean and certify systems. We will update as the situation warrants. Our From: Arnold, Melaney Sent: Saturday, August 29, 2015 6:22 PM To: Yantis, Ryan; Shay Drummond Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; Shah, Nirav Subject: RE: DRAFT - IVH Quincy update for QHW and others From: Yantis, Ryan Sent: Saturday, August 29, 2015 6:00 PM To: Arnold, Melaney; Shay Drummond Cc: WINNICKI, LENARD F; HOUSTON, CATHY S; Jeffries, Erica L; Shah, Nirav Subject: DRAFT - IVH Quincy update for QHW and others For response to the Quincy Herald Whig via email from me, once we have numbers...highlighted below. Q: Will there be any update today (Sat. Aug 28 at 6 pm.) on the Legionnaires' disease outbreak at the Illinois Veterans Home? ​ A: Our thoughts and prayers go to those two heroes who passed yesterday, and we offer our sincere condolences to their loved ones. There have been no additional deaths believed to be related to legionella in the past 24 hours, and while this is certainly welcome news, much remains to be done. The only numbers I would provide would be 28 individuals associated with the home –. If pressed I would be willing to say 23 residents and 3 staff, plus 2 resident deaths. Providing the number of people in care, treated in the hospital or home, and those with respiratory illness is going to fluctuate GREATLY over the next several days and getting into the numbers game never goes well. There are too many variables that change – someone dies, but does not test positive for Legionnaires’, someone has pneumonia but it’s due to another bacteria, a resident being treated at the facility goes home with family, etc. This is just my experience. We have ### residents in care in local or regional health care providing facilities, ### treated and in the Home, and ### with respiratory illness symptoms. We are continuing to work closely with our partners - the Adams County Health Dept., the Illinois Dept. of Public Health, and local care providers - focusing on our residents, their health, and to getting through this tough situation. ​ I updated the talking points a bit. Thanks From: Arnold, Melaney Sent: Saturday, August 29, 2015 5:50 PM To: Yantis, Ryan Subject: Re: IVH Quincy update What numbers do you need? On Aug 29, 2015, at 5:45 PM, Yantis, Ryan wrote: ​Matt Working on it and waiting on numbers from the Home and local health care providers. Hopefully soon. Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 5:31 PM To: Yantis, Ryan Subject: Re: IVH Quincy update ETA on an update? From: "Yantis, Ryan" Date: Saturday, August 29, 2015 9:54 AM To: Quincy Herald-Whig Subject: Re: IVH Quincy update ​Matt We're working on it. Will let you know. Thanks Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 9:54 AM To: Yantis, Ryan Subject: IVH Quincy update RyanWill there be any update today on the Legionnaires' disease outbreak at the Illinois Veterans Home? Thanks. -Matt Hopf The Herald-Whig Sent from Outlook Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Yantis, Ryan" To: "Shay Drummond" CC: "Arnold, Melaney" Date: 8/29/2015 7:31:39 PM Subject: Re: FYI Shay - you are doing awesome and standing tall for others. Any help I can provide, I am happy to do so. Call, email, or text, I'll try to help. Get some sleep and take care. This is a marathon, not a sprint. Ryan 312-520-6958 From: Shay Drummond Sent: Saturday, August 29, 2015 8:02 PM To: Yantis, Ryan Cc: Arnold, Melaney Subject: Re: FYI Ryan, Thanks for sharing your experience in this area. My practices to not respond and these situations in our local level, I have staff that I asked to look at the social media to get a pulse on what is going on but I find I do better if I just don't even read it. Thanks for all of your word smithing. Shay Sent from my iPhone On Aug 29, 2015, at 4:36 PM, Yantis, Ryan wrote: Shay & Melaney - No release of names from me/IDVA. I don't even have them. Previous professional life experience for me was handling death notifications for the Army. Army-wide. In the Pentagon, the uniformed and civilian folks who died on 9/11. I do not release info without giving families/next-of-kin time. Very, very serious subject for me. That said, the gent is grieving, and while some of his anger is justified, his father, his medical treatment was out of our hands. There's going to be a certain amount of lashout and anger. The Home, Blessing, and others need to step us and talk to people. And yes there will be lawsuits. We've faced many with the Homes in the 30 months I've been with IDVA. It's part of doing business. We just need to be consistent and do the right things. Ryan From: Shay Drummond Sent: Saturday, August 29, 2015 4:15 PM To: Arnold, Melaney Cc: Yantis, Ryan Subject: Re: FYI Agree on all points. I had not heard names mentioned at all. I am sure the questions are going to get more difficult. Thanks.... Sent from my iPhone On Aug 29, 2015, at 4:03 PM, Arnold, Melaney wrote: Definitely vigilant about what info and when. I’m not sure I understand when he says names mentioned – have any names been mentioned? It is understandable how upsetting this is, but for talking points – if pressed – testing/diagnosis for Legionnaires’ disease takes time. As soon as we knew a diagnosis, we shared the info. Also, I believe the treatment would have remained the same – correct? Emotion is going to start driving the news stories, so I envision things getting much more difficult moving forward. Thank you Shay From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Saturday, August 29, 2015 3:45 PM To: Arnold, Melaney; Yantis, Ryan Subject: FYI Importance: High Melaney and Ryan, See the message below that messaged me on FB today. This certainly brings it all home for me and why I want to be very diligent on when we release info and what info we release. I have not yet responded to this,….but I needed to share.. “My father is one of the two who passed away at the vets home. I know you are not responsible with how they handle things but it’s been really devastating to know that our choices for my dad’s care would have been different if we knew about the legionnaires We did not find out about or that my dad had it until 4 hours before he died. Now myself and my family instead of burying our father have to wait. Now we have to deal with the fact that maybe we did not do all we could have. The situation was handled badly to say the least but the lack of communication in mind killed my father a hero who served his country only to die in its care. We knew nothing about this and we had serval conversations with the vets home trying to make the very best choices we could for my dad this is more than inexcusable considering we had him at the ER on Tuesday and not one person mentioned anything including the nurses who were caring for him. It would be nice before names are mentioned that my family should be told about any further information especially when it comes to releasing names. I have no doubt everyone working very hard to get this under control but we ask ourselves why was no one working hard for my dad. Why did it take his death and another’s before the severity of this horrible disease was brought to the public attention. I hope no other families have to sit and watch their loved one die in the same way we did and then to find out it may have all been prevented…Sincerely the family US Army Vet.” Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Yantis, Ryan" To: "Shay Drummond" Melaney CC: Date: 8/29/2015 3:35:57 PM Subject: Re: FYI Shay & Melaney No release of names from me/IDVA. I don't even have them. Previous professional life experience for me was handling death notifications for the Army. Army-wide. In the Pentagon, the uniformed and civilian folks who died on 9/11. I do not release info without giving families/next-of-kin time. Very, very serious subject for me. That said, the gent is grieving, and while some of his anger is justified, his father, his medical treatment was out of our hands. There's going to be a certain amount of lashout and anger. The Home, Blessing, and others need to step us and talk to people. And yes there will be lawsuits. We've faced many with the Homes in the 30 months I've been with IDVA. It's part of doing business. We just need to be consistent and do the right things. Ryan From: Shay Drummond Sent: Saturday, August 29, 2015 4:15 PM To: Arnold, Melaney Cc: Yantis, Ryan Subject: Re: FYI Agree on all points. I had not heard names mentioned at all. I am sure the questions are going to get more difficult. Thanks.... Sent from my iPhone On Aug 29, 2015, at 4:03 PM, Arnold, Melaney wrote: Definitely vigilant about what info and when. I’m not sure I understand when he says names mentioned – have any names been mentioned? It is understandable how upsetting this is, but for talking points – if pressed – testing/diagnosis for Legionnaires’ disease takes time. As soon as we knew a diagnosis, we shared the info. Also, I believe the treatment would have remained the same – correct? Emotion is going to start driving the news stories, so I envision things getting much more difficult moving forward. Thank you Shay From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Saturday, August 29, 2015 3:45 PM To: Arnold, Melaney; Yantis, Ryan Subject: FYI Importance: High Melaney and Ryan, See the message below that messaged me on FB today. This certainly brings it all home for me and why I want to be very diligent on when we release info and what info we release. I have not yet responded to this,….but I needed to share.. “My father is one of the two who passed away at the vets home. I know you are not responsible with how they handle things but it’s been really devastating to know that our choices for my dad’s care would have been different if we knew about the legionnaires We did not find out about or that my dad had it until 4 hours before he died. Now myself and my family instead of burying our father have to wait. Now we have to deal with the fact that maybe we did not do all we could have. The situation was handled badly to say the least but the lack of communication in mind killed my father a hero who served his country only to die in its care. We knew nothing about this and we had serval conversations with the vets home trying to make the very best choices we could for my dad this is more than inexcusable considering we had him at the ER on Tuesday and not one person mentioned anything including the nurses who were caring for him. It would be nice before names are mentioned that my family should be told about any further information especially when it comes to releasing names. I have no doubt everyone working very hard to get this under control but we ask ourselves why was no one working hard for my dad. Why did it take his death and another’s before the severity of this horrible disease was brought to the public attention. I hope no other families have to sit and watch their loved one die in the same way we did and then to find out it may have all been prevented…Sincerely the family US Army Vet.” Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Yantis, Ryan" To: "Matthew Hopf" CC: Date: 8/29/2015 4:45:45 PM Subject: Re: IVH Quincy update ​Matt Working on it and waiting on numbers from the Home and local health care providers. Hopefully soon. Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 5:31 PM To: Yantis, Ryan Subject: Re: IVH Quincy update ETA on an update? From: "Yantis, Ryan" Date: Saturday, August 29, 2015 9:54 AM To: Quincy Herald-Whig Subject: Re: IVH Quincy update ​Matt We're working on it. Will let you know. Thanks Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 9:54 AM To: Yantis, Ryan Subject: IVH Quincy update RyanWill there be any update today on the Legionnaires' disease outbreak at the Illinois Veterans Home? Thanks. -Matt Hopf The Herald-Whig Sent from Outlook Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Yantis, Ryan" To: "Matthew Hopf" CC: Date: 8/29/2015 8:54:57 AM Subject: Re: IVH Quincy update ​Matt We're working on it. Will let you know. Thanks Ryan From: Matthew Hopf Sent: Saturday, August 29, 2015 9:54 AM To: Yantis, Ryan Subject: IVH Quincy update RyanWill there be any update today on the Legionnaires' disease outbreak at the Illinois Veterans Home? Thanks. -Matt Hopf The Herald-Whig Sent from Outlook Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Yantis, Ryan" To: "Shay Drummond" Nirav "Erica L" CC: "Arnold, Melaney" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "DIEHL, GWEN G" "SAWYER, HARRY H" "McGill, Patricia O" Date: 8/29/2015 8:54:08 AM Subject: Re: Press Release Commentary Will start updating the Talking Points and Q&A. Can we PLEASE leave the Date/time in the file name going forward? Using that method, it's vastly easier to find the most current version. Using the one word "Legionella" makes finding the most current file something of a challenge. Thanks From: Shay Drummond Sent: Saturday, August 29, 2015 9:47 AM To: Shah, Nirav; Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: RE: Press Release Commentary Updated talking points would be helpful as well. I am anticipating more questions on: What is being done? Is it safe for residents to return to home from hospital? These are topping our local questionsThanks. Shay From: Shah, Nirav [mailto:Nirav.Shah@illinois.gov] Sent: Saturday, August 29, 2015 9:44 AM To: Jeffries, Erica L Cc: Yantis, Ryan; Arnold, Melaney; Shay Drummond; WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary Agreed. -Nirav On Aug 29, 2015, at 9:42 AM, Jeffries, Erica L wrote: Thanks, Ryan. Given this morning's update, I think we're going to have to begin thinking about a press conference in the next day or so. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 29, 2015, at 09:39, Yantis, Ryan wrote: ​All Following on last night's press release announcing the two deaths at (8/28/15 @ 8:39 pm), media coverage I can access online is based on the Associated Press (AP) coverage. The story is being reported nation-wide. (See below) In general the reporting is fair, balanced, and accurate. Our information comports to the talking points and press releases, and demonstrates the combined concerns and efforts of all parties. We have outstanding requests for interviews by WGEM (Chad Mahoney) and Quincy Herald Whig (Matt Hopt). Given the concurrent Legionnaire's situation in NYC, California and elsewhere, our prominence is somewhat reduced in national media interest, but there is still the possibility. The relative remoteness of Quincy compared to diseases nodes easier to access (and with more people) moderates this potential. Examples- more that 40 found online, following general AP reporting Two deaths may be due to Legionnaire's disease at Vets Home Quincy Journal - ‎33 minutes ago‎ The recent outbreak of Legionnaire's disease at the Illinois Veterans Home may have caused the deaths of two residents. Their names have not been released pending notification of next-of-kin. In a press release, both are said to have had "underlyning ... Legionnaires' kills 2 Illinois veterans' home residents Medical Xpress - ‎4 hours ago‎ Those groups are most vulnerable to the disease. The source of the disease has not been determined, but Drummond said the health department is confident it's contained to the veterans' home. "The Legionella bacteria can be found anywhere, but it's ... 2 residents of veterans home die from Legionnaires' disease STLtoday.com - ‎10 hours ago‎ QUINCY, Ill. • Authorities say two residents of the Illinois Veterans' home in Quincy have died of Legionnaires' disease. The Illinois Department of Public Health said Friday the two residents had underlying medical conditions. However, both had been ... Legionnaires' kills 2 Illinois veterans' home residents The Elkhart (Nevada) Truth - ‎10 hours ago‎ QUINCY, Ill. (AP) — Two residents of an Illinois veterans' home have died of Legionnaires' Disease, the Illinois Department of Public Health said Friday. The health department said the two residents at the home in Quincy, about 300 miles southwest of ... Illinois: Two Are Dead in Outbreak of Legionnaires' Disease New York Times - ‎11 hours ago‎ Two residents of the Illinois Veterans' Home in Quincy have died of Legionnaires' disease, the authorities said Friday. The Illinois Department of Public Health said the two had underlying medical conditions. Both were among 23 residents of the home ...​ From: "Yantis, Ryan" To: Arnold Melaney CC: "Shay Drummond" "Shah, Nirav" "Jeffries, Erica L" "Neisen, Lisa \(PR\)" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "DIEHL, GWEN G" "SAWYER, HARRY H" "McGill, Patricia O" Date: 8/29/2015 10:50:54 AM Subject: Re: Press Release Commentary All WGEM Chad Mahoney called asking for an update and requesting someone from the Home/IDVA for an on-camera interview, citing the deaths and the emotional tie Quincy has to the Home. He confirmed we are providing info, and complimented Shay on her availability and willingness to share info. No other updated or new queries to me as of this email. ​ From: Arnold, Melaney Sent: Saturday, August 29, 2015 10:50 AM To: Yantis, Ryan Cc: Shay Drummond; Shah, Nirav; Jeffries, Erica L; Neisen, Lisa (PR); WINNICKI, LENARD F; HOUSTON, CATHY S; DIEHL, GWEN G; SAWYER, HARRY H; McGill, Patricia O Subject: Re: Press Release Commentary This is a technicality the media /public may not seize on, but it is Legionella (italicized) bacteria. But when referring to the illness - I think we should go with Legionnaires' disease. I can't open the document right now except on my phone, but will be able to later On Aug 29, 2015, at 10:28 AM, Yantis, Ryan wrote: All Please find attached the current Talking Points and Q&A (Legionella TP QA 2015-08-29 1015 AM.docx​) for staffing. All changes have been highlighted. If there are changes offered, please also summarize in the message. There are some data points we need to update. I attempted to answer Shay's questions: What is being done? Is it safe for residents to return to home from hospital? I also updated the deaths question, but we need our 1130 update to confirm today's numbers. Thanks Ryan From: "Yantis, Ryan" To: "Shay Drummond" Nirav "Erica L" "Lisa \(PR\)" "LENARD F" "CATHY S" Melaney CC: "DIEHL, GWEN G" "SAWYER, HARRY H" "McGill, Patricia O" Date: 8/29/2015 9:28:08 AM Subject: Re: Press Release Commentary Attachments: Legionella TP QA 2015-08-29 1015 AM.docx All Please find attached the current Talking Points and Q&A (Legionella TP QA 2015-08-29 1015 AM.docx​) for staffing. All changes have been highlighted. If there are changes offered, please also summarize in the message. There are some data points we need to update. I attempted to answer Shay's questions: What is being done? Is it safe for residents to return to home from hospital? I also updated the deaths question, but we need our 1130 update to confirm today's numbers. Thanks Ryan From: "Yantis, Ryan" To: WINNICKI "LENARD F" CC: "HOUSTON, CATHY S" "Jeffries, Erica L" "Arnold, Melaney" "Shay Drummond" Date: 8/29/2015 12:45:07 PM Subject: Re: WGEM Interview and Home Campus B-Roll ​Cathy is good to go when she's ready. I can call/email Chad to coordinate. We have confirmation from the Gov's Press Office on this interview as well, so that base is covered. Standing By Ryan From: WINNICKI, LENARD F. Sent: Saturday, August 29, 2015 1:22 PM To: Yantis, Ryan Cc: HOUSTON, CATHY S; Jeffries, Erica L Subject: Re: WGEM Interview and Home Campus B-Roll Cathy is gonna have a bite of lunch now and will be ready to go. I would like her to confirm when ready, though Len Winnicki, MSHS, LNHA Senior Nursing Home Administrator Illinois Department of Veteran Affairs One Veterans Drive Manteno, IL. 60950 Ph: (815) 468-6581 x210 Lenard.Winnicki@illinois.gov This e-mail and any attachments are intended solely for the person or entity to which addressed and may contain confidential information. Any copy or distribution of this information by person or entities other than the addressee is prohibited by law. If you have received this message in error, please contact the sender and delete this message along with any attachments. On Aug 29, 2015, at 12:58 PM, "Yantis, Ryan" wrote: ​Cathy & Len The camera will likely be from waist up, and more on face than on attire. I know this is a burden, but it's important. Again, happy to prep or talk either of you through it. Relax, be yourself, talk from knowledge, and BIFF (brief, informative, friendly, factual) Ryan From: HOUSTON, CATHY Sent: Saturday, August 29, 2015 12:55 PM To: Jeffries, Erica L; Yantis, Ryan; WINNICKI, LENARD F Subject: RE: WGEM Interview and Home Campus B-Roll I am in blue jeans. From: Jeffries, Erica L Sent: Saturday, August 29, 2015 12:49 PM To: HOUSTON, CATHY; Yantis, Ryan; WINNICKI, LENARD F. Subject: Fwd: WGEM Interview and Home Campus B-Roll Cathy, Would you be willing to do another interview? You'll be the biggest local celebrity Quincy has had in years! Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 Begin forwarded message: From: "Shah, Nirav" Date: August 29, 2015 at 12:37:33 CDT To: "Yantis, Ryan" , "Jeffries, Erica L" , "WINNICKI, LENARD F." , "HOUSTON, CATHY" , Shay Drummond , "Neisen, Lisa (PR)" , "Arnold, Melaney" Cc: "VACA, BRUCE" , "Ray, Jaimee M." Subject: Re: WGEM Interview and Home Campus B-Roll This is, of course, an IDVA decision. But Ryan, your analysis seems completely right to me. Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 IDPH_Logo1_blk_only <8583DF30-92C8-4590-83CE-4FE4BB4C51B6[13].png> From: , Ryan Date: Saturday, August 29, 2015 at 12:25 PM To: "Jeffries, Erica L" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" , Shay Drummond , "Neisen, Lisa (PR)" , "Arnold, Melaney" , Nirav Shah Cc: "VACA, BRUCE L" , "Ray, Jaimee M" Subject: WGEM Interview and Home Campus B-Roll ​All Per previous email, Chad Mahoney, WGEM TV remains interested in an on-camera, on-IVH-Q grounds interview with someone from the Home, or IDVA. My instinct says yes - give the interview. We are working to a solution and have nothing to hide. We have great working relationship with are partners on this - IDPH, ACDH, Blessing, others - and they are offering knowledge, skills, and abilities to help the Home meet this challenge. Saying no to an interview can undermine public support (which has been neutral-positive so far) and create the impression we have something to hide. He also asked to visit the home to get b-roll... I approved that. As with the previous, I am happy to help/standing by for a prep session on a call with a selects spokesperson at Quincy. Thanks - Ryan From: "Yantis, Ryan" To: HOUSTON "CATHY S" "LENARD F" CC: "Jeffries, Erica L" "Arnold, Melaney" "Shay Drummond" Date: 8/29/2015 12:57:53 PM Subject: Re: WGEM Interview and Home Campus B-Roll ​OK - WGEM Shavon Anderson, 20 minutes or so, meet at the Admin Building. ​Shavon was the young lady who interviewed Cathy the other night. From: HOUSTON, CATHY Sent: Saturday, August 29, 2015 1:52 PM To: Yantis, Ryan; WINNICKI, LENARD F Cc: Jeffries, Erica L; Arnold, Melaney; Shay Drummond Subject: RE: WGEM Interview and Home Campus B-Roll Whenever. I am here for the day. From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Saturday, August 29, 2015 1:45 PM To: WINNICKI, LENARD F. Cc: HOUSTON, CATHY; Jeffries, Erica L; Arnold, Melaney; Shay Drummond Subject: Re: WGEM Interview and Home Campus B-Roll ​Cathy is good to go when she's ready. I can call/email Chad to coordinate. We have confirmation from the Gov's Press Office on this interview as well, so that base is covered. Standing By Ryan From: WINNICKI, LENARD F. Sent: Saturday, August 29, 2015 1:22 PM To: Yantis, Ryan Cc: HOUSTON, CATHY S; Jeffries, Erica L Subject: Re: WGEM Interview and Home Campus B-Roll Cathy is gonna have a bite of lunch now and will be ready to go. I would like her to confirm when ready, though Len Winnicki, MSHS, LNHA Senior Nursing Home Administrator Illinois Department of Veteran Affairs One Veterans Drive Manteno, IL. 60950 Ph: (815) 468-6581 x210 Lenard.Winnicki@illinois.gov This e-mail and any attachments are intended solely for the person or entity to which addressed and may contain confidential information. Any copy or distribution of this information by person or entities other than the addressee is prohibited by law. If you have received this message in error, please contact the sender and delete this message along with any attachments. On Aug 29, 2015, at 12:58 PM, "Yantis, Ryan" wrote: ​Cathy & Len The camera will likely be from waist up, and more on face than on attire. I know this is a burden, but it's important. Again, happy to prep or talk either of you through it. Relax, be yourself, talk from knowledge, and BIFF (brief, informative, friendly, factual) Ryan From: HOUSTON, CATHY Sent: Saturday, August 29, 2015 12:55 PM To: Jeffries, Erica L; Yantis, Ryan; WINNICKI, LENARD F Subject: RE: WGEM Interview and Home Campus B-Roll I am in blue jeans. From: Jeffries, Erica L Sent: Saturday, August 29, 2015 12:49 PM To: HOUSTON, CATHY; Yantis, Ryan; WINNICKI, LENARD F. Subject: Fwd: WGEM Interview and Home Campus B-Roll Cathy, Would you be willing to do another interview? You'll be the biggest local celebrity Quincy has had in years! Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 Begin forwarded message: From: "Shah, Nirav" Date: August 29, 2015 at 12:37:33 CDT To: "Yantis, Ryan" , "Jeffries, Erica L" , "WINNICKI, LENARD F." , "HOUSTON, CATHY" , Shay Drummond , "Neisen, Lisa (PR)" , "Arnold, Melaney" Cc: "VACA, BRUCE" , "Ray, Jaimee M." Subject: Re: WGEM Interview and Home Campus B-Roll This is, of course, an IDVA decision. But Ryan, your analysis seems completely right to me. Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 IDPH_Logo1_blk_only <8583DF30-92C8-4590-83CE-4FE4BB4C51B6[13].png> From: , Ryan Date: Saturday, August 29, 2015 at 12:25 PM To: "Jeffries, Erica L" , "WINNICKI, LENARD F" , "HOUSTON, CATHY S" , Shay Drummond , "Neisen, Lisa (PR)" , "Arnold, Melaney" , Nirav Shah Cc: "VACA, BRUCE L" , "Ray, Jaimee M" Subject: WGEM Interview and Home Campus B-Roll ​ ll A Per previous email, Chad Mahoney, WGEM TV remains interested in an on-camera, on-IVH-Q grounds interview with someone from the Home, or IDVA. My instinct says yes - give the interview. We are working to a solution and have nothing to hide. We have great working relationship with are partners on this - IDPH, ACDH, Blessing, others - and they are offering knowledge, skills, and abilities to help the Home meet this challenge. Saying no to an interview can undermine public support (which has been neutral-positive so far) and create the impression we have something to hide. He also asked to visit the home to get b-roll... I approved that. As with the previous, I am happy to help/standing by for a prep session on a call with a selects spokesperson at Quincy. Thanks - Ryan From: "HOUSTON, CATHY" To: "Shay Drummond" "LENARD F." CC: Date: 8/30/2015 10:30:16 AM Subject: Legionella Tracking Log - 8-30-15 1100.xlsx Attachments: Legionella Tracking Log - 8-30-15 1100.xlsx UPDATED today From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/30/2015 3:11:05 PM Subject: Legionella Tracking Log - 8-30-15 1600.xlsx Attachments: Legionella Tracking Log - 8-30-15 1600.xlsx From: "Jeffries, Erica L" To: "Shay Drummond" CC: "Yantis, Ryan" "Shah, Nirav" "HOUSTON, CATHY" "WINNICKI, LENARD F." "VACA, BRUCE" "Ray, Jaimee M." "Arnold, Melaney" "Neisen, Lisa \(PR\)" Date: 8/30/2015 7:53:59 AM Subject: Re: QHW: Residents, family laud Illinois Vets Home staff asLegionnaires's disease cases climb This is great news to start the day. Thanks for sharing, Ryan. I've decided to head down to Quincy this morning. I should be there by 3pm. Just coming to offer support. I'll see you soon. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 30, 2015, at 08:39, Shay Drummond wrote: Opening my paper this morning was a bright spot- the reporters have all been talking community collaboration - which is how we play in our community. Our talking points are very helpful, I will be sending updates soon. Shay Sent from my iPhone On Aug 30, 2015, at 8:21 AM, Yantis, Ryan wrote: FYSA - coverage like this does not get much better. Talking points and responsiveness to the reporter help shape the story. Team effort. Residents, family laud Illinois Vets Home staff as Legionnaires's disease cases climb Posted: Aug 29, 2015 9:04 PM CDTUpdated: Aug 29, 2015 10:59 PM CDT Illinois Veterans Home resident Godfrey Rezba, left, sits with family members, from left, daughter Anteaus Rezba, great-granddaughter Audrey Booth, granddaughter Ashley Booth and stepdaughter Cindy Rezba on Saturday at the Ilinois Vets Home. H-W Photo Most Popular Stories Louisiana teenager killed in pickup truck crash Hancock County teen gets chance to make music video through Make-A-Wish Residents, family laud Illinois Vets Home staff as Legionnaires's disease cases climb 'Our community deserves better': Quincy police chief urges city to increase department's manpower Two confirmed dead from Legionnaires' disease outbreak at Illinois Veterans Home Keokuk woman killed near Wayland, Mo., after car strikes tree By MATT HOPF Staff Writer 217-221-3391 mhopf@whig.com @MHopfWHIG QUINCY -- Antreaus Rezba received a call Wednesday from officials at the Illinois Veterans Home to let her know that some residents were diagnosed with Legionnaires' disease. Rezba, who lives in Pennsylvania, had made plans earlier to travel to Quincy to see her father, Godfrey Rezba, and is not concerned about his care. She lauded the staff for their work in caring for her father as she and other members of the family visited with him Saturday outside Elmore Infirmary. "They have tons of extra work because they're monitoring everybody," she said. "They have their regular duties of taking care of everybody plus the extra stuff. I think their handling the level of stress really well." Officials with the Veterans Home say 28 residents have tested positive for Legionnaires' disease, including the two residents who died Friday. That's an increase of five from what they reported Friday. "Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires' disease and are making sure residents receive prompt medical attention if needed," spokesman Ryan Yantis said. Yantis said all residents presenting any symptoms of Legionnaires' disease will be treated as if they have it until lab results confirm they are negative for the bacteria. The disease is a severe form of pneumonia that can be fatal in 5 to 30 percent of the people who contract it. People 50 and older are more susceptible to it, especially who smoke, have a suppressed immune system, or suffer from chronic lung disease. Most cases of the disease are traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers and evaporative condensers of large air-conditioning units. The bacteria can be contracted only by inhaling contaminated water vapor. Resident Tom Meleski said there have been only minor inconveniences for him since the cases were discovered. "When you're a Vietnam veteran and you're used to living off the field, you get used to it," Meleski said. "They're taking every precaution for our safety and our well- being. It just requires a little more patience than you regularly have." Staff and residents are using bottled and container water for all water sources, and all decorative and drinking fountains have also been deactivated. "We have plenty of wipes for bathing and for hygiene, and bottled water," Meleski said. "The nurses and the staff have been right on top of things here." Environmental health and infectious disease staff continue to investigate possible sources of the Legionella bacteria. Yantis said the Veterans Home has established a remediation plan, including: º Cleaning hot water tanks º Cleaning the cooling tower, which was finished Friday. º Using bottled water for residents and staff. º Prepping a temporary chiller so the facility chiller could be certified by outside experts?. º Certifying the facility chiller by outside experts. º Keeping fountains and other potential sources of aerosolized water turned off. º Removing possible and suspected Legionella-infected systems and devices from use until they can be specially treated and tested before use. º Working with the Illinois Department of Public Health and other experts to clean and certify systems. LEGIONELLA BACTERIA FACTS º Legionella bacteria can cause Legionnaires' disease or Pontiac fever, collectively known as legionellosis. º The bacterium was named after an outbreak in 1976, when many people who went to a Philadelphia convention of the American Legion suffered came down with the disease. º An estimated 8,000 to 18,000 people are hospitalized with Legionnaires' disease each year in the United States. º Legionella bacteria are found naturally in the environment, usually in warm water. º Legionella bacteria are not transmitted from person to person. º People get Legionnaires' disease or Pontiac fever when they breathe in a mist or vapor that has been contaminated with Legionella bacteria. º Keeping Legionella bacteria out of water is the key to preventing infection. º Most people with Legionnaires' disease will have pneumonia (lung infection) since the Legionella bacteria grow and thrive in the lungs. Source: US. Centers for Disease Control and Prevention From: "Jeffries, Erica L" To: Neisen "Lisa \(PR\)" CC: "Yantis, Ryan" "Shay Drummond" "Kuida, Elliot" "Hendrickson, Emily" "Barthel, Mary" "Shah, Nirav" "WINNICKI, LENARD F." "HOUSTON, CATHY" "VACA, BRUCE" "Arnold, Melaney" Date: 8/30/2015 6:59:30 PM Subject: Re: Updated press release Good statement, Ryan. I agree with every word. Lisa, please let us know if you find anything that substantiates this claim. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 30, 2015, at 19:57, Neisen, Lisa (PR) wrote: Hi RyanSince we don't have any contact information to follow-up directly with the Iowa media outlet, we would like this statement to be included in the next press release update to emphasis community collaboration..."Blessing Hospital and their team of professional caregivers have been a key part of the team effort with the Illinois Veterans' Home - Quincy staff since this situation began. We have heard very complimentary comments from residents and their concerned family members once they return from Blessing to the Home." Hopefully this will help clarify matters. In the meantime, I'm goggling Iowa City media outlets searching for any comments about Blessing refusing to treat patients, etc. If I find, I will call the source to provide the correct information. Thanks for all your help, Lisa K. Neisen Director, Public Relations & Comm. Blessing Hospital, 1135 Broadway Quincy, IL 62305 (217) 223-8400, ext. 4190 Lisa.neisen@blessinghealthsystem.org -----Original Message----From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Sunday, August 30, 2015 6:48 PM To: Shay Drummond; Neisen, Lisa (PR) Cc: Jeffries, Erica L; Shah, Nirav; WINNICKI, LENARD F; HOUSTON, CATHY S; VACA, BRUCE L; Arnold, Melaney Subject: Re: Updated press release I'd say this is in Blessing's court to respond, DRAFT IDVA-IVH-Q COMMENT, SHOULD IOWA MEDIA QUERY: "We know of no situation where they have refused a resident from the Home seeking treatment for acute medical need since this situation began. Blessing Hospital and their team of professional caregivers have been a key part of the team effort with the Illinois Veterans' Home - Quincy staff since this situation began. We have heard very complimentary comments from residents and their concerned family members once they return from Blessing to the Home." ________________________________________ From: Shay Drummond Sent: Sunday, August 30, 2015 6:26 PM To: Yantis, Ryan Cc: Jeffries, Erica L; Shah, Nirav; WINNICKI, LENARD F; HOUSTON, CATHY S; VACA, BRUCE L; Arnold, Melaney Subject: Re: Updated press release Hi everybody I just received a call from Blessing Hospital their on duty administrator just received a call from a media outlet in Iowa City and they were wanting to do an interview on the topic of Blessing refusing to take patients from the veterans home and the legionnaires outbreak. The oncall administrator is letting Lisa Neisen their PIO know of the request and the on-call administrator refused to give any sort of statement. I am supposed to have a conference call with Blessing Hospital at 9:30 in the morning for status updates. Please give me your recommendations on how we need to proceed with this. Thank you. Shay Sent from my iPhone On Aug 30, 2015, at 2:26 PM, Yantis, Ryan wrote: Of course, I'll defer to the operational decision-makers, but I think we pass on a press release today. I think if we remain responsive and talk to media (background/educate) and also provide suitable on-the-record faces for interviews, that will go far to keep this as a local/regional story. Open, factual, transparent, and sincere communication goes a long way in a situation such as this. I'd hold off on a press release pending a major development (confirmation and remediation of source/ multiple deaths, etc.). Same for press conference. The real key in this is keeping IVH-Q staff, residents and families informed and engaged. They, and the strong team approach (IDPHACDH-IDVA-BH-IVHQ) to this has been our saving grace. We need to ask the CDC to be part of the team. Ryan ________________________________________ From: Shay Drummond Sent: Sunday, August 30, 2015 2:05 PM To: Yantis, Ryan Subject: Updated press release Hi Ryan will you be sending out an updated press release to us all today? Thanks! Sent from my iPhone The information contained in this e-mail message is PRIVILEGED AND CONFIDENTIAL and is intended for the use of the addressee and no one else. If you are not the intended recipient, please do not read, distribute, reproduce or use this e-mail message (or the attachments). Please delete the original and notify the sender of the mistaken transmission. Thank you. From: "Shah, Nirav" To: Yantis Ryan CC: "Jeffries, Erica L" "Shay Drummond" "HOUSTON, CATHY S" "WINNICKI, LENARD F" "VACA, BRUCE L" "Ray, Jaimee M" "Arnold, Melaney" "Neisen, Lisa \(PR\)" "Gentry-Wiseman, Michelle" Date: 8/30/2015 7:27:18 AM Subject: Re: QHW: Residents, family laud Illinois Vets Home staffas Legionnaires's disease cases climb Great story. Helps rebut the FB message we saw yesterday. Thank you! -Nirav On Aug 30, 2015, at 8:21 AM, Yantis, Ryan wrote: FYSA - coverage like this does not get much better. Talking points and responsiveness to the reporter help shape the story. Team effort. Residents, family laud Illinois Vets Home staff as Legionnaires's disease cases climb Posted: Aug 29, 2015 9:04 PM CDTUpdated: Aug 29, 2015 10:59 PM CDT Illinois Veterans Home resident Godfrey Rezba, left, sits with family members, from left, daughter Anteaus Rezba, great-granddaughter Audrey Booth, granddaughter Ashley Booth and stepdaughter Cindy Rezba on Saturday at the Ilinois Vets Home. H-W Photo Most Popular Stories Louisiana teenager killed in pickup truck crash Hancock County teen gets chance to make music video through Make-A-Wish Residents, family laud Illinois Vets Home staff as Legionnaires's disease cases climb 'Our community deserves better': Quincy police chief urges city to increase department's manpower Two confirmed dead from Legionnaires' disease outbreak at Illinois Veterans Home Keokuk woman killed near Wayland, Mo., after car strikes tree By MATT HOPF Staff Writer 217-221-3391 mhopf@whig.com @MHopfWHIG QUINCY -- Antreaus Rezba received a call Wednesday from officials at the Illinois Veterans Home to let her know that some residents were diagnosed with Legionnaires' disease. Rezba, who lives in Pennsylvania, had made plans earlier to travel to Quincy to see her father, Godfrey Rezba, and is not concerned about his care. She lauded the staff for their work in caring for her father as she and other members of the family visited with him Saturday outside Elmore Infirmary. "They have tons of extra work because they're monitoring everybody," she said. "They have their regular duties of taking care of everybody plus the extra stuff. I think their handling the level of stress really well." Officials with the Veterans Home say 28 residents have tested positive for Legionnaires' disease, including the two residents who died Friday. That's an increase of five from what they reported Friday. "Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires' disease and are making sure residents receive prompt medical attention if needed," spokesman Ryan Yantis said. Yantis said all residents presenting any symptoms of Legionnaires' disease will be treated as if they have it until lab results confirm they are negative for the bacteria. The disease is a severe form of pneumonia that can be fatal in 5 to 30 percent of the people who contract it. People 50 and older are more susceptible to it, especially who smoke, have a suppressed immune system, or suffer from chronic lung disease. Most cases of the disease are traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers and evaporative condensers of large air-conditioning units. The bacteria can be contracted only by inhaling contaminated water vapor. Resident Tom Meleski said there have been only minor inconveniences for him since the cases were discovered. "When you're a Vietnam veteran and you're used to living off the field, you get used to it," Meleski said. "They're taking every precaution for our safety and our wellbeing. It just requires a little more patience than you regularly have." Staff and residents are using bottled and container water for all water sources, and all decorative and drinking fountains have also been deactivated. "We have plenty of wipes for bathing and for hygiene, and bottled water," Meleski said. "The nurses and the staff have been right on top of things here." Environmental health and infectious disease staff continue to investigate possible sources of the Legionella bacteria. Yantis said the Veterans Home has established a remediation plan, including: є Cleaning hot water tanks є Cleaning the cooling tower, which was finished Friday. є Using bottled water for residents and staff. є Prepping a temporary chiller so the facility chiller could be certified by outside experts?. є Certifying the facility chiller by outside experts. є Keeping fountains and other potential sources of aerosolized water turned off. є Removing possible and suspected Legionella-infected systems and devices from use until they can be specially treated and tested before use. є Working with the Illinois Department of Public Health and other experts to clean and certify systems. LEGIONELLA BACTERIA FACTS є Legionella bacteria can cause Legionnaires' disease or Pontiac fever, collectively known as legionellosis. є The bacterium was named after an outbreak in 1976, when many people who went to a Philadelphia convention of the American Legion suffered came down with the disease. є An estimated 8,000 to 18,000 people are hospitalized with Legionnaires' disease each year in the United States. є Legionella bacteria are found naturally in the environment, usually in warm water. є Legionella bacteria are not transmitted from person to person. є People get Legionnaires' disease or Pontiac fever when they breathe in a mist or vapor that has been contaminated with Legionella bacteria. є Keeping Legionella bacteria out of water is the key to preventing infection. є Most people with Legionnaires' disease will have pneumonia (lung infection) since the Legionella bacteria grow and thrive in the lungs. Source: U.S. Centers for Disease Control and Prevention From: "Shah, Nirav" To: Yantis "Ryan ;Shay Drummond" "Lisa \(PR\)" CC: "Jeffries, Erica L" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "VACA, BRUCE L" "Arnold, Melaney" Date: 8/30/2015 6:12:19 PM Subject: Re: Updated press release Yes, I think that¹s right. _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 On 8/30/15, 6:48 PM, "Yantis, Ryan" wrote: > > >I'd say this is in Blessing's court to respond, DRAFT IDVA-IVH-Q COMMENT, >SHOULD IOWA MEDIA QUERY: > >"We know of no situation where they have refused a resident from the Home >seeking treatment for acute medical need since this situation began. > >Blessing Hospital and their team of professional caregivers have been a >key part of the team effort with the Illinois Veterans' Home - Quincy >staff since this situation began. > >We have heard very complimentary comments from residents and their >concerned family members once they return from Blessing to the Home." >________________________________________ >From: Shay Drummond >Sent: Sunday, August 30, 2015 6:26 PM >To: Yantis, Ryan >Cc: Jeffries, Erica L; Shah, Nirav; WINNICKI, LENARD F; HOUSTON, CATHY S; >VACA, BRUCE L; Arnold, Melaney >Subject: Re: Updated press release > >Hi everybody I just received a call from Blessing Hospital their on duty >administrator just received a call from a media outlet in Iowa City and >they were wanting to do an interview on the topic of Blessing refusing to >take patients from the veterans home and the legionnaires outbreak. The >on-call administrator is letting Lisa Neisen their PIO know of the >request and the on-call administrator refused to give any sort of >statement. >I am supposed to have a conference call with Blessing Hospital at 9:30 in >the morning for status updates. Please give me your recommendations on >how we need to proceed with this. Thank you. >Shay >Sent from my iPhone > >> On Aug 30, 2015, at 2:26 PM, Yantis, Ryan >>wrote: >> >> Of course, I'll defer to the operational decision-makers, but I think >>we pass on a press release today. >> >> I think if we remain responsive and talk to media (background/educate) >>and also provide suitable on-the-record faces for interviews, that will >>go far to keep this as a local/regional story. Open, factual, >>transparent, and sincere communication goes a long way in a situation >>such as this. >> >> I'd hold off on a press release pending a major development >>(confirmation and remediation of source/ multiple deaths, etc.). Same >>for press conference. >> >> The real key in this is keeping IVH-Q staff, residents and families >>informed and engaged. They, and the strong team approach >>(IDPH-ACDH-IDVA-BH-IVHQ) to this has been our saving grace. We need to >>ask the CDC to be part of the team. >> >> Ryan >> ________________________________________ >> From: Shay Drummond >> Sent: Sunday, August 30, 2015 2:05 PM >> To: Yantis, Ryan >> Subject: Updated press release >> >> Hi Ryan will you be sending out an updated press release to us all >>today? Thanks! >> >> Sent from my iPhone From: "Shah, Nirav" To: "Shay Drummond" Ryan CC: "Jeffries, Erica L" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "VACA, BRUCE L" "Arnold, Melaney" Date: 8/30/2015 5:46:47 PM Subject: Re: Updated press release Thanks, Shay. Is the angle there true? That is, is it the case that Blessing is refusing in any way to accept patients from the Home? If so, that¹s the first I¹ve heard of it. Nirav _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 On 8/30/15, 6:26 PM, "Shay Drummond" wrote: >Hi everybody I just received a call from Blessing Hospital their on duty >administrator just received a call from a media outlet in Iowa City and >they were wanting to do an interview on the topic of Blessing refusing to >take patients from the veterans home and the legionnaires outbreak. The >on-call administrator is letting Lisa Neisen their PIO know of the >request and the on-call administrator refused to give any sort of >statement. >I am supposed to have a conference call with Blessing Hospital at 9:30 in >the morning for status updates. Please give me your recommendations on >how we need to proceed with this. Thank you. >Shay >Sent from my iPhone > >> On Aug 30, 2015, at 2:26 PM, Yantis, Ryan >>wrote: >> >> Of course, I'll defer to the operational decision-makers, but I think >>we pass on a press release today. >> >> I think if we remain responsive and talk to media (background/educate) >>and also provide suitable on-the-record faces for interviews, that will >>go far to keep this as a local/regional story. Open, factual, >>transparent, and sincere communication goes a long way in a situation >>such as this. >> >> I'd hold off on a press release pending a major development >>(confirmation and remediation of source/ multiple deaths, etc.). Same >>for press conference. >> >> The real key in this is keeping IVH-Q staff, residents and families >>informed and engaged. They, and the strong team approach >>(IDPH-ACDH-IDVA-BH-IVHQ) to this has been our saving grace. We need to >>ask the CDC to be part of the team. >> >> Ryan >> ________________________________________ >> From: Shay Drummond >> Sent: Sunday, August 30, 2015 2:05 PM >> To: Yantis, Ryan >> Subject: Updated press release >> >> Hi Ryan will you be sending out an updated press release to us all >>today? Thanks! >> >> Sent from my iPhone From: "Shay Drummond" To: Austin "Connie <" "\(Connie.Austin@Illinois.gov\);>" "Fred \(Fred.Echols@Illinois.gov\);" CC: Date: 8/30/2015 10:38:31 AM Subject: Copy of Legionella Tracking Log - 8-30-15 1100.xlsx Attachments: Copy of Legionella Tracking Log - 8-30-15 1100.xlsx Updated line list from IVH 8-30-15. Connie same PW as the other spreadsheet. Couple of mentions on this – I see one has been transferred to ICVAH –Iowa City VA Hospital Also the death of unknown etiology – that resident will be autopsied but was not being treated nor had presented for any signs and symptoms. Thanks, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Yantis Ryan CC: "Shah, Nirav" "Jeffries, Erica L" "HOUSTON, CATHY S" "WINNICKI, LENARD F" "VACA, BRUCE L" "Ray, Jaimee M" "Arnold, Melaney" "Neisen, Lisa \(PR\)" Date: 8/30/2015 7:39:14 AM Subject: Re: QHW: Residents, family laud Illinois Vets Home staff asLegionnaires's disease cases climb Opening my paper this morning was a bright spot- the reporters have all been talking community collaboration - which is how we play in our community. Our talking points are very helpful, I will be sending updates soon. Shay Sent from my iPhone On Aug 30, 2015, at 8:21 AM, Yantis, Ryan wrote: FYSA - coverage like this does not get much better. Talking points and responsiveness to the reporter help shape the story. Team effort. Residents, family laud Illinois Vets Home staff as Legionnaires's disease cases climb Posted: Aug 29, 2015 9:04 PM CDTUpdated: Aug 29, 2015 10:59 PM CDT Illinois Veterans Home resident Godfrey Rezba, left, sits with family members, from left, daughter Anteaus Rezba, great-granddaughter Audrey Booth, granddaughter Ashley Booth and stepdaughter Cindy Rezba on Saturday at the Ilinois Vets Home. H-W Photo Most Popular Stories Louisiana teenager killed in pickup truck crash Hancock County teen gets chance to make music video through Make-A-Wish Residents, family laud Illinois Vets Home staff as Legionnaires's disease cases climb 'Our community deserves better': Quincy police chief urges city to increase department's manpower Two confirmed dead from Legionnaires' disease outbreak at Illinois Veterans Home Keokuk woman killed near Wayland, Mo., after car strikes tree By MATT HOPF Staff Writer 217-221-3391 mhopf@whig.com @MHopfWHIG QUINCY -- Antreaus Rezba received a call Wednesday from officials at the Illinois Veterans Home to let her know that some residents were diagnosed with Legionnaires' disease. Rezba, who lives in Pennsylvania, had made plans earlier to travel to Quincy to see her father, Godfrey Rezba, and is not concerned about his care. She lauded the staff for their work in caring for her father as she and other members of the family visited with him Saturday outside Elmore Infirmary. "They have tons of extra work because they're monitoring everybody," she said. "They have their regular duties of taking care of everybody plus the extra stuff. I think their handling the level of stress really well." Officials with the Veterans Home say 28 residents have tested positive for Legionnaires' disease, including the two residents who died Friday. That's an increase of five from what they reported Friday. "Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires' disease and are making sure residents receive prompt medical attention if needed," spokesman Ryan Yantis said. Yantis said all residents presenting any symptoms of Legionnaires' disease will be treated as if they have it until lab results confirm they are negative for the bacteria. The disease is a severe form of pneumonia that can be fatal in 5 to 30 percent of the people who contract it. People 50 and older are more susceptible to it, especially who smoke, have a suppressed immune system, or suffer from chronic lung disease. Most cases of the disease are traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers and evaporative condensers of large air-conditioning units. The bacteria can be contracted only by inhaling contaminated water vapor. Resident Tom Meleski said there have been only minor inconveniences for him since the cases were discovered. "When you're a Vietnam veteran and you're used to living off the field, you get used to it," Meleski said. "They're taking every precaution for our safety and our wellbeing. It just requires a little more patience than you regularly have." Staff and residents are using bottled and container water for all water sources, and all decorative and drinking fountains have also been deactivated. "We have plenty of wipes for bathing and for hygiene, and bottled water," Meleski said. "The nurses and the staff have been right on top of things here." Environmental health and infectious disease staff continue to investigate possible sources of the Legionella bacteria. Yantis said the Veterans Home has established a remediation plan, including: º Cleaning hot water tanks º Cleaning the cooling tower, which was finished Friday. º Using bottled water for residents and staff. º Prepping a temporary chiller so the facility chiller could be certified by outside experts?. º Certifying the facility chiller by outside experts. º Keeping fountains and other potential sources of aerosolized water turned off. º Removing possible and suspected Legionella-infected systems and devices from use until they can be specially treated and tested before use. º Working with the Illinois Department of Public Health and other experts to clean and certify systems. LEGIONELLA BACTERIA FACTS º Legionella bacteria can cause Legionnaires' disease or Pontiac fever, collectively known as legionellosis. º The bacterium was named after an outbreak in 1976, when many people who went to a Philadelphia convention of the American Legion suffered came down with the disease. º An estimated 8,000 to 18,000 people are hospitalized with Legionnaires' disease each year in the United States. º Legionella bacteria are found naturally in the environment, usually in warm water. º Legionella bacteria are not transmitted from person to person. º People get Legionnaires' disease or Pontiac fever when they breathe in a mist or vapor that has been contaminated with Legionella bacteria. º Keeping Legionella bacteria out of water is the key to preventing infection. º Most people with Legionnaires' disease will have pneumonia (lung infection) since the Legionella bacteria grow and thrive in the lungs. Source: U.S. Centers for Disease Control and Prevention From: "Shay Drummond" To: Yantis Ryan CC: "Jeffries, Erica L" "Shah, Nirav" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "VACA, BRUCE L" "Arnold, Melaney" Date: 8/30/2015 5:26:37 PM Subject: Re: Updated press release Hi everybody I just received a call from Blessing Hospital their on duty administrator just received a call from a media outlet in Iowa City and they were wanting to do an interview on the topic of Blessing refusing to take patients from the veterans home and the legionnaires outbreak. The on-call administrator is letting Lisa Neisen their PIO know of the request and the on-call administrator refused to give any sort of statement. I am supposed to have a conference call with Blessing Hospital at 9:30 in the morning for status updates. Please give me your recommendations on how we need to proceed with this. Thank you. Shay Sent from my iPhone > On Aug 30, 2015, at 2:26 PM, Yantis, Ryan wrote: > > Of course, I'll defer to the operational decision-makers, but I think we pass on a press release today. > > I think if we remain responsive and talk to media (background/educate) and also provide suitable on-the-record faces for interviews, that will go far to keep this as a local/regional story. Open, factual, transparent, and sincere communication goes a long way in a situation such as this. > > I'd hold off on a press release pending a major development (confirmation and remediation of source/ multiple deaths, etc.). Same for press conference. > > The real key in this is keeping IVH-Q staff, residents and families informed and engaged. They, and the strong team approach (IDPH-ACDH-IDVA-BH-IVHQ) to this has been our saving grace. We need to ask the CDC to be part of the team. > > Ryan > ________________________________________ > From: Shay Drummond > Sent: Sunday, August 30, 2015 2:05 PM > To: Yantis, Ryan > Subject: Updated press release > > Hi Ryan will you be sending out an updated press release to us all today? Thanks! > > Sent from my iPhone From: "Yantis, Ryan" To: Shah Nirav "Erica L ;Shay Drummond" "CATHY S" "LENARD F" "BRUCE L" "Jaimee M" Melaney "Lisa \(PR\)" CC: Date: 8/30/2015 7:21:09 AM Subject: QHW: Residents, family laud Illinois Vets Home staff as Legionnaires'sdisease cases climb FYSA - coverage like this does not get much better. Talking points and responsiveness to the reporter help shape the story. Team effort. Residents, family laud Illinois Vets Home staff as Legionnaires's disease cases climb Posted: Aug 29, 2015 9:04 PM CDTUpdated: Aug 29, 2015 10:59 PM CDT By MATT HOPF Staff Writer 217-221-3391 mhopf@whig.com @MHopfWHIG QUINCY -- Antreaus Rezba received a call Wednesday from officials at the Illinois Veterans Home to let her know that some residents were diagnosed with Legionnaires' disease. Rezba, who lives in Pennsylvania, had made plans earlier to travel to Quincy to see her father, Godfrey Rezba, and is not concerned about his care. She lauded the staff for their work in caring for her father as she and other members of the family visited with him Saturday outside Illinois Veterans Home resident Godfrey Rezba, left, sits with family members, from left, daughter Anteaus Rezba, great-granddaughter Audrey Booth, granddaughter Ashley Booth and stepdaughter Cindy Rezba members of the family visited with him Saturday outside Elmore Infirmary. "They have tons of extra work because they're monitoring everybody," she said. "They have their regular duties of taking care of everybody plus the extra stuff. I think their handling the level of stress really well." Officials with the Veterans Home say 28 residents have tested positive for Legionnaires' disease, including the two residents who died Friday. That's an increase of five from what they reported Friday. "Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires' disease and are making sure residents receive prompt medical attention if needed," spokesman Ryan Yantis said. on Saturday at the Ilinois Vets Home. H-W Photo Most Popular Stories Louisiana teenager killed in pickup truck crash Hancock County teen gets chance to make music video through Make-A-Wish Residents, family laud Illinois Vets Home staff as Legionnaires's disease cases climb 'Our community deserves better': Quincy police chief urges city to increase department's manpower Two confirmed dead from Legionnaires' disease outbreak at Illinois Veterans Home Keokuk woman killed near Wayland, Mo., after car strikes tree Yantis said all residents presenting any symptoms of Legionnaires' disease will be treated as if they have it until lab results confirm they are negative for the bacteria. The disease is a severe form of pneumonia that can be fatal in 5 to 30 percent of the people who contract it. People 50 and older are more susceptible to it, especially who smoke, have a suppressed immune system, or suffer from chronic lung disease. Most cases of the disease are traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers and evaporative condensers of large air-conditioning units. The bacteria can be contracted only by inhaling contaminated water vapor. Resident Tom Meleski said there have been only minor inconveniences for him since the cases were discovered. "When you're a Vietnam veteran and you're used to living off the field, you get used to it," Meleski said. "They're taking every precaution for our safety and our wellbeing. It just requires a little more patience than you regularly have." Staff and residents are using bottled and container water for all water sources, and all decorative and drinking fountains have also been deactivated. "We have plenty of wipes for bathing and for hygiene, and bottled water," Meleski said. "The nurses and the staff have been right on top of things here." Environmental health and infectious disease staff continue to investigate possible sources of the Legionella bacteria. Yantis said the Veterans Home has established a remediation plan, including: º Cleaning hot water tanks º Cleaning the cooling tower, which was finished Friday. º Using bottled water for residents and staff. º Prepping a temporary chiller so the facility chiller could be certified by outside experts?. º Certifying the facility chiller by outside experts. º Keeping fountains and other potential sources of aerosolized water turned off. º Removing possible and suspected Legionella-infected systems and devices from use until they can be specially treated and tested before use. º Working with the Illinois Department of Public Health and other experts to clean and certify systems. LEGIONELLA BACTERIA FACTS º Legionella bacteria can cause Legionnaires' disease or Pontiac fever, collectively known as legionellosis. º The bacterium was named after an outbreak in 1976, when many people who went to a Philadelphia convention of the American Legion suffered came down with the disease. º An estimated 8,000 to 18,000 people are hospitalized with Legionnaires' disease each year in the United States. º Legionella bacteria are found naturally in the environment, usually in warm water. º Legionella bacteria are not transmitted from person to person. º People get Legionnaires' disease or Pontiac fever when they breathe in a mist or vapor that has been contaminated with Legionella bacteria. º Keeping Legionella bacteria out of water is the key to preventing infection. º Most people with Legionnaires' disease will have pneumonia (lung infection) since the Legionella bacteria grow and thrive in the lungs. Source: U.S. Centers for Disease Control and Prevention From: "Yantis, Ryan" To: "Shay Drummond" "Lisa \(PR\)" CC: "Jeffries, Erica L" "Shah, Nirav" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "VACA, BRUCE L" "Arnold, Melaney" Date: 8/30/2015 5:48:07 PM Subject: Re: Updated press release I'd say this is in Blessing's court to respond, DRAFT IDVA-IVH-Q COMMENT, SHOULD IOWA MEDIA QUERY: "We know of no situation where they have refused a resident from the Home seeking treatment for acute medical need since this situation began. Blessing Hospital and their team of professional caregivers have been a key part of the team effort with the Illinois Veterans' Home - Quincy staff since this situation began. We have heard very complimentary comments from residents and their concerned family members once they return from Blessing to the Home." ________________________________________ From: Shay Drummond Sent: Sunday, August 30, 2015 6:26 PM To: Yantis, Ryan Cc: Jeffries, Erica L; Shah, Nirav; WINNICKI, LENARD F; HOUSTON, CATHY S; VACA, BRUCE L; Arnold, Melaney Subject: Re: Updated press release Hi everybody I just received a call from Blessing Hospital their on duty administrator just received a call from a media outlet in Iowa City and they were wanting to do an interview on the topic of Blessing refusing to take patients from the veterans home and the legionnaires outbreak. The on-call administrator is letting Lisa Neisen their PIO know of the request and the on-call administrator refused to give any sort of statement. I am supposed to have a conference call with Blessing Hospital at 9:30 in the morning for status updates. Please give me your recommendations on how we need to proceed with this. Thank you. Shay Sent from my iPhone > On Aug 30, 2015, at 2:26 PM, Yantis, Ryan wrote: > > Of course, I'll defer to the operational decision-makers, but I think we pass on a press release today. > > I think if we remain responsive and talk to media (background/educate) and also provide suitable on-the-record faces for interviews, that will go far to keep this as a local/regional story. Open, factual, transparent, and sincere communication goes a long way in a situation such as this. > > I'd hold off on a press release pending a major development (confirmation and remediation of source/ multiple deaths, etc.). Same for press conference. > > The real key in this is keeping IVH-Q staff, residents and families informed and engaged. They, and the strong team approach (IDPH-ACDH-IDVABH-IVHQ) to this has been our saving grace. We need to ask the CDC to be part of the team. > > Ryan > ________________________________________ > From: Shay Drummond > Sent: Sunday, August 30, 2015 2:05 PM > To: Yantis, Ryan > Subject: Updated press release > > Hi Ryan will you be sending out an updated press release to us all today? Thanks! > > Sent from my iPhone From: "Arnold, Melaney" To: Yantis "Ryan ;'Shay Drummond" CC: Date: 8/31/2015 9:50:47 AM Subject: cases Ryan ~ It looks like we’re at 29 cases, including 4 Legionnaires’ disease confirmed deaths. Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: "Arnold, Melaney" To: 'Albert "Alison P. \(CDC/OID/NCIRD\)" Ryan CC: "Shay Drummond" Date: 8/31/2015 4:17:23 PM Subject: RE: CDC Hi Alison ~ We are updating numbers on the IDPH website daily around noon. http://www.dph.illinois.gov/ From: Albert, Alison P. (CDC/OID/NCIRD) [mailto:aqp0@cdc.gov] Sent: Monday, August 31, 2015 4:51 PM To: Yantis, Ryan; Arnold, Melaney Cc: Shay Drummond Subject: RE: CDC Hi Ryan, Thanks so much for sending these along – they look great. Are you posting updated numbers on the website each day at noon or just updating this document? Best, Alison From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Monday, August 31, 2015 5:42 PM To: Arnold, Melaney ; Albert, Alison P. (CDC/OID/NCIRD) Cc: Shay Drummond Subject: RE: CDC Hi Alison – Looking forward to working with you. Please find attached our most recent set of Talking Points and Q&As. We update numbers daily at noon, and loop in Shay Drummond at Adams County Health. Ryan Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: Arnold, Melaney Sent: Monday, August 31, 2015 4:35 PM To: Yantis, Ryan Subject: CDC Alison P. Albert, MPH, CHES Health Communications Specialist, Division of Bacterial Diseases (DBD) National Center for Immunization and Respiratory Diseases (NCIRD) Centers for Disease Control and Prevention (CDC) o: 404-639-3604 bb: 404-428-6620 e-mail: apalbert@cdc.gov Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: "Arnold, Melaney" To: Echols "Fred ;;>" CC: "Austin, Connie" "Conover, Craig" "Shah, Nirav" "DeWitt, Justin" jwelch@co.adams.il.us Date: 8/31/2015 7:04:37 AM Subject: RE: Correction: August 30th Case Count Update Thank you. Sorry to bombard you with questions this morning, but I’m thinking about our media strategy. 1. How many confirmed community cases do we have? 2. Do we know how many cases of Legionnaires’ disease have been reported in Quincy/Adams County over the past 5-10 years? Is it possible Legionella bacteria is more common in this area? 3. Is there a way to know if doctors in the area are testing more for Legionnaires’ disease because of the IVH outbreak? From: Echols, Fred Sent: Monday, August 31, 2015 8:00 AM To: Arnold, Melaney; sdrummond@co.adams.il.us Cc: Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; jwelch@co.adams.il.us Subject: RE: Correction: August 30th Case Count Update We expect to receive the results today. I will let you know when we receive the information. -Fred PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Arnold, Melaney Sent: Monday, August 31, 2015 7:58 AM To: Echols, Fred; sdrummond@co.adams.il.us Cc: Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; jwelch@co.adams.il.us Subject: RE: Correction: August 30th Case Count Update When do you think we’ll have lab results for the 4 IVH death? From: Echols, Fred Sent: Sunday, August 30, 2015 12:26 PM To: sdrummond@co.adams.il.us; Arnold, Melaney Cc: Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; jwelch@co.adams.il.us Subject: Correction: August 30th Case Count Update Today’s corrected case count summary is provided below: · Total cases: 29 o 26 residents 1. Includes 3 deaths (3 laboratory confirmed cases; labs are pending for one of the residents that passed so they are not included in the total ) o 3 IVH staff This information has been relayed to Melaney. -Fred PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Sunday, August 30, 2015 11:19 AM To: Arnold, Melaney Cc: Echols, Fred; Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; Jerrod Welch Subject: RE: August 30th Update No labs are still pending on one. From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Sunday, August 30, 2015 11:12 AM To: Shay Drummond Cc: Echols, Fred; Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; Jerrod Welch Subject: Re: August 30th Update Are all 4 deaths in cases with confirmed LD? On Aug 30, 2015, at 10:51 AM, Shay Drummond wrote: Good morning, Here are my updates: No new labs returned due to the weekend – I anticipate Monday and Tuesday a large number of results back. We had one pass this morning – at IVH Overnight there were 2 admits to BH – One is in ICU and one is in ODU – both IVH residents 2 in ICU – one on vent – diminished over the evening but has since stabilized. 19 total in BH – (4 returned to home) Currently IVH is caring for 45 plus overnight they had 6 present with elevated temps and an additional 3 with low-grade temps – treating all. In addition: a resident of a cottage went to Jacksonville to visit her daughter and became ill and is in ICU in Jacksonville – IVH is working with the family and hospital to ensure lab work is being done. This is also the mother of another one of our hospitalized IVH residents. I have let BH know that there is potential at any given time to see more admits with the number that they are caring for. Also discussed lab capabilities so that they could notify LabCorp of the # of tests that will be rolling in over the weekend from IVH. BH stated that the ED was slow and they had bed capacity open up over the weekend. No report of increase of worried well or community members presenting to ED or walk in clinics. EH: Jeff Conte city Engineer is expecting IEPA in tomorrow at 9:30 am to do testing of City water and is also going to meet with IVH admin and engineer. Justin, let me know what time your team will be arriving so we can all coordinate conversations. I am anticipating a collaborative effort with all. I anticipate our numbers changing tomorrow as we get the labs back. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Arnold, Melaney" To: Echols "Fred ;sdrummond@co.adams.il.us;;Shah>" Nirav CC: "Austin, Connie" "Conover, Craig" "DeWitt, Justin" "Holmes, Tal" "Culp, David" "Albertson, Justin" "Clegg, Whitney" "Beron, Andrew" Date: 8/31/2015 9:41:33 AM Subject: RE: Legionellosis Outbreak & Cluster Case Count Update (8/31/2015) Confirming – all 4 deaths are indeed confirmed cases? Thanks From: Echols, Fred Sent: Monday, August 31, 2015 10:41 AM To: sdrummond@co.adams.il.us; A rnold, Melaney; jwelch@co.adams.il.us; Shah, Nirav Cc: A ustin, C onnie; C onover, Craig; DeWitt, Justin; Holmes, Tal; Culp, David; A lbertson, Justin; C legg, Whitney; Beron, A ndrew Subject: Legionellosis Outbreak & C luster Case Count Update (8/31/2015) To All, Today’s case count summary for the Legionellosis outbreak in Adams County is provided below: · IVH Outbreak o Case total: 29  26 residents · Includes 4 deaths of laboratory confirmed cases  3 IVH staff Please let me know if you have any questions or concerns. Thanks. Respectfully Yours, Fredrick L. Echols, MD Chief,Communicable Diseases Illinois Department of Public Health Phone: 217-782-2016 Fax: 217-524-0962 Email: Fred.Echols@Illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "Arnold, Melaney" To: "Shay Drummond" "Fred ;Jerrod Welch" Nirav CC: "Austin, Connie" "Conover, Craig" "DeWitt, Justin" "Holmes, Tal" "Culp, David" "Albertson, Justin" "Clegg, Whitney" "Beron, Andrew" Date: 8/31/2015 9:49:43 AM Subject: RE: Legionellosis Outbreak & Cluster Case Count Update (8/31/2015) Thank you. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 31, 2015 10:44 AM To: Arnold, Melaney; Echols, Fred; Jerrod Welch; Shah, Nirav Cc: Austin, Connie; Conover, Craig; DeWitt, Justin; Holmes, Tal; Culp, David; Albertson, Justin; Clegg, Whitney; Beron, Andrew Subject: RE: Legionellosis Outbreak & Cluster Case Count Update (8/31/2015) Yes, Melaney, confirmed and families are notified. Thanks, Shay From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Monday, August 31, 2015 10:42 AM To: Echols, Fred; Shay Drummond; Jerrod Welch; Shah, Nirav Cc: Austin, Connie; Conover, Craig; DeWitt, Justin; Holmes, Tal; Culp, David; Albertson, Justin; Clegg, Whitney; Beron, Andrew Subject: RE: Legionellosis Outbreak & Cluster Case Count Update (8/31/2015) Confirming – all 4 deaths are indeed confirmed cases? Thanks From: Echols, Fred Sent: Monday, August 31, 2015 10:41 AM To: sdrummond@co.adams.il.us; Arnold, Melaney; jwelch@co.adams.il.us; Shah, Nirav Cc: Austin, Connie; Conover, Craig; DeWitt, Justin; Holmes, Tal; Culp, David; Albertson, Justin; Clegg, Whitney; Beron, Andrew Subject: Legionellosis Outbreak & Cluster Case Count Update (8/31/2015) To All, Today’s case count summary for the Legionellosis outbreak in Adams County is provided below: · IVH Outbreak o Case total: 29  26 residents · Includes 4 deaths of laboratory confirmed cases  3 IVH staff Please let me know if you have any questions or concerns. Thanks. Respectfully Yours, Fredrick L. Echols, MD Chief,Communicable Diseases Illinois Department of Public Health Phone: 217-782-2016 Fax: 217-524-0962 Email: Fred.Echols@Illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "Arnold, Melaney" To: "Shay Drummond" Ryan CC: Date: 8/31/2015 1:01:51 PM Subject: RE: Media Questions My thoughts – I don’t want to appear that we’re withholding information, but I’m trying to temper our message. The following is what I have PROPOSED to IDPH staff, but has not been approved. What do you think of this media strategy? “Illinois has had more than 200 cases of Legionnaires’ disease each year over the past 3 years, so cases in communities do occur. Health offices will look at all confirmed cases of Legionnaires’ disease in Quincy to see if they are possibility related to the Illinois Veterans’ Home outbreak.” It may not be enough to say just that, but we could try. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 31, 2015 1:51 PM To: Arnold, Melaney; Yantis, Ryan Subject: Media Questions Importance: High KHQA had gotten a call from a Quincy person who’s father lives at is in hospital with a confirmed case. We need to formulate a message to address the community cases, as KHQA wants to run the family members story. Also when these labs come in shortly our counts are going to shift. We are also seeing many more staff presenting at walk-ins with symptoms that are being tested. Thanks…look forward to your update, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Arnold, Melaney" To: "Shay Drummond" Ryan CC: Date: 8/31/2015 2:22:55 PM Subject: RE: Media Questions IDPH director is fine with the proposed response: Illinois has had more than 200 cases of Legionnaires’ disease each year over the past 3 years, so cases in communities do occur. Health officials will look at all confirmed cases of Legionnaires’ disease in Quincy to see if they are possibility related to the Illinois Veterans’ Home outbreak. I have not received a call from KHQA. Thanks From: Arnold, Melaney Sent: Monday, August 31, 2015 2:02 PM To: 'Shay Drummond'; Yantis, Ryan Subject: RE: Media Questions My thoughts – I don’t want to appear that we’re withholding information, but I’m trying to temper our message. The following is what I have PROPOSED to IDPH staff, but has not been approved. What do you think of this media strategy? “Illinois has had more than 200 cases of Legionnaires’ disease each year over the past 3 years, so cases in communities do occur. Health offices will look at all confirmed cases of Legionnaires’ disease in Quincy to see if they are possibility related to the Illinois Veterans’ Home outbreak.” It may not be enough to say just that, but we could try. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 31, 2015 1:51 PM To: Arnold, Melaney; Yantis, Ryan Subject: Media Questions Importance: High KHQA had gotten a call from a Quincy person who’s father lives at is in hospital with a confirmed case. We need to formulate a message to address the community cases, as KHQA wants to run the family members story. Also when these labs come in shortly our counts are going to shift. We are also seeing many more staff presenting at walk-ins with symptoms that are being tested. Thanks…look forward to your update, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Arnold, Melaney" To: Yantis "Ryan ;'Shay Drummond" CC: "Shah, Nirav" "Jeffries, Erica L" Date: 8/31/2015 10:26:08 AM Subject: Talking points Attachments: Legionella TP QA 2015-08-31_1100 AM.docx Talking points for today, August 31, 2015. Ryan – not sure who you would like to distribute to at the home. Approved by IDPH communicable disease and Environmental Health. Brief mention of CDC based on information provided to me from CDC. Thanks Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: "Austin, Connie" To: Kutty "Preeta \(CDC/OID/NCIRD\)" CC: "Westercamp, Matthew \(CDC/OID/NCIRD\)" "Kunz, Jasen M. \(CDC/ONDIEH/NCEH\)" "Shay Drummond" "Jon Campos" jwelch@co.adams.il.us Date: 8/31/2015 7:18:49 PM Subject: .ppt Attachments: cdcs_Legionella_ppt_August312015.pptx Here is today’s powerpoint reflecting this mornings case count and a few maps. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: "Shay Drummond" CC: "Echols, Fred" Date: 8/31/2015 10:28:00 AM Subject: numbers Shay, Before we give the 11:15 am numbers can you make sure Cathy has the same numbers. Apparently she gives the Veterans Affairs folks different numbers. I think we decided on the call to have the information from Blessing and IVH come in to you and you send to us and then it goes to PIOs. I don’t think they need to get bogged down in one more or one less but if you can clarify with Cathy before reporting them maybe that will close the loop! Sorry for the minutiae. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Austin, Connie" To: Arnold Melaney "Fred ;;>" CC: "Conover, Craig" "Shah, Nirav" "DeWitt, Justin" jwelch@co.adams.il.us Date: 8/31/2015 12:17:09 PM Subject: RE: Correction: August 30th Case Count Update 4 community cases with no direct link to facility. We are mapping this and hope to have that done once Jon can provide the addresses of the community cases. Legionella cases-Adams county As you can see from the table there is not a lot of Legionellosis in Adams County in past years. Other years not listed from 2005-2015 are 0. The health care providers in the area have been provided with information about the outbreak and may indeed have increased testing for the disease. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Arnold, Melaney Sent: Monday, August 31, 2015 8:05 AM To: Echols, Fred; sdrummond@co.adams.il.us Cc: Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; jwelch@co.adams.il.us Subject: RE: Correction: August 30th Case Count Update Thank you. Sorry to bombard you with questions this morning, but I’m thinking about our media strategy. 1. How many confirmed community cases do we have? 2. Do we know how many cases of Legionnaires’ disease have been reported in Quincy/Adams County over the past 5-10 years? Is it possible Legionella bacteria is more common in this area? 3. Is there a way to know if doctors in the area are testing more for Legionnaires’ disease because of the IVH outbreak? From: Echols, Fred Sent: Monday, August 31, 2015 8:00 AM To: Arnold, Melaney; sdrummond@co.adams.il.us Cc: Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; jwelch@co.adams.il.us Subject: RE: Correction: August 30th Case Count Update We expect to receive the results today. I will let you know when we receive the information. -Fred PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Arnold, Melaney Sent: Monday, August 31, 2015 7:58 AM To: Echols, Fred; sdrummond@co.adams.il.us Cc: Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; jwelch@co.adams.il.us Subject: RE: Correction: August 30th Case Count Update When do you think we’ll have lab results for the 4 IVH death? From: Echols, Fred Sent: Sunday, August 30, 2015 12:26 PM To: sdrummond@co.adams.il.us; Arnold, Melaney Cc: Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; jwelch@co.adams.il.us Subject: Correction: August 30th Case Count Update Today’s corrected case count summary is provided below: · Total cases: 29 o 26 residents 1. Includes 3 deaths (3 laboratory confirmed cases; labs are pending for one of the residents that passed so they are not included in the total ) o 3 IVH staff This information has been relayed to Melaney. -Fred PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Sunday, August 30, 2015 11:19 AM To: Arnold, Melaney Cc: Echols, Fred; Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; Jerrod Welch Subject: RE: August 30th Update No labs are still pending on one. From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Sunday, August 30, 2015 11:12 AM To: Shay Drummond Cc: Echols, Fred; Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; Jerrod Welch Subject: Re: August 30th Update Are all 4 deaths in cases with confirmed LD? On Aug 30, 2015, at 10:51 AM, Shay Drummond wrote: Good morning, Here are my updates: No new labs returned due to the weekend – I anticipate Monday and Tuesday a large number of results back. We had one pass this morning – at IVH Overnight there were 2 admits to BH – One is in ICU and one is in ODU – both IVH residents 2 in ICU – one on vent – diminished over the evening but has since stabilized. 19 total in BH – (4 returned to home) Currently IVH is caring for 45 plus overnight they had 6 present with elevated temps and an additional 3 with low-grade temps – treating all. In addition: a resident of a cottage went to Jacksonville to visit her daughter and became ill and is in ICU in Jacksonville – IVH is working with the family and hospital to ensure lab work is being done. This is also the mother of another one of our hospitalized IVH residents. I have let BH know that there is potential at any given time to see more admits with the number that they are caring for. Also discussed lab capabilities so that they could notify LabCorp of the # of tests that will be rolling in over the weekend from IVH. BH stated that the ED was slow and they had bed capacity open up over the weekend. No report of increase of worried well or community members presenting to ED or walk in clinics. EH: Jeff Conte city Engineer is expecting IEPA in tomorrow at 9:30 am to do testing of City water and is also going to meet with IVH admin and engineer. Justin, let me know what time your team will be arriving so we can all coordinate conversations. I am anticipating a collaborative effort with all. I anticipate our numbers changing tomorrow as we get the labs back. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Echols, Fred" To: sdrummond@co.adams.il.us CC: "Austin, Connie" Date: 8/31/2015 2:33:38 PM Subject: A few quick questions Shay, Were you able to obtain the informational handouts the Veterans’ Affairs staff provided to the cottage residents? Has the LHD received any additional lab results today? Respectfully Yours, Fredrick L. Echols, MD Chief,Communicable Diseases Illinois Department of Public Health Phone: 217-782-2016 Fax: 217-524-0962 Email: Fred.Echols@Illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "Echols, Fred" To: ;Arnold "Melaney ;; Shah>" Nirav CC: "Austin, Connie" "Conover, Craig" "DeWitt, Justin" "Holmes, Tal" "Culp, David" "Albertson, Justin" "Clegg, Whitney" "Beron, Andrew" Date: 8/31/2015 9:40:39 AM S u b j e c t : Legionellosis Outbreak & Cluster Case Count Update (8/31/2015) To All, Today’s case count summary for the Legionellosis outbreak in Adams County is provided below: · IVH Outbreak o Case total: 29  26 residents · Includes 4 deaths of laboratory confirmed cases  3 IVH staff Please let me know if you have any questions or concerns. Thanks. Respectfully Yours, Fredrick L. Echols, MD Chief,Communicable Diseases Illinois Department of Public Health Phone: 217-782-2016 Fax: 217-524-0962 Email: Fred.Echols@Illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "Echols, Fred" To: ;Austin Connie Jodi CC: Date: 8/31/2015 5:15:56 PM Subject: RE: Copy of Legionella Tracking Log - 8-31-15 1500.xlsx Great! Thank you. We will be looking for them. -Fred PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 31, 2015 6:05 PM To: Echols, Fred; Austin, Connie; Morgan, Jodi Subject: FW: Copy of Legionella Tracking Log - 8-31-15 1500.xlsx This is from IVH – I have not checked it against mind, just forwarding to you. PW protected. I am also getting all of the UA tests from pre/48 hours – so we should be sending about 11-12 your way. From: Shay Drummond Sent: Monday, August 31, 2015 6:03 PM To: Shay Drummond Subject: Copy of Legionella Tracking Log - 8-31-15 1500.xlsx From: To: ;Austin . . . gm. . CC: Date: 8/31/2015 9:25:29 AM Subject: RE: numbers I?ll call you and we can walk through it together. -FRED NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond Sent: Monday, August 31, 2015 10:24 AM To: Echols, Fred; Austin, Connie Subject: RE: numbers Importance: High Hi I am trying to figure out howl have 27 on total ?can you help me clarify? have 27 residents and that includes the 4 deaths that are lab confirmed. have 3 NH with confirmed cases in addition to the 27. From: Echols, Fred Sent: Monday, August 31, 2015 10:03 AM To: Shay Drummond; Austin, Connie Subject: RE: numbers I have the following: 29 total cases 0 26 residents Including 3 deaths of laboratory confirmed cases One additional death has occurred but is not included in the current count because his lab results are pending- 3 NH staff There are 4 community cases that are not associated with the outbreak H611, PRI VYLE GED ONFIDEN TLALI NOT I This email transmission (and/or the documents accompanying such) may contain privileged/con?dential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond Sent: Monday, August 31, 2015 9:02 AM To: Echols, Fred; Austin, Connie Subject: numbers Here is what I have: 27 con?rmed NH Residents (I thinl- is included on your line list but his lab tests are still pending) 3 confirmed IVH Staff 3 confirmed deaths (these are included in the total case count) 1 pending death - waiting for labs Community cases: 4 confirmed Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Of?ce: 217-222-8440 x148 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and con?dential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: ;Austin CC: Date: 8/31/2015 9:02:32 AM Subject: RE: numbers I have the following: 29 total cases 0 26 residents Including 3 deaths of laboratory confirmed cases One additional death has occurred but is not included in the current count because his lab results are pending- 3 IVH staff There are 4 community cases that are not associated with the outbreak it NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/con?dential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking ofany action in reliance on the contents ofsuch information is strictly prohibited. Ifyou have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond Sent: Monday, August 31, 2015 9:02 A To: Echols, Fred; Austin, Connie Subject: numbers Here is what I have: 27 con?rmed IVH Residents (I think-is included on your line list but his lab tests are still pending) 3 con?rmed IVH Staff 3 con?rmed deaths (these are included in the total case count) 1 pending death - waiting for labs Community cases: 4 con?rmed Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 Cell: 217-316-2795 Publich CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and con?dential use of the designated recipients named above. The documents accompanying this transmission may conta'n con?dential health information that is legally privileged. The authorized rec?pient of this ?nformation is prohibited from disclosing this information to any other party unless requ?red to do so by law or regalations and is requied to destroy the information after its stated need has been fu?led. lithe reader of this message is not the ?ntended recipient. you are hereby noti?ed that you have received this document it error and that any review, dissem'nation, distriiution or copying of this message is strictly prohbied. lfyou have received this e?mail in error, please notity us and delete the orig?nd message. Tharit you. From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/31/2015 12:08:48 PM Subject: FW: FYI…..maybe you can get the official copy. From: DAUGHERTY, MICHELLE Sent: Monday, August 31, 2015 12:40 PM To: KELLEY, LINDSEY; HOUSTON, CATHY Cc: PERRINE, HOLLY Subject: She called to let me know that she had gotten her test results back and did test positive for Legionella. She also asked about a Workman’s Comp packet. I referred her to HR. Michelle Daugherty, RN, PSA Rehab/Schapers Illinois Veteran’s Home, Quincy 1707 N. 12th St, Quincy, IL 62301 217-222-8641 ext 452 michelle.daugherty@illinois.gov From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/31/2015 1:01:57 PM Subject: IVHQ This is just an FYI—head’s up. Do Not know if you have the mother spoken about below in your records?? I would assume they will be checking this individual also. From: ECKHOFF, CHUCK Sent: Monday, August 31, 2015 1:30 PM To: KELLEY, LINDSEY; HOUSTON, CATHY Subject: came to work today, but around 1230 said he wasn’t feeling well and asked if he could leave. Asked the symptoms and said sore throat, body ache, headache and tires. Said his mother was diagnosed with Legionella. Said he was heading to the clinic. Will let you know if I hear anything else. Chuck Eckhoff, CDM, CFPP Dietary Manager II Illinois Veteran’s Home 1707 N 12th Street Quincy, IL 62301 217-222-8641, ext 324 From: "HOUSTON, CATHY" To: WINNICKI "LENARD F. ;Shay Drummond" BRUCE CC: "HOUSTON, CATHY" Date: 8/31/2015 9:15:45 AM Subject: Legionella Tracking Log - 8-30-15 1600.xlsx Attachments: Legionella Tracking Log - 8-30-15 1600.xlsx Updated this am 10:00 From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/31/2015 1:04:07 PM Subject: RE: IVHQ Shay… Just found out that this is son. From: HOUSTON, CATHY Sent: Monday, August 31, 2015 2:02 PM To: Shay Drummond Subject: IVHQ This is just an FYI—head’s up. Do Not know if you have the mother spoken about below in your records?? I would assume they will be checking this individual also. From: ECKHOFF, CHUCK Sent: Monday, August 31, 2015 1:30 PM To: KELLEY, LINDSEY; HOUSTON, CATHY Subject: came to work today, but around 1230 said he wasn’t feeling well and asked if he could leave. Asked the symptoms and said sore throat, body ache, headache and tires. Said his mother was diagnosed with Legionella. Said he was heading to the clinic. Will let you know if I hear anything else. Chuck Eckhoff, CDM, CFPP Dietary Manager II Illinois Veteran’s Home 1707 N 12th Street Quincy, IL 62301 217-222-8641, ext 324 From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 8/31/2015 4:26:09 PM Subject: tracking Attachments: Legionella Tracking Log - 8-31-15 1500.xlsx Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 CATHY.S.HOUSTON@illinois.gov From: "Jeffries, Erica L" To: "Shay Drummond" CC: "VACA, BRUCE" "HOUSTON, CATHY" "WINNICKI, LENARD F." Date: 8/31/2015 12:10:30 PM Subject: Re: Random Idea I think that's worth exploring, Shay. We've already coordinated with the ILNG on bringing in medics, in the event we need staff support. We could certainly think about using them as extra hands on deck for the flushing of the pipes. We will have to think about the messaging for that though. It might raise some alarm. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 31, 2015, at 13:02, Shay Drummond wrote: Hi, If we are going to need to do a massive group effort for remediation plans Would it be possible to bring in a group of national guard/or other organized group that we can provide just-in-time training to and the could help execute and also if we need assistance mobilizing the residents in the process? We have done mass immunization clinics, flood responses, etc, using incident command and a team approach here locally in the past. Just thinking outside the box…. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Morgan, Jodi" To: "Shay Drummond" CC: Date: 8/31/2015 5:07:54 PM Subject: RE: Copy of Legionella Tracking Log - 8-31-15 1500.xlsx Where should our courier pick them up at? From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 31, 2015 6:05 PM To: Echols, Fred; Austin, Connie; Morgan, Jodi Subject: FW: Copy of Legionella Tracking Log - 8-31-15 1500.xlsx This is from IVH – I have not checked it against mind, just forwarding to you. PW protected. I am also getting all of the UA tests from pre/48 hours – so we should be sending about 11-12 your way. From: Shay Drummond Sent: Monday, August 31, 2015 6:03 PM To: Shay Drummond Subject: Copy of Legionella Tracking Log - 8-31-15 1500.xlsx From: "Morgan, Jodi" To: Cox "Robert F. ;Shay Drummond" CC: "Johnson, Bernard T." Date: 8/31/2015 8:52:43 AM Subject: RE: legionella tissue information Attachments: CDC form-50-34 for Legionella testing_08312015.pdf To Clarify: If they are sending it directly to CDC, the CDC form needs to be completed, not the IDPH form, correct? Thanks, Jodi From: Cox, Robert F. Sent: Monday, August 31, 2015 9:38 AM To: patti.schrock@mcleancountyil.gov Cc: Johnson, Bernard T.; Morgan, Jodi Subject: legionella tissue information Please see information below for tissue sample sites and shipping. I have highlighted in yellow. This was information shared from our Communicable Disease section to Adams County Health Department. Please call me if you need help with the attached CDC form. Bob Below are instructions for fresh-frozen tissue specimens. Once collected, the specimens must be kept frozen at < -20⁰C. They cannot be sent out to IDPH lab until Monday, so we will have to determine how the specimens will be transported to IDPH lab (either by courier or shipped—this is still under discussion). The Blessing Hospital lab will have to store the collected specimens until then, so we should verify they have the capability for appropriate temperature storage. The same IDPH lab form used for urine antigen specimens should be completed and sent with specimen. Per CDC guidelines, use dry ice for shipment of fresh frozen tissue. If excessively hot, it is recommended to use a combination of dry ice and a frozen gel pack for packaging. PLEASE NOTE: if the patient was on antibiotics, the culture may not grow legionella and an isolate may not be obtained. It’s important that the family also is informed of this prior to agreeing to collection of any specimens. CDC has requested fresh-frozen tissue specimens for legionella testing. Guidance from CDC on collecting pathology specimens: Fresh-frozen tissue may be submitted for culture and molecular-based assays. The preferred pulmonary sites include: 1. Hilar lung with segmental bronchi, primary bronchi, and trachea 2. Peripheral pulmonary parenchyma from both lungs Specimen Shipping Instructions for Legionella Testing During Outbreak Investigations Specimen Type Tests Available Minimum Preparation Requirements Respiratory Specimens (sputum, BAL, tracheal aspirate, tissue, etc.)† Culture, PCR, DFA 500 μl None Short-term Storage Long-term Storage Shipping (next day, Monday – Thursday) Freeze immediately < -20⁰C Freeze < -20⁰C Ship frozen < -20⁰C (super cold packs) http://www.cdc.gov/legionella/downloads/shipping-instructions.pdf Also from CDC path instructions: Please include relevant documentation (1) a cover letter outlining a brief clinical history, including relevant demographic / epidemiologic information (2) a completed lab submission form (can use IDPH form) (3) a copy of (a) the autopsy report (preliminary or final) or (b) surgical pathology report (4) copies of pertinent laboratory results (microbiology, hematology, serology, culture, and/or biochemical) (5) images (clinical and/or gross autopsy photos) Robert F. Cox MPH, MT(ASCP) Clinical Microbiology Supervisor, RO Illinois Department of Public Health Division of Laboratories 825 North Rutledge Street P.O. Box 19435 Springfield, IL 62702 Phone: 217-557-2623 Fax: 217-557-2618 Robert.F.Cox@illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "Shah, Nirav" To: Austin Connie Melaney "Fred ;; >" CC: "Conover, Craig" "DeWitt, Justin" jwelch@co.adams.il.us Date: 8/31/2015 9:03:05 PM Subject: Re: Correction: August 30th Case Count Update Thanks — very interesting. _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Connie Date: Monday, August 31, 2015 at 1:17 PM To: "Arnold, Melaney" , "Echols, Fred" , "sdrummond@co.adams.il.us" Cc: "Conover, Craig" , Nirav Shah , "DeWitt, Justin" , "jwelch@co.adams.il.us" Subject: RE: Correction: August 30th Case Count Update 4 community cases with no direct link to facility. We are mapping this and hope to have that done once Jon can provide the addresses of the community cases. Legionella cases-Adams county As you can see from the table there is not a lot of Legionellosis in Adams County in past years. Other years not listed from 2005-2015 are 0. The health care providers in the area have been provided with information about the outbreak and may indeed have increased testing for the disease. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Arnold, Melaney Sent: Monday, August 31, 2015 8:05 AM To: Echols, Fred; sdrummond@co.adams.il.us Cc: Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; jwelch@co.adams.il.us Subject: RE: Correction: August 30th Case Count Update Thank you. Sorry to bombard you with questions this morning, but I’m thinking about our media strategy. 1. How many confirmed community cases do we have? 2. Do we know how many cases of Legionnaires’ disease have been reported in Quincy/Adams County over the past 5-10 years? Is it possible Legionella bacteria is more common in this area? 3. Is there a way to know if doctors in the area are testing more for Legionnaires’ disease because of the IVH outbreak? From: Echols, Fred Sent: Monday, August 31, 2015 8:00 AM To: Arnold, Melaney; sdrummond@co.adams.il.us Cc: Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; jwelch@co.adams.il.us Subject: RE: Correction: August 30th Case Count Update We expect to receive the results today. I will let you know when we receive the information. -Fred PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Arnold, Melaney Sent: Monday, August 31, 2015 7:58 AM To: Echols, Fred; sdrummond@co.adams.il.us Cc: Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; jwelch@co.adams.il.us Subject: RE: Correction: August 30th Case Count Update When do you think we’ll have lab results for the 4 IVH death? From: Echols, Fred Sent: Sunday, August 30, 2015 12:26 PM To: sdrummond@co.adams.il.us; Arnold, Melaney Cc: Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; jwelch@co.adams.il.us Subject: Correction: August 30th Case Count Update Today’s corrected case count summary is provided below: · Total cases: 29 o 26 residents 1. Includes 3 deaths (3 laboratory confirmed cases; labs are pending for one of the residents that passed so they are not included in the total ) o 3 IVH staff This information has been relayed to Melaney. -Fred PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Sunday, August 30, 2015 11:19 AM To: Arnold, Melaney Cc: Echols, Fred; Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; Jerrod Welch Subject: RE: August 30th Update No labs are still pending on one. From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Sunday, August 30, 2015 11:12 AM To: Shay Drummond Cc: Echols, Fred; Austin, Connie; Conover, Craig; Shah, Nirav; DeWitt, Justin; Jerrod Welch Subject: Re: August 30th Update Are all 4 deaths in cases with confirmed LD? On Aug 30, 2015, at 10:51 AM, Shay Drummond wrote: Good morning, Here are my updates: No new labs returned due to the weekend – I anticipate Monday and Tuesday a large number of results back. We had one pass this morning – at IVH Overnight there were 2 admits to BH – One is in ICU and one is in ODU – both IVH residents 2 in ICU – one on vent – diminished over the evening but has since stabilized. 19 total in BH – (4 returned to home) Currently IVH is caring for 45 plus overnight they had 6 present with elevated temps and an additional 3 with low-grade temps – treating all. In addition: a resident of a cottage went to Jacksonville to visit her daughter and became ill and is in ICU in Jacksonville – IVH is working with the family and hospital to ensure lab work is being done. This is also the mother of another one of our hospitalized IVH residents. I have let BH know that there is potential at any given time to see more admits with the number that they are caring for. Also discussed lab capabilities so that they could notify LabCorp of the # of tests that will be rolling in over the weekend from IVH. BH stated that the ED was slow and they had bed capacity open up over the weekend. No report of increase of worried well or community members presenting to ED or walk in clinics. EH: Jeff Conte city Engineer is expecting IEPA in tomorrow at 9:30 am to do testing of City water and is also going to meet with IVH admin and engineer. Justin, let me know what time your team will be arriving so we can all coordinate conversations. I am anticipating a collaborative effort with all. I anticipate our numbers changing tomorrow as we get the labs back. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Echols "Fred <" "\(Fred.Echols@Illinois.gov\);>" "Connie \(Connie.Austin@Illinois.gov\);" CC: Date: 8/31/2015 5:04:53 PM Subject: FW: Copy of Legionella Tracking Log - 8-31-15 1500.xlsx Attachments: Copy of Legionella Tracking Log - 8-31-15 1500.xlsx This is from IVH – I have not checked it against mind, just forwarding to you. PW protected. I am also getting all of the UA tests from pre/48 hours – so we should be sending about 11-12 your way. From: Shay Drummond Sent: Monday, August 31, 2015 6:03 PM To: Shay Drummond Subject: Copy of Legionella Tracking Log - 8-31-15 1500.xlsx From: "Shay Drummond" To: Austin "Connie <" "\(Connie.Austin@Illinois.gov\);>" "Fred <" "\(Fred.Echols@Illinois.gov\)>" CC: Date: 8/31/2015 8:03:23 AM Subject: Legionella Tracking Log - 8-30-15 1600.xlsx Attachments: Legionella Tracking Log - 8-30-15 1600.xlsx This is the list from IVH as of last night. Calling Cathy for an update now. This is pw protected. From: "Shay Drummond" To: Morgan Jodi CC: Date: 8/31/2015 5:10:16 PM Subject: RE: Copy of Legionella Tracking Log - 8-31-15 1500.xlsx Jodi we will have them ready for pick up at the health department.. Thanks! Just talked to lab and still no results, he is going to call my cell. Talk to you later, Shay From: Morgan, Jodi [mailto:Jodi.Morgan@illinois.gov] Sent: Monday, August 31, 2015 6:08 PM To: Shay Drummond Subject: RE: Copy of Legionella Tracking Log - 8-31-15 1500.xlsx Where should our courier pick them up at? From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 31, 2015 6:05 PM To: Echols, Fred; Austin, Connie; Morgan, Jodi Subject: FW: Copy of Legionella Tracking Log - 8-31-15 1500.xlsx This is from IVH – I have not checked it against mind, just forwarding to you. PW protected. I am also getting all of the UA tests from pre/48 hours – so we should be sending about 11-12 your way. From: Shay Drummond Sent: Monday, August 31, 2015 6:03 PM To: Shay Drummond Subject: Copy of Legionella Tracking Log - 8-31-15 1500.xlsx From: "Shay Drummond" To: HOUSTON CATHY CC: Date: 8/31/2015 1:07:45 PM Subject: RE: IVHQ Thanks for the heads up. From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Monday, August 31, 2015 2:04 PM To: Shay Drummond Subject: RE: IVHQ Shay… Just found out that this is son. From: HOUSTON, CATHY Sent: Monday, August 31, 2015 2:02 PM To: Shay Drummond Subject: IVHQ This is just an FYI—head’s up. Do Not know if you have the mother spoken about below in your records?? I would assume they will be checking this individual also. From: ECKHOFF, CHUCK Sent: Monday, August 31, 2015 1:30 PM To: KELLEY, LINDSEY; HOUSTON, CATHY Subject: came to work today, but around 1230 said he wasn’t feeling well and asked if he could leave. Asked the symptoms and said sore throat, body ache, headache and tires. Said his mother was diagnosed with Legionella. Said he was heading to the clinic. Will let you know if I hear anything else. Chuck Eckhoff, CDM, CFPP Dietary Manager II Illinois Veteran’s Home 1707 N 12th Street Quincy, IL 62301 217-222-8641, ext 324 From: "Shay Drummond" To: Arnold Melaney "Fred ;Jerrod Welch" Nirav CC: "Austin, Connie" "Conover, Craig" "DeWitt, Justin" "Holmes, Tal" "Culp, David" "Albertson, Justin" "Clegg, Whitney" "Beron, Andrew" Date: 8/31/2015 9:43:30 AM Subject: RE: Legionellosis Outbreak & Cluster Case Count Update (8/31/2015) Yes, Melaney, confirmed and families are notified. Thanks, Shay From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Monday, August 31, 2015 10:42 AM To: Echols, Fred; Shay Drummond; Jerrod Welch; Shah, Nirav Cc: Austin, Connie; Conover, Craig; DeWitt, Justin; Holmes, Tal; Culp, David; Albertson, Justin; Clegg, Whitney; Beron, Andrew Subject: RE: Legionellosis Outbreak & Cluster Case Count Update (8/31/2015) Confirming – all 4 deaths are indeed confirmed cases? Thanks From: Echols, Fred Sent: Monday, August 31, 2015 10:41 AM To: sdrummond@co.adams.il.us; Arnold, Melaney; jwelch@co.adams.il.us; Shah, Nirav Cc: Austin, Connie; Conover, Craig; DeWitt, Justin; Holmes, Tal; Culp, David; Albertson, Justin; Clegg, Whitney; Beron, Andrew Subject: Legionellosis Outbreak & Cluster Case Count Update (8/31/2015) To All, Today’s case count summary for the Legionellosis outbreak in Adams County is provided below: · IVH Outbreak o Case total: 29  26 residents · Includes 4 deaths of laboratory confirmed cases  3 IVH staff Please let me know if you have any questions or concerns. Thanks. Respectfully Yours, Fredrick L. Echols, MD Chief,Communicable Diseases Illinois Department of Public Health Phone: 217-782-2016 Fax: 217-524-0962 Email: Fred.Echols@Illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "Shay Drummond" To: Arnold Melaney Ryan CC: Date: 8/31/2015 1:06:31 PM S u b j e c t : RE: Media Questions That sounds good – From: Arnold, Melaney [mailto:Melaney Arnold@Illinois.gov] Sent: Monday, August 31, 2015 2:02 PM To: Shay Drummond; Yantis, Ryan Subject: RE: Media Questions My thoughts – I don’t want to appear that we’re withholding information, but I’m trying to temper our message. The following is what I have PROPOSED to IDPH staff, but has not been approved. What do you think of this media strategy? “Illinois has had more than 200 cases of Legionnaires’ disease each year over the past 3 years, so cases in communities do occur. Health offices will look at all confirmed cases of Legionnaires’ disease in Quincy to see if they are possibility related to the Illinois Veterans’ Home outbreak.” It maynot be enough to say just that, but we could try. From: Shay Drummond [mailto:sdrummond@co.adams il.us] Sent: Monday, August 31, 2015 1:51 PM To: Arnold, Melaney; Yantis, Ryan Subject: Media Questions Importance: High KHQA had gotten a call from a Quincy person who’s father lives at is in hospital with a confirmed case. We need to formulate a message to address the community cases, as KHQA wants to run the family members story. Also when these labs come in shortly our counts are going to shift. We are also seeing many more staff presenting at walk-ins with symptoms that are being tested. Thanks…look forward to your update, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONF DENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. f the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: Connie CC: Date: 8/31/2015 9:24:16 AM Subject: RE: numbers Hi I am trying to ?gure out howl have 27 on total ?can you help me clarify? I have 27 residents and that includes the 4 deaths that are lab confirmed. have 3 IVH with confirmed cases in addition to the 27. From: Echols, Fred Sent: Monday, August 31, 2015 10:03 AM To: Shay Drummond; Austin, Connie Subject: RE: numbers have the following: 29 total cases 0 26 residents Including 3 deaths of laboratory confirmed cases One additional death has occurred but is not included in the current count because his lab results are pending- 3 IVH staff There are 4 community cases that are not associated with the outbreak -FRED WBHONFIDENTMLIT NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is in en?dg?d?o?nlirf?or?the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: Shay Drummond Sent: Monday, August 31, 2015 9:02 AM To: Echols, Fred; Austin, Connie Subject: numbers Here is what I have: 27 confirmed + IVH Residents (I think 3 confirmed + IVH Staff . is included on your line list but his lab tests are still pending) 3 confirmed deaths (these are included in the total + case count) 1 pending death – waiting for labs Community cases: 4 confirmed + Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: HOUSTON CATHY CC: Date: 8/31/2015 12:09:59 PM Subject: RE: Thanks Cathy, we will fax it over. Waiting on the fax machine now,thinking I am getting a bunch of results. From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Monday, August 31, 2015 1:09 PM To: Shay Drummond Subject: FW: FYI…..maybe you can get the official copy. From: DAUGHERTY, MICHELLE Sent: Monday, August 31, 2015 12:40 PM To: KELLEY, LINDSEY; HOUSTON, CATHY Cc: PERRINE, HOLLY Subject: She called to let me know that she had gotten her test results back and did test positive for Legionella. She also asked about a Workman’s Comp packet. I referred her to HR. Michelle Daugherty, RN, PSA Rehab/Schapers Illinois Veteran’s Home, Quincy 1707 N. 12th St, Quincy, IL 62301 217-222-8641 ext 452 michelle.daugherty@illinois.gov From: "Shay Drummond" To: WINNICKI "LENARD F." "Erica L" CC: "VACA, BRUCE" "HOUSTON, CATHY" "DIEHL, GWEN" Date: 8/31/2015 12:43:53 PM Subject: RE: Random Idea We have an adult Adams County Medical Reserve Corps that we use for all of our public health events, many are nurses as well. We could get a large number of volunteers that have had experience with our drive through flu clinics, flood response and mass vaccination clinics. They all understand incident command and team approach. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: WINNICKI, LENARD F. [mailto:LENARD.WINNICKI@illinois.gov] Sent: Monday, August 31, 2015 1:36 PM To: Jeffries, Erica L Cc: Shay Drummond; VACA, BRUCE; HOUSTON, CATHY; DIEHL, GWEN Subject: Re: Random Idea Gwen and I were just talking, possible groups for manpower: -Boy/Girl Scouts with staff supervision -College/high school students for service hours, with staff supervision -Nursing/CNA student with supervision -Fire/EMS staff Len Winnicki, MSHS, LNHA Senior Nursing Home Administrator Illinois Department of Veteran Affairs One Veterans Drive Manteno, IL. 60950 Ph: (815) 468-6581 x210 Lenard.Winnicki@illinois.gov This e-mail and any attachments are intended solely for the person or entity to which addressed and may contain confidential information. Any copy or distribution of this information by person or entities other than the addressee is prohibited by law. If you have received this message in error, please contact the sender and delete this message along with any attachments. On Aug 31, 2015, at 1:10 PM, "Jeffries, Erica L" wrote: I think that's worth exploring, Shay. We've already coordinated with the ILNG on bringing in medics, in the event we need staff support. We could certainly think about using them as extra hands on deck for the flushing of the pipes. We will have to think about the messaging for that though. It might raise some alarm. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 31, 2015, at 13:02, Shay Drummond wrote: Hi, If we are going to need to do a massive group effort for remediation plans Would it be possible to bring in a group of national guard/or other organized group that we can provide just-in-time training to and the could help execute and also if we need assistance mobilizing the residents in the process? We have done mass immunization clinics, flood responses, etc, using incident command and a team approach here locally in the past. Just thinking outside the box…. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: WINNICKI "LENARD F." "Erica L" CC: "VACA, BRUCE" "HOUSTON, CATHY" "DIEHL, GWEN" Date: 8/31/2015 12:51:04 PM Subject: RE: Random Idea Yes, and they know the residents and staff as well and the facility. From: WINNICKI, LENARD F. [mailto:LENARD.WINNICKI@illinois.gov] Sent: Monday, August 31, 2015 1:50 PM To: Shay Drummond; Jeffries, Erica L Cc: VACA, BRUCE; HOUSTON, CATHY; DIEHL, GWEN Subject: RE: Random Idea Good idea. They may be an easier/quicker team to activate at shorter notice than the Guard. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 31, 2015 1:44 PM To: WINNICKI, LENARD F.; Jeffries, Erica L Cc: VACA, BRUCE; HOUSTON, CATHY; DIEHL, GWEN Subject: RE: Random Idea We have an adult Adams County Medical Reserve Corps that we use for all of our public health events, many are nurses as well. We could get a large number of volunteers that have had experience with our drive through flu clinics, flood response and mass vaccination clinics. They all understand incident command and team approach. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: WINNICKI, LENARD F. [mailto:LENARD.WINNICKI@illinois.gov] Sent: Monday, August 31, 2015 1:36 PM To: Jeffries, Erica L Cc: Shay Drummond; VACA, BRUCE; HOUSTON, CATHY; DIEHL, GWEN Subject: Re: Random Idea Gwen and I were just talking, possible groups for manpower: -Boy/Girl Scouts with staff supervision -College/high school students for service hours, with staff supervision -Nursing/CNA student with supervision -Fire/EMS staff Len Winnicki, MSHS, LNHA Senior Nursing Home Administrator Illinois Department of Veteran Affairs One Veterans Drive Manteno, IL. 60950 Ph: (815) 468-6581 x210 Lenard.Winnicki@illinois.gov This e-mail and any attachments are intended solely for the person or entity to which addressed and may contain confidential information. Any copy or distribution of this information by person or entities other than the addressee is prohibited by law. If you have received this message in error, please contact the sender and delete this message along with any attachments. On Aug 31, 2015, at 1:10 PM, "Jeffries, Erica L" wrote: I think that's worth exploring, Shay. We've already coordinated with the ILNG on bringing in medics, in the event we need staff support. We could certainly think about using them as extra hands on deck for the flushing of the pipes. We will have to think about the messaging for that though. It might raise some alarm. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 31, 2015, at 13:02, Shay Drummond wrote: Hi, If we are going to need to do a massive group effort for remediation plans Would it be possible to bring in a group of national guard/or other organized group that we can provide just-in-time training to and the could help execute and also if we need assistance mobilizing the residents in the process? We have done mass immunization clinics, flood responses, etc, using incident command and a team approach here locally in the past. Just thinking outside the box…. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "WINNICKI, LENARD F." To: "Shay Drummond" "Erica L" CC: "VACA, BRUCE" "HOUSTON, CATHY" "DIEHL, GWEN" Date: 8/31/2015 12:50:27 PM Subject: RE: Random Idea Good idea. They may be an easier/quicker team to activate at shorter notice than the Guard. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 31, 2015 1:44 PM To: WINNICKI, LENARD F.; Jeffries, Erica L Cc: VACA, BRUCE; HOUSTON, CATHY; DIEHL, GWEN Subject: RE: Random Idea We have an adult Adams County Medical Reserve Corps that we use for all of our public health events, many are nurses as well. We could get a large number of volunteers that have had experience with our drive through flu clinics, flood response and mass vaccination clinics. They all understand incident command and team approach. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: WINNICKI, LENARD F. [mailto:LENARD.WINNICKI@illinois.gov] Sent: Monday, August 31, 2015 1:36 PM To: Jeffries, Erica L Cc: Shay Drummond; VACA, BRUCE; HOUSTON, CATHY; DIEHL, GWEN Subject: Re: Random Idea Gwen and I were just talking, possible groups for manpower: -Boy/Girl Scouts with staff supervision -College/high school students for service hours, with staff supervision -Nursing/CNA student with supervision -Fire/EMS staff Len Winnicki, MSHS, LNHA Senior Nursing Home Administrator Illinois Department of Veteran Affairs One Veterans Drive Manteno, IL. 60950 Ph: (815) 468-6581 x210 Lenard.Winnicki@illinois.gov This e-mail and any attachments are intended solely for the person or entity to which addressed and may contain confidential information. Any copy or distribution of this information by person or entities other than the addressee is prohibited by law. If you have received this message in error, please contact the sender and delete this message along with any attachments. On Aug 31, 2015, at 1:10 PM, "Jeffries, Erica L" wrote: I think that's worth exploring, Shay. We've already coordinated with the ILNG on bringing in medics, in the event we need staff support. We could certainly think about using them as extra hands on deck for the flushing of the pipes. We will have to think about the messaging for that though. It might raise some alarm. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 31, 2015, at 13:02, Shay Drummond wrote: Hi, If we are going to need to do a massive group effort for remediation plans Would it be possible to bring in a group of national guard/or other organized group that we can provide just-in-time training to and the could help execute and also if we need assistance mobilizing the residents in the process? We have done mass immunization clinics, flood responses, etc, using incident command and a team approach here locally in the past. Just thinking outside the box…. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "WINNICKI, LENARD F." To: Jeffries "Erica L" CC: "Shay Drummond" "VACA, BRUCE" "HOUSTON, CATHY" "DIEHL, GWEN" Date: 8/31/2015 12:36:00 PM Subject: Re: Random Idea Gwen and I were just talking, possible groups for manpower: -Boy/Girl Scouts with staff supervision -College/high school students for service hours, with staff supervision -Nursing/CNA student with supervision -Fire/EMS staff Len Winnicki, MSHS, LNHA Senior Nursing Home Administrator Illinois Department of Veteran Affairs One Veterans Drive Manteno, IL. 60950 Ph: (815) 468-6581 x210 Lenard.Winnicki@illinois.gov This e-mail and any attachments are intended solely for the person or entity to which addressed and may contain confidential information. Any copy or distribution of this information by person or entities other than the addressee is prohibited by law. If you have received this message in error, please contact the sender and delete this message along with any attachments. On Aug 31, 2015, at 1:10 PM, "Jeffries, Erica L" wrote: I think that's worth exploring, Shay. We've already coordinated with the ILNG on bringing in medics, in the event we need staff support. We could certainly think about using them as extra hands on deck for the flushing of the pipes. We will have to think about the messaging for that though. It might raise some alarm. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Aug 31, 2015, at 13:02, Shay Drummond wrote: Hi, If we are going to need to do a massive group effort for remediation plans Would it be possible to bring in a group of national guard/or other organized group that we can provide just-in-time training to and the could help execute and also if we need assistance mobilizing the residents in the process? We have done mass immunization clinics, flood responses, etc, using incident command and a team approach here locally in the past. Just thinking outside the box…. Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Yantis, Ryan" To: Jeffries "Erica L" "LENARD F" "BRUCE L" "CATHY S" "Melaney ;Shay Drummond" CC: Date: 8/31/2015 11:09:43 AM Subject: Open Queries = for IDVA Conf Call at Noon Attachments: Legionella TP QA 2015-08-31_1101 AM.docx All – this is what I am tracking so far…. Updated TP, attached Media Quincy Herald Whig Reporter Doug Wilson WGEM Radio Greg Haubrich AP St. Louis Alan Scher Zagier WGEM TV Travis Quincy Herald Whig David Adam Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) Query Time 0759 08/31/2015 1006 08/31/2015 1030 08/31/2015 1047 08/31/2015 1157 08/31/2015 Query / Interest Interview someone from the Home /IDVA ASAP Interview someone from the Home /IDVA on 9/1/15 at 0720, live Number Update; may want interview Interview someone from the Home /IDVA ASAP at Home Interview with Bruce Vaca/Home rep Deadline/Timing ASAP today Status From: "Yantis, Ryan" To: Arnold "Melaney ;;>" CC: "Shay Drummond" Date: 8/31/2015 3:42:24 PM Subject: RE: CDC Attachments: Legionella TP QA 2015-08-31_1101 AM.docx Hi Alison – Looking forward to working with you. Please find attached our most recent set of Talking Points and Q&As. We update numbers daily at noon, and loop in Shay Drummond at Adams County Health. Ryan Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: Arnold, Melaney Sent: Monday, August 31, 2015 4:35 PM To: Yantis, Ryan Subject: CDC Alison P. Albert, MPH, CHES Health Communications Specialist, Division of Bacterial Diseases (DBD) National Center for Immunization and Respiratory Diseases (NCIRD) Centers for Disease Control and Prevention (CDC) o: 404-639-3604 bb: 404-428-6620 e-mail: apalbert@cdc.gov Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: "Yantis, Ryan" To: Arnold "Melaney ;'Shay Drummond" CC: Date: 8/31/2015 1:14:10 PM S u b j e c t : RE: Media Questions OK; thanks From: Arnold, Melaney Sent: Monday, August 31, 2015 2:02 PM To: 'Shay Drummond'; Yantis, Ryan Subject: RE: Media Questions My thoughts – I don’t want to appear that we’re withholding information, but I’m trying to temper our message. The following is what I have PROPOSED to IDPH staff, but has not been approved. What do you think of this media strategy? “Illinois has had more than 200 cases of Legionnaires’ disease each year over the past 3 years, so cases in communities do occur. Health offices will look at all confirmed cases of Legionnaires’ disease in Quincy to see if theyare possibility related to the Illinois Veterans’ Home outbreak.” It may not be enough to say just that, but we could try. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Monday, August 31, 2015 1:51 PM To: Arnold, Melaney; Yantis, Ryan Subject: Media Questions Importance: High KHQA had gotten a call from a Quincy person who’s father lives at Sunset and is in hospital with a confirmed case. We need to formulate a message to address the community cases, as KHQA wants to run the family members story. Also when these labs come in shortly our counts are going to shift. We are also seeing many more staff presenting at walk-ins with symptoms that are being tested. Thanks…look forward to your update, Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Yantis, Ryan" To: Arnold "Melaney ;'Shay Drummond" CC: "Shah, Nirav" "Jeffries, Erica L" "WINNICKI, LENARD F" "HOUSTON, CATHY S" "VACA, BRUCE L" "Ray, Jaimee M" Date: 8/31/2015 10:35:46 AM Subject: Updated Talking Points Q&A - 2015-08-31_1101 Talking points Attachments: Legionella TP QA 2015-08-31_1101 AM.docx All – With continued thanks to Melaney for her great work. Updated to also include Home Chiller and temp Chiller status. Will share this document with GPO for awareness and let them know of the media queries. Alan Scher Zagier, The Associated Press, St. Louis, MO is asking for Home actions, and may want an interview this afternoon. Will prep a media call sheet ASAP with all know IDVA – Home interview requests. Ryan From: Arnold, Melaney Sent: Monday, August 31, 2015 11:26 AM To: Yantis, Ryan; 'Shay Drummond' Cc: Shah, Nirav; Jeffries, Erica L Subject: Talking points Talking points for today, August 31, 2015. Ryan – not sure who you would like to distribute to at the home. Approved by IDPH communicable disease and Environmental Health. Brief mention of CDC based on information provided to me from CDC. Thanks Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: "Arnold, Melaney" To: Yantis "Ryan ;Shay Drummond" "Alison P. \(CDC/OID/NCIRD\)" "Ian \(CDC/OID/NCIRD\) \(CTR\)" CC: "Jeffries, Erica L" "Shah, Nirav" "Jerrod Welch" Date: 9/1/2015 7:28:52 AM Subject: DRAFT - news release Attachments: 09.01.15 Legionnaires 7 deaths.docx I think with the additional deaths and the jump in cases, we need to issue an update to media. If we don’t, it might appear we’re trying to hide them. Draft attached. Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: "Arnold, Melaney" To: Jeffries "Erica L" CC: "Yantis, Ryan" "Shay Drummond" "Albert, Alison P. \(CDC/OID/NCIRD\)" "Branam, Ian \(CDC/OID/NCIRD\) \(CTR\)" "Shah, Nirav" "Jerrod Welch" Date: 9/1/2015 8:17:05 AM Subject: RE: DRAFT - news release Got it. Thanks From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Tuesday, September 01, 2015 9:02 AM To: Arnold, Melaney Cc: Yantis, Ryan; Shay Drummond; Albert, Alison P. (CDC/OID/NCIRD); Branam, Ian (CDC/OID/NCIRD) (CTR); Shah, Nirav; Jerrod Welch Subject: Re: DRAFT - news release The following can be added as my quote: "We are being hyper-vigilant in monitoring our residents and we continue to follow the guidance of our interagency partners to implement remediation efforts across our Home. The safety and quality of care for our residents and staff are our primary concerns." Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217- 785-4114 On Sep 1, 2015, at 08:29, Arnold, Melaney wrote: I think with the additional deaths and the jump in cases, we need to issue an update to media. If we don’t, it might appear we’re trying to hide them. Draft attached. Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH <09.01.15 Legionnaires 7 deaths.docx> From : "Arnold, Melaney" To: 'Albert "Alison P. \(CDC/OID/NCIRD\)" "Ryan ;Shay Drummond" "Ian \(CDC/OID/NCIRD\) \(CTR\)" CC: "Jeffries, Erica L" "Shah, Nirav" "Jerrod Welch" Date: 9/1/2015 8:00:13 AM Subject: RE: DRAFT - news release After receiving input from Adams County Health Department and vets affairs, and after making sure families have been notified. From: Albert, Alison P. (CDC/OID/NCIRD) [mailto:aqp0@cdc.gov] Sent: Tuesday, September 01, 2015 8:56 AM To: Arnold, Melaney; Yantis, Ryan; Shay Drummond; Branam, Ian (CDC/OID/NCIRD) (CTR) Cc: Jeffries, Erica L; Shah, Nirav; Jerrod Welch Subject: RE: DRAFT - news release Hi Melaney, Thanks for sharing. No concerns on my end. When do you intend to post this? Thanks, Alison From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Tuesday, September 01, 2015 9:29 AM To: Yantis, Ryan ; Shay Drummond ; Albert, Alison P. (CDC/OID/NCIRD) ; Branam, Ian (CDC/OID/NCIRD) (CTR) Cc: Jeffries, Erica L ; Shah, Nirav ; Jerrod Welch Subject: DRAFT - news release I think with the additional deaths and the jump in cases, we need to issue an update to media. If we don’t, it might appear we’re trying to hide them. Draft attached. Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: "Arnold, Melaney" To: Echols "Fred ;sdrummond@co.adams.il.us;;Shah>" Nirav CC: "Austin, Connie" "Conover, Craig" "DeWitt, Justin" "Holmes, Tal" "Culp, David" "Albertson, Justin" "Clegg, Whitney" "Beron, Andrew" Date: 9/1/2015 9:57:47 AM Subject: RE: Legionellosis Outbreak & Cluster Case Count Update (09/1/2015) Thank you. From: Echols, Fred Sent: Tuesday, September 01, 2015 10:57 AM To: sdrummond@co.adams.il.us; Arnold, Melaney; jwelch@co.adams.il.us; Shah, Nirav Cc: Austin, Connie; Conover, Craig; DeWitt, Justin; Holmes, Tal; Culp, David; Albertson, Justin; Clegg, Whitney; Beron, Andrew Subject: Legionellosis Outbreak & Cluster Case Count Update (09/1/2015) To All, Today’s case count summary for the legionellosis outbreak in Adams County is provided below: · IVH Outbreak o Case total: 39  35 residents · Includes 7 deaths of laboratory confirmed cases  4 IVH staff Please let me know if you have any questions or concerns. Thanks. Respectfully Yours, Fredrick L. Echols, MD Chief,Communicable Diseases Illinois Department of Public Health Phone: 217-782-2016 Fax: 217-524-0962 Email: Fred.Echols@Illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "Arnold, Melaney" To: "Shay Drummond" Ryan CC: "VACA, BRUCE L" "WINNICKI, LENARD F" Date: 9/1/2015 11:27:20 AM Subject: RE: Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update No problem from IDPH angle. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 12:21 PM To: Yantis, Ryan; Arnold, Melaney Cc: VACA, BRUCE L; WINNICKI, LENARD F Subject: RE: Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update This is a call from the Homes standpoint. Also I don’t want to create unnecessary concern over one area of the home or campus. This is based from OSHA and AFSCME both calling and visiting trying to get info. We could get a pic of them entering data at ACHD but that certainly is not the exciting field shot they are trying for. From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 12:16 PM To: Arnold, Melaney; Shay Drummond Cc: VACA, BRUCE L; WINNICKI, LENARD F Subject: FW: Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update Quincy Herald-Whig wants to have a photographer go w CDC to get images of them working/testing on the IVH-Q Campus. Any concerns? There would be an escort of sorts from the Home (I am in Chicago). Alison from CDC wants to ensure we are all good on this. No issues from IDVA and the Home. From: Albert, Alison P. (CDC/OID/NCIRD) [mailto:aqp0@cdc.gov] Sent: Tuesday, September 01, 2015 12:11 PM To: Yantis, Ryan Subject: Re: Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update Hi Ryan --- one more Q about the photography request. Are state and local HDs ok with it? And thanks for sending this! Sent from my BlackBerry 10 smartphone. From: Yantis, Ryan Sent: Tuesday, September 1, 2015 1:04 PM To: Yantis, Ryan Subject: Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update For Immediate Release Sept. 1, 2015 CONTACTS: See Below Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of a total of seven residents at the Illinois Veterans’ Home-Quincy. The seven residents, all of whom had underlying medical conditions, were among the 39 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “While saddened by the loss of our residents, having been at the Home and talking with the staff and our residents, I am impressed with their resilience and spirit,” said IDVA Director Erica Jeffries. “We remain vigilant in monitoring our residents and we continue to follow the guidance of our interagency partners to implement remediation efforts across our Home. The safety and quality of care for our residents and staff are our primary concerns.” “We continue to work diligently with our public health and Veterans’ Affairs partners to get immediate medical care to residents or staff at the Home who are experiencing respiratory illness,” said IDPH Director Nirav D. Shah, M.D., J.D. “Unfortunately, we expect to see additional cases and possibly additional deaths because the incubation period for Legionnaires’ disease can be up to two weeks, and because patients with underlying medical conditions are at increased risk of more severe illness.” On August 30, 2015, IDPH requested aid from the U.S. Centers for Disease Control and Prevention (CDC) for epidemiology and environmental health assistance. Yesterday, three CDC Epidemic Intelligence Service Officers and one environmental health specialist arrived at the Illinois Veterans’ Home – Quincy to work with IDVA and IDPH in investigating the Legionnaires’ disease outbreak. CDC will also provide laboratory support from its headquarters in Atlanta, GA. IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Due to the nature of the bacteria, test results can take up to two weeks. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. For more information about Legionnaires’ disease, visit the IDPH website. For media seeking additional information, please contact: IDVA / IVH-Q: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d)217-222-8440 x148 (c)217-316-2795 sdrummond@co.adams.il.us From: "Arnold, Melaney" To: Yantis "Ryan ;; >" CC: "Shay Drummond" Date: 9/1/2015 11:52:47 AM Subject: RE: St. Louis Public Radio - Health on IVH-Q situation Hi Durrie ~ What are your questions and I’ll see if I can help. Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: Yantis, Ryan Sent: Tuesday, September 01, 2015 11:39 AM To: durrie@umsl.edu Cc: Arnold, Melaney; Shay Drummond Subject: RE: St. Louis Public Radio - Health on IVH-Q situation Resending to corrected email From: Yantis, Ryan Sent: Tuesday, September 01, 2015 10:49 AM To: 'durrie@iumsl.edu' Cc: Arnold, Melaney; Shay Drummond Subject: St. Louis Public Radio - Health on IVH-Q situation Durrie – Thanks for your call and invite to discuss the situation at the Illinois Veterans’ Home – Quincy. As I mentioned, we are compiling our update and I don’t want to give you information that will soon be out of date. Also, I am looping in Melaney from Illinois Dept. of Public Health and Shay Drummond from Adams County Health Dept. They are also good sources on this situation. Please call or email after noon (12:00) and we should have an update to share. Meanwhile, here is some general I’ve been sharing with media. General Statement (as if noon, August 31 – we will be updating number shortly) ​: Currently 29 individuals from the Illinois Veterans’ Home in Quincy have tested positive for Legionnaires’ disease, and sadly, four have died. Our thoughts and prayers go to the families of those who passed yesterday, and we offer our sincere condolences to their loved ones.​ The Adams County Health Department, the Illinois Department of Public Health, the Illinois Department of Veterans’ Affairs, Quincy Veterans’ Home, Blessing Hospital, and other medical providers, with guidance from the Centers for Disease Control and Prevention, are working together very closely to track patients with respiratory illness who have a connection with the home. Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires’ disease and are making sure residents receive prompt medical attention if needed. ​Compounding the challenge of identifying and treating individuals with Legionnaires’ disease is that we typically see other respiratory issues in residents this time of year. Therefore, all residents presenting any respiratory, pneumonia–type symptoms will be treated as if they have Legionnaires’ disease until lab results confirm the individual is negative for the bacteria. Environmental health and infectious disease staff continue to visit the home to investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources. Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. There is no evidence that Legionnaires’ disease is transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures in order to prevent additional individuals from being infected. The Illinois Veterans’ Home-Quincy has established a remediation plan including: - Cleaning hot water tanks - Cleaning the cooling tower - Using bottled water for residents and staff - Prepping a temporary chiller so the Home’s facility chiller could be certified by outside experts​ - Certifying the Home’s facility chiller by outside experts - Keeping fountains and other potential sources of aerosolized water turned off - Removing possible/suspected Legionella-infected systems/devices from use until they can be specially treated and tested before use. - Working with IDPH and other experts to clean and certify systems. We will update as we can. Our focus is on providing great care for our residents; keeping them, our staff, and those impacted by this situation informed and engaged; and working with our partner agencies, providers, and team to resolve this a quickly as possible. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Arnold, Melaney" To: "Shay Drummond" Ryan CC: Date: 9/1/2015 10:29:57 AM Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. And the hits just keep on coming. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 11:30 AM To: Arnold, Melaney; Yantis, Ryan Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Thanks and an FYI am getting inquiries from OSHA and AFSCME!!! From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Tuesday, September 01, 2015 11:18 AM To: Yantis, Ryan; Shay Drummond; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Updated numbers. Also attached is the final news release, which will be sent to media at noon today. Thank you. From: Yantis, Ryan Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Arnold, Melaney" To: "Shay Drummond" Ryan "CATHY S" CC: Date: 9/1/2015 10:05:23 AM Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. We will issue the news release at noon today. I’m still waiting one final approval. I’ll get you the release BEFORE it goes out. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 11:04 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Just, did. Ryan is there going to be a formal press release or are we free to release numbers? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 11:03 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. In convo with Cathy this AM, the Home has a solid notification protocol for change in status of residents if/when symptomatic, or there is a change in condition. The staff call and brief the family (POA power of attorney or ICE designates), and should a resident get a confirming test result, then the Infectious Disease Nurse at the Home talks to the family. This is all charted. Generally the families are in attendance if a resident is expectant/in comfort care/hospice, but notification is made if the family is not present. Again, all charted. While not answering for Blessing, Cathy was very positive about their standards of notification and family communication. Blessing would handle any notification for residents under their care. We might want to loop in the Blessing PR folks… From: Arnold, Melaney Sent: Tuesday, September 01, 2015 10:55 AM To: 'Shay Drummond'; Yantis, Ryan; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Not yet. Connie said she was going to talk with you at 11:15 and we would have numbers by 11:30. Also – do you know if the families have been notified? I know you’ve been busy. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 10:50 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Hi have you gotten the updates from Fred? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Arnold, Melaney" To: "Shay Drummond" Ryan "CATHY S" CC: Date: 9/1/2015 10:02:02 AM Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. I have them now. Updating. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 10:50 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Hi have you gotten the updates from Fred? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Arnold, Melaney" To: Yantis "Ryan ;Shay Drummond" "CATHY S" CC: Date: 9/1/2015 10:17:41 AM Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Attachments: Legionella TP QA 2015-09-01_1115 AM.docx 09.01.15 Legionnaires 7 deaths.docx Updated numbers. Also attached is the final news release, which will be sent to media at noon today. Thank you. From: Yantis, Ryan Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Arnold, Melaney" To: "Shay Drummond" CC: "Yantis, Ryan" "HOUSTON, CATHY S" Date: 9/1/2015 10:02:13 AM S u b j e c t : RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Thank you. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 11:00 AM To: Arnold, Melaney Cc: Yantis, Ryan; HOUSTON, CATHY S Subject: Re: Updated TP Q&A 2015-09-01 1000 AM for staffing. All have been notified Sent from my iPhone On Sep 1, 2015, at 10:54 AM, Arnold, Melaney wrote: Not yet. Connie said she was going to talk with you at 11:15 and we would have numbers by 11:30. Also – do you know if the families have been notified? I know you’ve been busy. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 10:50 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Hi have you gotten the updates from Fred? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Arnold, Melaney" To: "Shay Drummond" Ryan "CATHY S" CC: Date: 9/1/2015 9:54:35 AM Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Not yet. Connie said she was going to talk with you at 11:15 and we would have numbers by 11:30. Also – do you know if the families have been notified? I know you’ve been busy. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 10:50 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Hi have you gotten the updates from Fred? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Austin, Connie" To: "Shay Drummond" "Jon Campos" CC: Date: 9/1/2015 7:42:22 AM Subject: FW: ADDITION TO UPDATE - Legionnaires Disease, Adams County See question and response from our emergency response partners. And response from Craig in case you get the same question. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Conover, Craig Sent: Tuesday, September 01, 2015 7:00 AM To: Moomey, Tammy Cc: Mitchell, Joe; Culp, David; Morgan, Jodi; McCann, Ken; Martin, Aaron; Echols, Fred; Austin, Connie Subject: Re: ADDITION TO UPDATE - Legionnaires Disease, Adams County My draft response would be--others can comment: Potential sources have been mitigated: standard precautions for patient care. Individuals doing sampling etc in which aerosols may be generated --respiratory protection to avoid aerosols until system is given a clean bill of health. From: Moomey, Tammy Sent: Monday, August 31, 2015 8:58 PM To: Conover, Craig Subject: Fwd: ADDITION TO UPDATE - Legionnaires Disease, Adams County Dr. Conover, I missed you on this email. Sorry! Sent from my iPhone Begin forwarded message: From: "Moomey, Tammy" Date: August 31, 2015 at 8:46:09 PM CDT To: "Shah, Nirav" , "Rayman, Erik" , "Gentry-Wiseman, Michelle" , "Culp, David" , "Bryars, Debra" , "Mitchell, Joe" Cc: "Rawls, Winfred" , "Swehla, Gina" , "Patterson, Tricia" Subject: Fwd: ADDITION TO UPDATE - Legionnaires Disease, Adams County Please see below from IEMA Director Joseph requesting information on first responder PPE. Please advise on how you would like us to proceed. We can certainly have a coordinated approach as we did with Ebola with IDPH being the lead/SME on content and development of guidance documents. Tammy Sent from my iPhone Begin forwarded message: From: "Moomey, Tammy" Date: August 31, 2015 at 8:20:24 PM CDT To: "Felchner, Gene" Cc: "Patterson, Tricia" , "Rawls, Winfred" , "Swehla, Gina" , "Barnett, Cara" Subject: Re: ADDITION TO UPDATE - Legionnaires Disease, Adams County Gene, the fact sheets say person to person spread of Legionellos does not occur. It is most commonly contracted by inhaling mist or vapor from a water source contaminated with the bacteria. We will need to discuss with staff and get recommendations on masks/respirators etc and get back to you. Tammy. Sent from my iPhone On Aug 31, 2015, at 8:02 PM, Felchner, Gene wrote: Hate to bother you two so late. But any help on the Director's question would be appreciated. Holler when you can. Thanks. Gene Sent from my iPhone Begin forwarded message: From: "Joseph, James" Date: August 31, 2015 at 6:08:21 PM CDT To: "Rasch, Paul" Cc: "Klinger, Joe" , "Ricker, Jennifer" , "Thompson, Patti" , "Felchner, Gene" , "Flemming, Robert" Subject: Re: ADDITION TO UPDATE - Legionnaires Disease, Adams County Thanks Paul. Joe - with Paul being out now, Pls touch base with someone at IDPH. After the first reported reported cases of ebola in the US last year, there was a lot of questions about how first responders approach a potential Ebola victim. We should work with IDPH to create the appropriate PPE recommendation for first responders and hospital workers, as well as any other facts about legionnaires disease for the same community. A lot of what we put out in DuPage was the same PPE recommendations as other situations would require, but putting something out specifically since there was so many questions and a lot of media hype was important. I have a copy of the type of documents we created and disseminated to DuPage County first responders if you would like to use that as a reference guide with IDPH. I gave a copy to Monken last year, and he left his copy in the office, so I technically have an extra one for you to have. I think it is important that IEMA and IDPH come up with something together on this. James James K. Joseph, Director Illinois Emergency Management Agency 2200 S. Dirksen Pkwy. Springfield, IL 62703 P: 217-782-2700 E: james.joseph@illinois.gov Sent from my iPhone On Aug 31, 2015, at 4:55 PM, Rasch, Paul wrote: All Apologize for a second e-mail; IDPH just provided further information. In addition to my first e-mail: · · · · · Potable water system remediation is ongoing today Illinois EPA testing municipal water in Quincy today Four additional lab confirmed cases in the surrounding community (unclear at this point if they are sporadic cases, identified because of increased testing, or linked to outbreak) IDPH will coordinate shipping of additional lab specimens to CDC Mapping of community cases is ongoing Thanks! Paul Paul Rasch, Jr. Manager, State Emergency Operations Center Illinois Emergency Management Agency Office: 217.558.5127 Cell: 217.685.3708 From: Rasch, Paul Sent: Monday, August 31, 2015 4:39 PM To: Joseph, James; Klinger, Joe; Ricker, Jennifer; Thompson, Patti Cc: Felchner, Gene; Flemming, Robert Subject: UPDATE - Legionnaires Disease, Adams County All IDPH advises that the outbreak of Legionnaires Disease at the State Veteran’s Home in Quincy which they reported last week is expanding. At this point four deaths have been attributed to the disease and the total number of cases is up to twenty-nine. IDPH is remaining in close contact with the facility and local health officials to monitor the situation, and a CDC team will be at the Home tomorrow to evaluate the situation. As previously, they are just providing us with situational awareness and no action on our part is currently requested or required. Thanks Paul Paul Rasch, Jr. Manager, State Emergency Operations Center Illinois Emergency Management Agency Office: 217.558.5127 Cell: 217.685.3708 From: "Austin, Connie" To: Echols Fred; Jodi; Nirav; Michelle; Erik; Craig; David; Kyle; Melaney; Divya CC: "Kelly-Shannon, Kate D." "Holmes, Tal" "McCann, Ken" "Bryars, Debra" "Clegg, Whitney" "Albertson, Justin" "DeWitt, Justin" "Rawls, Winfred" "Johnson, Bernard T." "Charles, Matt" "Bryars, Debra" "Martin, Aaron" "Beron, Andrew" xzj3@cdc.gov "Ward, Peter" "Arbise, Ben" "Lucht, Roland" "Kutty, Preeta \(CDC/OID/NCIRD\)" "Shay Drummond" jwelch@co.adams.il.us "Jon Campos" Date: 9/1/2015 7:20:09 PM Subject: Health Update: Legionella Adams County IVH, September 1 late pm Attachments: cdcs_Legionella_ppt_sept12015.pptx Submitted by (email): · Alert Level: Division of Infectious Disease Health Update 9/1 Type of Event : Outbreak/ Legionella Location: Illinois Veterans Home, Quincy, Adams Co Setting: Long Term Care Facility · · · · · · Objective Information: · · · · Power point attached. Some of the .pdf are blurry so we will work on clearing that up for tomorrow. There are 39 laboratory confirmed cases. Four of the confirmed cases are persons who work at the IVH campus. Seven fatalities have been reported in residents of the IVH who are laboratory confirmed with legionellosis. One person was found close to death without known symptoms of legionellosis and is being autopsied; initial information is that the lungs may be involved. Three autopsies are being done tonight in Mclean County on Adams County legionellosis cases. Approximately 40-50 persons have pending test results. The facility is no longer allowing admissions. The potable water system remediation is very complex and will take time to accomplish correctly. The cooling plastic media in the cooling tower will be replaced once the supplies can be ordered. Prevailing winds are from SW to NE in Quincy. There are four additional laboratory confirmed cases in the surrounding community area. One community case from a LTC facility (Sunset Home) died with legionella. The IDPH Env team requested the facility turn off the decorative fountain outside the Sunset Home and collected samples. The press is aware of this case. The CDC team started work this morning in Quincy IL. They will be providing epi and environmental consultation. A press release was issued today. There is press interest in the outbreak. Various entities such as AFSCME and OSHA have inquired into this outbreak. IDPH OPR is assisting with the transport of specimens mission. Human clinical specimens are going to the IDPH Springfield lab for shipment to CDC from Quincy and from Bloomington. Specimens from patients with discordant results or who had a urine · · · Assessment: · · Next Steps: antigen collected within 48 hours of onset are being sent to CDC along with autopsy specimens. IDPH DID has now updated the Access database with information from the 60+ questionnaires, lab results and clinical data. There are over 100 records in the database. This will allow for more rapid summaries of the situation. Several calls were held today with the CDC epi team and an overall conference call with all parties involved in the outbreak investigation. Legionella case numbers for the IVH facility are rising with 7 fatalities. Due to the incubation period for Legionella of up to 14 days, cases can be expected for 14 days after the source has been remediated (approximately September 11). The first step of remediation of the cooling tower was on August 27 and potable water restrictions were put in place on Wednesday, August 26. Four community cases have been identified. Three possibilities for the source at IVH are the cooling tower, decorative fountain and potable water system. There are reasons why both the potable water system and the cooling tower are both strong possibilities. The environmental testing results are taking more time than expected due to the high volume of testing from across the U.S. at the laboratory doing the testing. The various agencies are working together very effectively at this point to coordinate the best response to this outbreak. Kudos to all the hard work by all the many individuals who are working on this! o Await human and environmental testing results o IDPH Env Health, IVH employees, CDC employees and IEPA employees are working at the facility on remediation issues. o Continue maintaining the database with updated information o Coordinate with LHD and CDC on epidemiologic issues. --Health Alert: provides vital, time-sensitive information for a specific incident or situation; warrants immediate action or attention by health officials, laboratorians, clinicians, and members of the public; and conveys the highest level of importance. --Health Advisory: provides important information for a specific incident or situation; contains recommendations or actionable items to be performed by public health officials, laboratorians, and/or clinicians; may not require immediate action. --Health Update: provides updated information regarding an incident or situation; unlikely to require immediate action. PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Austin, Connie" To: Echols Fred; Jodi; Nirav; Michelle; Erik; Craig; "David; ;" Kyle; Melaney; Divya CC: "Kelly-Shannon, Kate D." "Holmes, Tal" "McCann, Ken" "Bryars, Debra" "Clegg, Whitney" "Albertson, Justin" "DeWitt, Justin" "Rawls, Winfred" "Johnson, Bernard T." "Charles, Matt" "Bryars, Debra" "Martin, Aaron" "Beron, Andrew" xzj3@cdc.gov "Ward, Peter" "Arbise, Ben" "Lucht, Roland" "Kutty, Preeta \(CDC/OID/NCIRD\)" "Shay Drummond" jwelch@co.adams.il.us "Jon Campos" Date: 9/1/2015 7:20:09 PM Subject: Health Update: Legionella Adams County IVH, September 1 late pm Attachments: cdcs_Legionella_ppt_sept12015.pptx Submitted by (email): · Alert Level: Division of Infectious Disease Health Update 9/1 Type of Event : Outbreak/ Legionella Location: Illinois Veterans Home, Quincy, Adams Co Setting: Long Term Care Facility · · · · · · Objective Information: · · · · Power point attached. Some of the .pdf are blurry so we will work on clearing that up for tomorrow. There are 39 laboratory confirmed cases. Four of the confirmed cases are persons who work at the IVH campus. Seven fatalities have been reported in residents of the IVH who are laboratory confirmed with legionellosis. One person was found close to death without known symptoms of legionellosis and is being autopsied; initial information is that the lungs may be involved. Three autopsies are being done tonight in Mclean County on Adams County legionellosis cases. Approximately 40-50 persons have pending test results. The facility is no longer allowing admissions. The potable water system remediation is very complex and will take time to accomplish correctly. The cooling plastic media in the cooling tower will be replaced once the supplies can be ordered. Prevailing winds are from SW to NE in Quincy. There are four additional laboratory confirmed cases in the surrounding community area. One community case from a LTC facility (Sunset Home) died with legionella. The IDPH Env team requested the facility turn off the decorative fountain outside the Sunset Home and collected samples. The press is aware of this case. The CDC team started work this morning in Quincy IL. They will be providing epi and environmental consultation. A press release was issued today. There is press interest in the outbreak. Various entities such as AFSCME and OSHA have inquired into this outbreak. IDPH OPR is assisting with the transport of specimens mission. Human clinical specimens are going to the IDPH Springfield lab for shipment to CDC from Quincy and from Bloomington. Specimens from patients with discordant results or who had a urine · · · Assessment: · · Next Steps: antigen collected within 48 hours of onset are being sent to CDC along with autopsy specimens. IDPH DID has now updated the Access database with information from the 60+ questionnaires, lab results and clinical data. There are over 100 records in the database. This will allow for more rapid summaries of the situation. Several calls were held today with the CDC epi team and an overall conference call with all parties involved in the outbreak investigation. Legionella case numbers for the IVH facility are rising with 7 fatalities. Due to the incubation period for Legionella of up to 14 days, cases can be expected for 14 days after the source has been remediated (approximately September 11). The first step of remediation of the cooling tower was on August 27 and potable water restrictions were put in place on Wednesday, August 26. Four community cases have been identified. Three possibilities for the source at IVH are the cooling tower, decorative fountain and potable water system. There are reasons why both the potable water system and the cooling tower are both strong possibilities. The environmental testing results are taking more time than expected due to the high volume of testing from across the U.S. at the laboratory doing the testing. The various agencies are working together very effectively at this point to coordinate the best response to this outbreak. Kudos to all the hard work by all the many individuals who are working on this! o Await human and environmental testing results o IDPH Env Health, IVH employees, CDC employees and IEPA employees are working at the facility on remediation issues. o Continue maintaining the database with updated information o Coordinate with LHD and CDC on epidemiologic issues. --Health Alert: provides vital, time-sensitive information for a specific incident or situation; warrants immediate action or attention by health officials, laboratorians, clinicians, and members of the public; and conveys the highest level of importance. --Health Advisory: provides important information for a specific incident or situation; contains recommendations or actionable items to be performed by public health officials, laboratorians, and/or clinicians; may not require immediate action. --Health Update: provides updated information regarding an incident or situation; unlikely to require immediate action. PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Austin, Connie" To: "Shay Drummond" CC: Date: 9/1/2015 6:59:53 AM Subject: RE: Fatality Updates Will check. Just don’t want to get the PIOs going without being sure we can release those deaths, with family notifications etc. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 7:59 AM To: Austin, Connie Subject: RE: Fatality Updates Did you get the faxes? From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Tuesday, September 01, 2015 7:55 AM To: Shay Drummond Subject: RE: Fatality Updates Shay, Thanks for sending info. We need to make sure these are Legionella cases and the families have been notified before forwarding to anyone. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 7:33 AM To: Arnold, Melaney; Austin, Connie; Conover, Craig; Echols, Fred; Shah, Nirav Cc: Jerrod Welch; Jon Campos Subject: Fatality Updates Importance: High We are starting the day on a sad note…Blessing Hospital called me this morning and we lost two over the evening and our death that we were waiting on lab results also came back positive. I am faxing over the information on all three. In addition over the evening we had labs come and and that put our total count of lab confirmed IVH at 37. Over the evening IVH had 2 more that they are treating with signs and symptoms. This is certainly going to be a tipping point on the media intensity. Thanks for your assistance on the messaging. Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Austin, Connie" To: "Shay Drummond" CC: Date: 9/1/2015 6:55:21 AM Subject: RE: Fatality Updates Shay, Thanks for sending info. We need to make sure these are Legionella cases and the families have been notified before forwarding to anyone. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 7:33 AM To: A rnold, Melaney; Austin, Connie; Conover, Craig; Echols, Fred; Shah, Nirav Cc: Jerrod Welch; Jon Campos Subject: Fatality Updates Importance: High We are starting the day on a sad note…Blessing Hospital called me this morning and we lost two over the evening and our death that we were waiting on lab results also came back positive. I am faxing over the information on all three. In addition over the evening we had labs come and and that put our total count of lab confirmed IVH at 37. Over the evening IVH had 2 more that they are treating with signs and symptoms. This is certainly going to be a tipping point on the media intensity. Thanks for your assistance on the messaging. Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. F r o m: "Bell, Scott S." To: Ajayi "Olafimihan; Allen Alexander; Allyson Stephens; Brian Tauke; Brian Wood; Camryn Gann; Carey Panier; Cheryl Lee; Chris Pozzi; Christopher Adams; Colleen Swaim; David McDowell; Don Cavi; Dorothy David; Eric Lane; Erin Anderson ; Evelyn Neavear; Franci Borrowman; JeffBennett; Katie Lynn; KerriAllen; Kimberly Bradley; Kurt Kuchle; Kyle Lloyd; Paul Guse; RyanWilliams; Sam Jarvis; Sarah Willett; Shay Drummond; Ted Pumo; Tony Dede; Wil ;" CC: D ate: 9/1/2015 6:35:31 AM S u b j e c t : 9/2 quarterly LHD EH Directors meeting All, sorry for the short notice but due to the Legionella outbreak in Quincy, meeting planning understandably was not a priority. Therefore there is no formal agenda. Please give me some feedback ASAP on your preference for proceeding with an informal agenda (legislative and program updates/discussions and whatever topics the group wants to discuss) or cancel this meeting. Shay has already expressed interest in a Quincy Legionella outbreak presentation at the next meeting. J. Scott Bell, LEHP, HHS Regional Supervisor IL Department of Public Health 5415 N. University St. Peoria, IL 61614 309 693 5371 fax 309 693 5118 scott.s.bell@illinois.gov Fr om: "Bell, Scott S." To : "Wil Hayes';" "Olafimihan; Allen Alexander; AllysonStephens; Brian Tauke; Brian Wood; Camryn Gann; Carey Panier; Cheryl Lee; Chris Pozzi; Christopher Adams; Colleen Swaim; David McDowell; Don Cavi; Dorothy David; Eric Lane; Erin Anderson; Evelyn Neavear; Franci Borrowman; Jeff Bennett; Katie Lynn; Kerri Allen; Kimberly Bradley; Kurt Kuchle; Kyle Lloyd; Paul Guse; Ryan Williams; Sam Jarvis; Sarah Willett; Shay Drummond; Ted Pumo; Tony ;" CC: D a te: 9/1/2015 8:11:27 AM Su b j e c t: RE: 9/2 quarterly LHD EH Directors meeting Conference room # is 309 693 4972 From: Wil Hayes [mailto:whayes@peoriacounty.org] Sent: Tuesday, September 01, 2015 9:08 AM To: Bell, Scott S.; Ajayi, Olafimihan; Allen Alexander; Allyson Stephens; Brian Tauke; Brian Wood; Camryn Gann; Carey Panier; Cheryl Lee; Chris Pozzi; Christopher Adams; Colleen Swaim; David McDowell; Don Cavi; Dorothy David; Eric Lane; Erin Anderson; Evelyn Neavear; Franci Borrowman; Jeff Bennett; Katie Lynn; Kerri Allen; Kimberly Bradley; Kurt Kuchle; Kyle Lloyd; Paul Guse; Ryan Williams; Sam Jarvis; Sarah Willett; Shay Drummond; Ted Pumo; Tony Dede Subject: RE: 9/2 quarterly LHD EH Directors meeting We already have the room reserved so why don't we go ahead and meet. With everything Adams' County has going on Peoria will assume hosting responsibilities. I will get an agenda to Scott later this morning so he xan send it to everyone. Scott will you line up a conference call number that individuals can use to call in. Thanks Sent from my Verizon Wireless 4G LTE smartphone -------- Original message -------From: "Bell, Scott S." Date: 09/01/2015 7:35 AM (GMT-06:00) To: "Ajayi, Olafimihan" , Allen Alexander , Allyson Stephens , Brian Tauke , Brian Wood , Camryn Gann , Carey Panier , Cheryl Lee , Chris Pozzi , Christopher Adams , Colleen Swaim , David McDowell , Don Cavi , Dorothy David , Eric Lane , Erin Anderson , Evelyn Neavear , Franci Borrowman , Jeff Bennett , Katie Lynn , Kerri Allen , Kimberly Bradley , Kurt Kuchle , Kyle Lloyd , Paul Guse , Ryan Williams , Sam Jarvis , Sarah Willett , Shay Drummond , Ted Pumo , Tony Dede , Wil Hayes Subject: 9/2 quarterly LHD EH Directors meeting All, sorry for the short notice but due to the Legionella outbreak in Quincy, meeting planning understandably was not a priority. Therefore there is no formal agenda. Please give me some feedback ASAP on your preference for proceeding with an informal agenda (legislative and program updates/discussions and whatever topics the group wants to discuss) or cancel this meeting. Shay has already expressed interest in a Quincy Legionella outbreak presentation at the next meeting. J. Scott Bell, LEHP, HHS Regional Supervisor IL Department of Public Health 5415 N. University St. Peoria, IL 61614 309 693 5371 fax 309 693 5118 scott.s.bell@illinois.gov From: "Echols, Fred" To: ;Arnold "Melaney ;; Shah>" Nirav CC: "Austin, Connie" "Conover, Craig" "DeWitt, Justin" "Holmes, Tal" "Culp, David" "Albertson, Justin" "Clegg, Whitney" "Beron, Andrew" Date: 9/1/2015 9:57:24 AM S u b j e c t : Legionellosis Outbreak & Cluster Case Count Update (09/1/2015) To All, Today’s case count summary for the legionellosis outbreak in Adams County is provided below: · IVH Outbreak o Case total: 39  35 residents · Includes 7 deaths of laboratory confirmed cases  4 IVH staff Please let me know if you have any questions or concerns. Thanks. Respectfully Yours, Fredrick L. Echols, MD Chief,Communicable Diseases Illinois Department of Public Health Phone: 217-782-2016 Fax: 217-524-0962 Email: Fred.Echols@Illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 9/1/2015 2:49:26 PM Subject: RE: Tracking LD S&S Also— —transplant patient that was at Iowa City……was discharged and went home with family for a while. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 3:45 PM To: HOUSTON, CATHY Subject: RE: Tracking LD S&S Great, any new changes? From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Tuesday, September 01, 2015 3:44 PM To: Shay Drummond Subject: Tracking LD S&S Updated……still working on CXRs and Antibiotics getting them all listed and double checked. Will have on tomorrow’s. Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 CATHY.S.HOUSTON@illinois.gov From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 9/1/2015 2:48:52 PM Subject: RE: Tracking LD S&S More staff….since we are asking for S&S when they are calling in. I have no idea if some are being tested. Several new today…..urines have been sent. Mainly lo-grade temps. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 3:45 PM To: HOUSTON, CATHY Subject: RE: Tracking LD S&S Great, any new changes? From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Tuesday, September 01, 2015 3:44 PM To: Shay Drummond Subject: Tracking LD S&S Updated……still working on CXRs and Antibiotics getting them all listed and double checked. Will have on tomorrow’s. Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 CATHY.S.HOUSTON@illinois.gov From: "HOUSTON, CATHY" To: Yantis Ryan "Melaney ;'Shay Drummond" CC: Date: 9/1/2015 10:53:48 AM S u b j ect: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. I also called Blessing to assure they were notified and they were. From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 11:03 AM To: Arnold, Melaney; 'Shay Drummond'; HOUSTON, CATHY Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. In convo with Cathy this AM, the Home has a solid notification protocol for change in status of residents if/when symptomatic, or there is a change in condition. The staff call and brief the family (POA power of attorney or ICE designates), and should a resident get a confirming test result, then the Infectious Disease Nurse at the Home talks to the family. This is all charted. Generally the families are in attendance if a resident is expectant/in comfort care/hospice, but notification is made if the family is not present. Again, all charted. While not answering for Blessing, Cathy was very positive about their standards of notification and family communication. Blessing would handle any notification for residents under their care. We might want to loop in the Blessing PR folks… From: Arnold, Melaney Sent: Tuesday, September 01, 2015 10:55 AM To: 'Shay Drummond'; Yantis, Ryan; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Not yet. Connie said she was going to talk with you at 11:15 and we would have numbers by 11:30. Also – do you know if the families have been notified? I know you’ve been busy. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 10:50 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Hi have you gotten the updates from Fred? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "HOUSTON, CATHY" To: "Shay Drummond" CC: Date: 9/1/2015 2:43:45 PM Subject: Tracking LD S&S Attachments: Legionella Tracking Log - 09-01-15 1500.xlsx Updated……still working on CXRs and Antibiotics getting them all listed and double checked. Will have on tomorrow’s. Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 CATHY.S.HOUSTON@illinois.gov From: "Jeffries, Erica L" To: "Shay Drummond" CC: "HOUSTON, CATHY" "VACA, BRUCE" "WINNICKI, LENARD F." Date: 9/1/2015 6:37:38 AM Subject: CDC Good morning, Shay, I know the CDC are planning to meet you at your office at 8am. What time do you plan to come to the Home? We want to be standing by to meet you all. Thanks so much. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 From: "Jeffries, Erica L" To: "Shay Drummond" CC: "HOUSTON, CATHY" "VACA, BRUCE" "WINNICKI, LENARD F." Date: 9/1/2015 6:41:04 AM Subject: Re: CDC Great - thank you so much. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Sep 1, 2015, at 07:39, Shay Drummond wrote: Hi Erica, I would say we would be heading your wa y around 8:30 – I will message you as soon as I have ETA. Thanks! Shay From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Tuesday, September 01, 2015 7:38 AM To: Shay Drummond Cc: HOUSTON, CATHY; VACA, BRUCE; WINNICKI, LENARD F. Subject: CDC Good morning, Shay, I know the CDC are planning to meet you at your office at 8am. What time do you plan to come to the Home? We want to be standing by to meet you all. Thanks so much. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 From: "Jeffries, Erica L" To: Arnold Melaney CC: "Yantis, Ryan" "Shay Drummond" "Albert, Alison P. \(CDC/OID/NCIRD\)" "Branam, Ian \(CDC/OID/NCIRD\) \(CTR\)" "Shah, Nirav" "Jerrod Welch" Date: 9/1/2015 8:02:19 AM Subject: Re: DRAFT - news release The following can be added as my quote: "We are being hyper-vigilant in monitoring our residents and we continue to follow the guidance of our interagency partners to implement remediation efforts across our Home. The safety and quality of care for our residents and staff are our primary concerns." Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 On Sep 1, 2015, at 08:29, Arnold, Melaney wrote: I think with the additional deaths and the jump in cases, we need to issue an update to media. If we don’t, it might appear we’re trying to hide them. Draft attached. Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH <09.01.15 Legionnaires 7 deaths.docx> From: "Meka, Anu" To: amnda_christian amy_henderson anita_pike Brown_adm carol carrie_skiles curt dale diana_sangmon hugh_montgmery jarod_adms jessica kayla_cass Linda logan logan_Don morgan_hd nancy nina nroegge@casscohealth.org Pam phyllis Pike robin ronda sangmon shay steve steve <_emergency> tdietrich@co.adams.il.us teresa CC: Date: 9/1/2015 11:04:49 AM Subject: FW: News Release - Legionnaires' Attachments: 09.01.15 Legionnaires 7 deaths.docx FYI – on the ongoing Legionnaire’s disease From: Rawls, Winfred Sent: Tuesday, September 01, 2015 11:43 AM To: Moomey, Tammy Subject: FW: News Release - Legionnaires' FYI /SA…OPR Staff Update…. From: Arnold, Melaney Sent: Tuesday, September 01, 2015 11:21 AM This news release is being sent at NOON today to media statewide. Thank you. Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of a total of seven residents at the Illinois Veterans’ Home-Quincy. The seven residents, all of whom had underlying medical conditions, were among the 39 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “While saddened by the loss of our residents, having been at the Home and talking with the staff and our residents, I am impressed with their resilience and spirit,” said IDVA Director Erica Jeffries. “We remain vigilant in monitoring our residents and we continue to follow the guidance of our interagency partners to implement remediation efforts across our Home. The safety and quality of care for our residents and staff are our primary concerns.” “We continue to work diligently with our public health and Veterans’ Affairs partners to get immediate medical care to residents or staff at the Home who are experiencing respiratory illness,” said IDPH Director Nirav D. Shah, M.D., J.D. “Unfortunately, we expect to see additional cases and possibly additional deaths because the incubation period for Legionnaires’ disease can be up to two weeks, and because patients with underlying medical conditions are at increased risk of more severe illness.” On August 30, 2015, IDPH requested aid from the U.S. Centers for Disease Control and Prevention (CDC) for epidemiology and environmental health assistance. Yesterday, three CDC Epidemic Intelligence Service Officers and one environmental health specialist arrived at the Illinois Veterans’ Home – Quincy to work with IDVA and IDPH in investigating the Legionnaires’ disease outbreak. CDC will also provide laboratory support from its headquarters in Atlanta, GA. IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Due to the nature of the bacteria, test results can take up to two weeks. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. For more information about Legionnaires’ disease, visit the IDPH website. For media seeking additional information, please contact: IDVA / IVH-Q: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d)217-222-8440 x148 (c)217-316-2795 sdrummond@co.adams.il.us ### Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: "Meka, Anu" To: jwelch@co.adams.il.us CC: "Triena Dietrich" "Shay Drummond" Date: 9/1/2015 7:55:10 AM Subject: Legionella - ACHD A t t a c h m e n t s : ATT00001.txt Hi Jarod, Just wanted to update you on the ongoing Legionellosis from IDPH side. There is a CDC team coming to IL to assist with this. See the image attached. Just came to know the death count now is 6. IDPHis coming to Blessing hosp to get some human specimens for lab testing. IDPH is setting up a virtual IMT, please reach out to us (me or Gina - Gina.swehla@illinois.gov) for any help. Keep me updated Thanks Anu From: "Meka, Anu" To: "Shay Drummond" CC: "Jerrod Welch" "Triena Dietrich" Date: 9/1/2015 9:17:41 AM Subject: Re: Legionella - ACHD Ok, thnx Sent from my iPhone > On Sep 1, 2015, at 9:02 AM, "Shay Drummond" wrote: > > X thanks Avenue no supplies needed at this time. We will keep you posted if we need anything. > > Sent from my iPhone > >> On Sep 1, 2015, at 8:59 AM, Meka, Anu wrote: >> >> A quick question>> Has IPhMAS request been sent out on any supplies of need if any? >> Is your MRC being utilized for any at this point? >> Pls don't hesitate to reach IDPH including Win if need be >> Anu >> Sent from my iPhone >> >>> On Sep 1, 2015, at 8:55 AM, "Meka, Anu" wrote: >>> >>> Hi Jarod, >>> Just wanted to update you on the ongoing Legionellosis from IDPH side. There is a CDC team coming to IL to assist with this. See the image attached. Just came to know the death count now is 6. IDPHis coming to Blessing hosp to get some human specimens for lab testing. IDPH is setting up a virtual IMT, please reach out to us (me or Gina - Gina.swehla@illinois.gov) for any help. >>> Keep me updated >>> Thanks >>> Anu >>> >>> >>> Sent from my iPhone From: "Meka, Anu" To: jwelch@co.adams.il.us CC: "Triena Dietrich" "Shay Drummond" Date: 9/1/2015 7:59:48 AM Subject: Re: Legionella - ACHD A quick questionHas IPhMAS request been sent out on any supplies of need if any? Is your MRC being utilized for any at this point? Pls don't hesitate to reach IDPH including Win if need be Anu Sent from my iPhone > On Sep 1, 2015, at 8:55 AM, "Meka, Anu" wrote: > > Hi Jarod, > Just wanted to update you on the ongoing Legionellosis from IDPH side. There is a CDC team coming to IL to assist with this. See the image attached. Just came to know the death count now is 6. IDPHis coming to Blessing hosp to get some human specimens for lab testing. IDPH is setting up a virtual IMT, please reach out to us (me or Gina - Gina.swehla@illinois.gov) for any help. > Keep me updated > Thanks > Anu > > > Sent from my iPhone From: "Morgan, Jodi" To: "Shay Drummond" jcampos@co.adams.il.us jwelch@co.adams.il.us CC: "Cox, Robert F." Date: 9/1/2015 7:48:10 AM Subject: FW: OPR assistance They are en route to pick up the urine specimens. From: Moomey, Tammy Sent: Tuesday, September 01, 2015 8:46 AM To: Morgan, Jodi Cc: Culp, David; Mitchell, Joe; Swehla, Gina; Austin, Connie; Rawls, Winfred; Patterson, Tricia; Johnson, Bernard T.; Holmes, Tal; Echols, Fred; Cox, Robert F. Subject: Re: OPR assistance Brian Kieninger, RN, EMS coordinator is headed to Quincy/Adams Co now. His ETA is 11 a.m. Who is the point of contact at Adams Co? Sent from my iPhone On Aug 31, 2015, at 8:07 PM, Moomey, Tammy wrote: Ok, we will make the arrangements and will advise specifics in the morning. Sent from my iPhone On Aug 31, 2015, at 6:21 PM, Morgan, Jodi wrote: I spoke with Shay and they will have the specimens ready for pick up at the local health department. They have some to pick up at the IVH and hospital, so they should have them all at the LHD by 10AM. Adams County Health Dept 330 Vermont St Quincy 217-222-8440 Thank you very much!! Jodi From: Culp, David Sent: Monday, August 31, 2015 5:20 PM To: Moomey, Tammy; Mitchell, Joe; Swehla, Gina; Austin, Connie; Morgan, Jodi Cc: Rawls, Winfred; Patterson, Tricia; Johnson, Bernard T.; Holmes, Tal; Echols, Fred Subject: RE: OPR assistance Importance: High Excellent Tammy Connie Austin and Jodi Morgan from Division of Infectious Diseases can provide informational assistance per your request Dave From: Moomey, Tammy Sent: Monday, August 31, 2015 5:18 PM To: Mitchell, Joe; Swehla, Gina Cc: Rawls, Winfred; Culp, David; Patterson, Tricia Subject: RE: OPR assistance Importance: High Joe – we were making arrangements to coordinate the pick up of the samples from Quincy hospital. The lab supervisor at the hospital said they do not have any samples for pick up tomorrow and are unaware of any coming in. We can cover this, but need to verify the information. Please advise. Thanks, Tammy From: Mitchell, Joe Sent: Monday, August 31, 2015 3:53 PM To: Swehla, Gina; Moomey, Tammy Cc: Rawls, Winfred; Culp, David; Patterson, Tricia Subject: FW: OPR assistance Gina and Tammy, As part of the Legionella response related to the Quincy Veterans Home, the DID CD section is requesting OPR logistics support for transport of specimens to the IDPH Lab. We appreciate any assistance you can provide. Let me know if you have any questions. Thanks, Joe Joe Mitchell Section Chief, Environmental Health Services Division of Environmental Health Illinois Department of Public Health 525 West Jefferson Street, 3rd Floor Springfield, IL 62761 Phone: 217/785-3176 E-mail: joe.mitchell@illinois.gov If you’re interested in more information about the outbreak response, there is a daily afternoon briefing starting today at 4pm. Please Dial: 888-494-4032 Access Code: 801-0680-889 From: Morgan, Jodi Sent: Monday, August 31, 2015 3:42 PM To: Mitchell, Joe Cc: Culp, David; Austin, Connie Subject: OPR assistance 1. Tuesday: Transport two urine specimens from Blessing Hospital in Quincy to IDPH lab in Springfield. Blessing Hospital: 1005 Broadway St, Quincy, IL 62301 (217) 223-8400 2. Wednesday morning: Transport specimens from Bloomington coroner’s office to IDPH lab. Dry ice will be needed for some of the specimens, will advise further tomorrow after confirming details with IDPH lab. McLean County Coroner’s office: 104 W Front St, Bloomington, IL 61701 (309) 888-5210 Thank you!!! Jodi Jodi Morgan, RN BSN CIC Infection Prevention & Control Communicable Disease Control Section Office of Health Protection Illinois Department of Public Health 525 W. Jefferson Springfield, IL 62761-0001 T: 217-782-2016 F: 217-524-0962 Jodi.Morgan@illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Morgan, Jodi" To: "Shay Drummond" CC: Date: 9/1/2015 8:57:01 AM Subject: RE: OPR assistance Do you have a total of 12 urines you are sending? Thanks, jodi From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 9:36 AM To: Morgan, Jodi Cc: Jon Campos; Jerrod Welch; Cox, Robert F. Subject: Re: OPR assistance We have it ready. Sent from my iPhone On Sep 1, 2015, at 8:48 AM, Morgan, Jodi wrote: They are en route to pick up the urine specimens. From: Moomey, Tammy Sent: Tuesday, September 01, 2015 8:46 AM To: Morgan, Jodi Cc: Culp, David; Mitchell, Joe; Swehla, Gina; Austin, Connie; Rawls, Winfred; Patterson, Tricia; Johnson, Bernard T.; Holmes, Tal; Echols, Fred; Cox, Robert F. Subject: Re: OPR assistance Brian Kieninger, RN, EMS coordinator is headed to Quincy/Adams Co now. His ETA is 11 a.m. Who is the point of contact at Adams Co? Sent from my iPhone On Aug 31, 2015, at 8:07 PM, Moomey, Tammy wrote: Ok, we will make the arrangements and will advise specifics in the morning. Sent from my iPhone On Aug 31, 2015, at 6:21 PM, Morgan, Jodi wrote: I spoke with Shay and they will have the specimens ready for pick up at the local health department. They have some to pick up at the IVH and hospital, so they should have them all at the LHD by 10AM. Adams County Health Dept 330 Vermont St Quincy 217-222-8440 Thank you very much!! Jodi From: Culp, David Sent: Monday, August 31, 2015 5:20 PM To: Moomey, Tammy; Mitchell, Joe; Swehla, Gina; Austin, Connie; Morgan, Jodi Cc: Rawls, Winfred; Patterson, Tricia; Johnson, Bernard T.; Holmes, Tal; Echols, Fred Subject: RE: OPR assistance Importance: High Excellent Tammy Connie Austin and Jodi Morgan from Division of Infectious Diseases can provide informational assistance per your request Dave From: Moomey, Tammy Sent: Monday, August 31, 2015 5:18 PM To: Mitchell, Joe; Swehla, Gina Cc: Rawls, Winfred; Culp, David; Patterson, Tricia Subject: RE: OPR assistance Importance: High Joe – we were making arrangements to coordinate the pick up of the samples from Quincy hospital. The lab supervisor at the hospital said they do not have any samples for pick up tomorrow and are unaware of any coming in. We can cover this, but need to verify the information. Please advise. Thanks, Tammy From: Mitchell, Joe Sent: Monday, August 31, 2015 3:53 PM To: Swehla, Gina; Moomey, Tammy Cc: Rawls, Winfred; Culp, David; Patterson, Tricia Subject: FW: OPR assistance Gina and Tammy, As part of the Legionella response related to the Quincy Veterans Home, the DID CD section is requesting OPR logistics support for transport of specimens to the IDPH Lab. We appreciate any assistance you can provide. Let me know if you have any questions. Thanks, Joe Joe Mitchell Section Chief, Environmental Health Services Division of Environmental Health Illinois Department of Public Health 525 West Jefferson Street, 3rd Floor Springfield, IL 62761 Phone: 217/785-3176 E-mail: joe.mitchell@illinois.gov If you’re interested in more information about the outbreak response, there is a daily afternoon briefing starting today at 4pm. Please Dial: 888-494-4032 Access Code: 801-0680-889 From: Morgan, Jodi Sent: Monday, August 31, 2015 3:42 PM To: Mitchell, Joe Cc: Culp, David; Austin, Connie Subject: OPR assistance 1. Tuesday: Transport two urine specimens from Blessing Hospital in Quincy to IDPH lab in Springfield. Blessing Hospital: 1005 Broadway St, Quincy, IL 62301 (217) 223-8400 2. Wednesday morning: Transport specimens from Bloomington coroner’s office to IDPH lab. Dry ice will be needed for some of the specimens, will advise further tomorrow after confirming details with IDPH lab. McLean County Coroner’s office: 104 W Front St, Bloomington, IL 61701 (309) 888-5210 Thank you!!! Jodi Jodi Morgan, RN BSN CIC Infection Prevention & Control Communicable Disease Control Section Office of Health Protection Illinois Department of Public Health 525 W. Jefferson Springfield, IL 62761-0001 T: 217-782-2016 F: 217-524-0962 Jodi.Morgan@illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Morgan, Jodi" To: "Shay Drummond" CC: Date: 9/1/2015 9:03:22 AM Subject: RE: OPR assistance I thought we only had 5 discordant? From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 10:01 AM To: Morgan, Jodi Subject: Re: OPR assistance No it is at least nine burins were sending for that are discordant labs and then the balance are the urines that were taken less than 48 hours after onset of symptoms that we were retesting. Sent from my iPhone On Sep 1, 2015, at 9:57 AM, Morgan, Jodi wrote: Do you have a total of 12 urines you are sending? Thanks, jodi From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 9:36 AM To: Morgan, Jodi Cc: Jon Campos; Jerrod Welch; Cox, Robert F. Subject: Re: OPR assistance We have it ready. Sent from my iPhone On Sep 1, 2015, at 8:48 AM, Morgan, Jodi wrote: They are en route to pick up the urine specimens. From: Moomey, Tammy Sent: Tuesday, September 01, 2015 8:46 AM To: Morgan, Jodi Cc: Culp, David; Mitchell, Joe; Swehla, Gina; Austin, Connie; Rawls, Winfred; Patterson, Tricia; Johnson, Bernard T.; Holmes, Tal; Echols, Fred; Cox, Robert F. Subject: Re: OPR assistance Brian Kieninger, RN, EMS coordinator is headed to Quincy/Adams Co now. His ETA is 11 a.m. Who is the point of contact at Adams Co? Sent from my iPhone On Aug 31, 2015, at 8:07 PM, Moomey, Tammy wrote: Ok, we will make the arrangements and will advise specifics in the morning. Sent from my iPhone On Aug 31, 2015, at 6:21 PM, Morgan, Jodi wrote: I spoke with Shay and they will have the specimens ready for pick up at the local health department. They have some to pick up at the IVH and hospital, so they should have them all at the LHD by 10AM. Adams County Health Dept 330 Vermont St Quincy 217-222-8440 Thank you very much!! Jodi From: Culp, David Sent: Monday, August 31, 2015 5:20 PM To: Moomey, Tammy; Mitchell, Joe; Swehla, Gina; Austin, Connie; Morgan, Jodi Cc: Rawls, Winfred; Patterson, Tricia; Johnson, Bernard T.; Holmes, Tal; Echols, Fred Subject: RE: OPR assistance Importance: High Excellent Tammy Connie Austin and Jodi Morgan from Division of Infectious Diseases can provide informational assistance per your request Dave From: Moomey, Tammy Sent: Monday, August 31, 2015 5:18 PM To: Mitchell, Joe; Swehla, Gina Cc: Rawls, Winfred; Culp, David; Patterson, Tricia Subject: RE: OPR assistance Importance: High Joe – we were making arrangements to coordinate the pick up of the samples from Quincy hospital. The lab supervisor at the hospital said they do not have any samples for pick up tomorrow and are unaware of any coming in. We can cover this, but need to verify the information. Please advise. Thanks, Tammy From: Mitchell, Joe Sent: Monday, August 31, 2015 3:53 PM To: Swehla, Gina; Moomey, Tammy Cc: Rawls, Winfred; Culp, David; Patterson, Tricia Subject: FW: OPR assistance Gina and Tammy, As part of the Legionella response related to the Quincy Veterans Home, the DID CD section is requesting OPR logistics support for transport of specimens to the IDPH Lab. We appreciate any assistance you can provide. Let me know if you have any questions. Thanks, Joe Joe Mitchell Section Chief, Environmental Health Services Division of Environmental Health Illinois Department of Public Health 525 West Jefferson Street, 3rd Floor Springfield, IL 62761 Phone: 217/785-3176 E-mail: joe.mitchell@illinois.gov If you’re interested in more information about the outbreak response, there is a daily afternoon briefing starting today at 4pm. Please Dial: 888-494-4032 Access Code: 801-0680-889 From: Morgan, Jodi Sent: Monday, August 31, 2015 3:42 PM To: Mitchell, Joe Cc: Culp, David; Austin, Connie Subject: OPR assistance 1. Tuesday: Transport two urine specimens from Blessing Hospital in Quincy to IDPH lab in Springfield. Blessing Hospital: 1005 Broadway St, Quincy, IL 62301 (217) 223-8400 2. Wednesday morning: Transport specimens from Bloomington coroner’s office to IDPH lab. Dry ice will be needed for some of the specimens, will advise further tomorrow after confirming details with IDPH lab. McLean County Coroner’s office: 104 W Front St, Bloomington, IL 61701 (309) 888-5210 Thank you!!! Jodi Jodi Morgan, RN BSN CIC Infection Prevention & Control Communicable Disease Control Section Office of Health Protection Illinois Department of Public Health 525 W. Jefferson Springfield, IL 62761-0001 T: 217-782-2016 F: 217-524-0962 Jodi.Morgan@illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: To: I CC: "Johnson Bernard Date: 9/1/2015 8:50:15 AM Subject: RE: Status update on Legionella specimens Hi Bob, See new info in red below. Kate is working on transport of today?s autopsy specimens. Stay From: Morgan, Jodi Sent: Monday, August 31, 2015 2:47 PM To: Cox, Robert F. Austin, Connie Cc: Johnson, Bernard T. Subject: RE: Status update on Legionella specimens Bob, As per our conversation: The tissue specimens are coming to IDPH lab via Jim from Bloomington. The last autopsy specimens will not be done until after 3PM. He anticipates arriving after 5PM. McLean County was getting him a couple of coolers and dry ice and ice packs. I sent them the instructions for 'shipping? the specimens but clarified they are coming to IDPH lab via Jim as driver. Specimens will be arriving for: Tomorrow, they are doing two more autopsies after 5 PM and specimens will have to be picked up Weds AM. Still working that out. Those cases are: The urines that will be sent are the ones with discordant results. Shay planned to collect all five of these: These are repeats that were done less than 48 hours after onset: We haven’t gotten these in INEDSS yet. Shay said they were trying to get a urine on every single one of these, so I haven’t been able to confirm they are coming, but this is what we anticipate is coming. HUGE thank you to Tom for his help last night also!!! Thank you! Jodi From: Cox, Robert F. Sent: Monday, August 31, 2015 1:42 PM To: Austin, Connie; Morgan, Jodi Cc: Johnson, Bernard T. Subject: Status update on Legionella specimens Has shipment to CDC for the tissue specimens been worked out? Are there urines still coming for shipment to CDC today? Thank you, Bob Robert F. Cox MPH, Clinical Microbiology Supervisor, R0 Illinois Department of Public Health Division of Laboratories 825 North Rutledge Street PO. Box 19435 Spring?eld, IL 62702 Phone: 217-557-2623 Fax 217-557-2618 EEGWTONFIDENTMLI NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/con?dential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "Shah, Nirav" To: Austin Connie; Fred; Jodi; Michelle; Erik; Craig; David; Kyle; Melaney; Divya CC: "Kelly-Shannon, Kate D." "Holmes, Tal" "McCann, Ken" "Bryars, Debra" "Clegg, Whitney" "Albertson, Justin" "DeWitt, Justin" "Rawls, Winfred" "Johnson, Bernard T." "Charles, Matt" "Bryars, Debra" "Martin, Aaron" "Beron, Andrew" xzj3@cdc.gov "Ward, Peter" "Arbise, Ben" "Lucht, Roland" "Kutty, Preeta \(CDC/OID/NCIRD\)" "Shay Drummond" jwelch@co.adams.il.us "Jon Campos" Date: 9/1/2015 8:27:03 PM Subject: Re: Health Update: Legionella Adams County IVH, September 1 late pm Thank you very much. _______________________________________ Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health 69 W. Washington Street, Suite 3506 Chicago, IL 60602 (312) 814-5278 535 W. Jefferson Street Springfield, IL 62761 (217) 557-2556 From: , Connie Date: Tuesday, September 1, 2015 at 8:20 PM To: "Echols, Fred" , "Morgan, Jodi" , Nirav Shah , "Gentry-Wiseman, Michelle" , "Rayman, Erik" , "Conover, Craig" , "Culp, David" , Kyle Stone , "Arnold, Melaney" , "Little, Divya Mohan" Cc: "Kelly-Shannon, Kate D." , "Holmes, Tal" , "McCann, Ken" , "Bryars, Debra" , "Clegg, Whitney" , "Albertson, Justin" , "DeWitt, Justin" , "Rawls, Winfred" , "Johnson, Bernard T." , "Charles, Matt" , "Bryars, Debra" , "Martin, Aaron" , "Beron, Andrew" , "xzj3@cdc.gov" , "Ward, Peter" , "Arbise, Ben" , "Lucht, Roland" , "Kutty, Preeta (CDC/OID/NCIRD)" , Shay Drummond , "jwelch@co.adams.il.us" , Jon Campos Subject: Health Update: Legionella Adams County IVH, September 1 late pm Submitted by (email): · Alert Level: Division of Infectious Disease Health Update 9/1 Type of Event : Outbreak/ Legionella Location: Illinois Veterans Home, Quincy, Adams Co Setting: Long Term Care Facility · · · · · · Objective Information: · · · · Power point attached. Some of the .pdf are blurry so we will work on clearing that up for tomorrow. There are 39 laboratory confirmed cases. Four of the confirmed cases are persons who work at the IVH campus. Seven fatalities have been reported in residents of the IVH who are laboratory confirmed with legionellosis. One person was found close to death without known symptoms of legionellosis and is being autopsied; initial information is that the lungs may be involved. Three autopsies are being done tonight in Mclean County on Adams County legionellosis cases. Approximately 40-50 persons have pending test results. The facility is no longer allowing admissions. The potable water system remediation is very complex and will take time to accomplish correctly. The cooling plastic media in the cooling tower will be replaced once the supplies can be ordered.Prevailing winds are from SW to NE in Quincy. There are four additional laboratory confirmed cases in the surrounding community area. One community case from a LTC facility (Sunset Home) died with legionella. The IDPH Env team requested the facility turn off the decorative fountain outside the Sunset Home and collected samples. The press is aware of this case. The CDC team started work this morning in Quincy IL. They will be providing epi and environmental consultation. A press release was issued today. There is press interest in the outbreak. Various entities such as AFSCME and OSHA have inquired into this outbreak. IDPH OPR is assisting with the transport of specimens mission. Human clinical specimens are going to the IDPH Springfield lab for shipment to CDC from Quincy and from Bloomington. Specimens from patients with discordant results or who had a urine antigen collected within 48 hours of onset are being sent to CDC along with autopsy specimens. · · · Assessment: · · Next Steps: IDPH DID has now updated the Access database with information from the 60+ questionnaires, lab results and clinical data. There are over 100 records in the database. This will allow for more rapid summaries of the situation. Several calls were held today with the CDC epi team and an overall conference call with all parties involved in the outbreak investigation. Legionella case numbers for the IVH facility are rising with 7 fatalities. Due to the incubation period for Legionella of up to 14 days, cases can be expected for 14 days after the source has been remediated (approximately September 11). The first step of remediation of the cooling tower was on August 27 and potable water restrictions were put in place on Wednesday, August 26. Four community cases have been identified. Three possibilities for the source at IVH are the cooling tower, decorative fountain and potable water system. There are reasons why both the potable water system and the cooling tower are both strong possibilities. The environmental testing results are taking more time than expected due to the high volume of testing from across the U.S. at the laboratory doing the testing. The various agencies are working together very effectively at this point to coordinate the best response to this outbreak. Kudos to all the hard work by all the many individuals who are working on this! o Await human and environmental testing results o IDPH Env Health, IVH employees, CDC employees and IEPA employees are working at the facility on remediation issues. o Continue maintaining the database with updated information o Coordinate with LHD and CDC on epidemiologic issues. --Health Alert: provides vital, time-sensitive information for a specific incident or situation; warrants immediate action or attention by health officials, laboratorians, clinicians, and members of the public; and conveys the highest level of importance. --Health Advisory: provides important information for a specific incident or situation; contains recommendations or actionable items to be performed by public health officials, laboratorians, and/or clinicians; may not require immediate action. --Health Update: provides updated information regarding an incident or situation; unlikely to require immediate action. PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Shay Drummond" To: HOUSTON "CATHY <" "\(CATHY.S.HOUSTON@illinois.gov\);>" CC: Date: 9/1/2015 9:58:09 AM Subject: FW: Legionellosis Outbreak & Cluster Case Count Update (09/1/2015) From: Echols, Fred [mailto:Fred.Echols@Illinois.gov] Sent: Tuesday, September 01, 2015 10:57 AM To: Shay Drummond; Arnold, Melaney; Jerrod Welch; Shah, Nirav Cc: Austin, Connie; Conover, Craig; DeWitt, Justin; Holmes, Tal; Culp, David; Albertson, Justin; Clegg, Whitney; Beron, Andrew Subject: Legionellosis Outbreak & Cluster Case Count Update (09/1/2015) To All, Today’s case count summary for the legionellosis outbreak in Adams County is provided below: · IVH Outbreak o Case total: 39  35 residents · Includes 7 deaths of laboratory confirmed cases  4 IVH staff Please let me know if you have any questions or concerns. Thanks. Respectfully Yours, Fredrick L. Echols, MD Chief,Communicable Diseases Illinois Department of Public Health Phone: 217-782-2016 Fax: 217-524-0962 Email: Fred.Echols@Illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "Shay Drummond" To: Albertson "Justin <" "\(Justin.Albertson@illinois.gov\);>" CC: Date: 9/1/2015 10:39:13 AM Subject: Legionella Tracking Log - 8-31-15 1500.xlsx Attachments: Legionella Tracking Log - 8-31-15 1500.xlsx From: "Shay Drummond" To: Albertson "Justin <" "\(Justin.Albertson@illinois.gov\);>" CC: Date: 9/1/2015 4:06:31 PM Subject: Legionella Tracking Log - 09-01-15 1500.xlsx Attachments: Legionella Tracking Log - 09-01-15 1500.xlsx Her note was that she is still working on getting chest x-rays put into the data sheet. From: "Shay Drummond" To: Austin Connie CC: "Jon Campos" Date: 9/1/2015 8:36:17 AM Subject: Re: ADDITION TO UPDATE - Legionnaires Disease, Adams County I agree. Sent from my iPhone On Sep 1, 2015, at 8:42 AM, Austin, Connie wrote: See question and response from our emergency response partners. And response from Craig in case you get the same question. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Conover, Craig Sent: Tuesday, September 01, 2015 7:00 AM To: Moomey, Tammy Cc: Mitchell, Joe; Culp, David; Morgan, Jodi; McCann, Ken; Martin, Aaron; Echols, Fred; Austin, Connie Subject: Re: ADDITION TO UPDATE - Legionnaires Disease, Adams County My draft response would be--others can comment: Potential sources have been mitigated: standard precautions for patient care. Individuals doing sampling etc in which aerosols may be generated --respiratory protection to avoid aerosols until system is given a clean bill of health. From: Moomey, Tammy Sent: Monday, August 31, 2015 8:58 PM To: Conover, Craig Subject: Fwd: ADDITION TO UPDATE - Legionnaires Disease, Adams County Dr. Conover, I missed you on this email. Sorry! Sent from my iPhone Begin forwarded message: From: "Moomey, Tammy" Date: August 31, 2015 at 8:46:09 PM CDT To: "Shah, Nirav" , "Rayman, Erik" , "Gentry-Wiseman, Michelle" , "Culp, David" , "Bryars, Debra" , "Mitchell, Joe" Cc: "Rawls, Winfred" , "Swehla, Gina" , "Patterson, Tricia" Subject: Fwd: ADDITION TO UPDATE - Legionnaires Disease, Adams County Please see below from IEMA Director Joseph requesting information on first responder PPE. Please advise on how you would like us to proceed. We can certainly have a coordinated approach as we did with Ebola with IDPH being the lead/SME on content and development of guidance documents. Tammy Sent from my iPhone Begin forwarded message: From: "Moomey, Tammy" Date: August 31, 2015 at 8:20:24 PM CDT To: "Felchner, Gene" Cc: "Patterson, Tricia" , "Rawls, Winfred" , "Swehla, Gina" , "Barnett, Cara" Subject: Re: ADDITION TO UPDATE - Legionnaires Disease, Adams County Gene, the fact sheets say person to person spread of Legionellos does not occur. It is most commonly contracted by inhaling mist or vapor from a water source contaminated with the bacteria. We will need to discuss with staff and get recommendations on masks/respirators etc and get back to you. Tammy. Sent from my iPhone On Aug 31, 2015, at 8:02 PM, Felchner, Gene wrote: Hate to bother you two so late. But any help on the Director's question would be appreciated. Holler when you can. Thanks. Gene Sent from my iPhone Begin forwarded message: From: "Joseph, James" Date: August 31, 2015 at 6:08:21 PM CDT To: "Rasch, Paul" Cc: "Klinger, Joe" , "Ricker, Jennifer" , "Thompson, Patti" , "Felchner, Gene" , "Flemming, Robert" Subject: Re: ADDITION TO UPDATE - Legionnaires Disease, Adams County Thanks Paul. Joe - with Paul being out now, Pls touch base with someone at IDPH. After the first reported reported cases of ebola in the US last year, there was a lot of questions about how first responders approach a potential Ebola victim. We should work with IDPH to create the appropriate PPE recommendation for first responders and hospital workers, as well as any other facts about legionnaires disease for the same community. A lot of what we put out in DuPage was the same PPE recommendations as other situations would require, but putting something out specifically since there was so many questions and a lot of media hype was important. I have a copy of the type of documents we created and disseminated to DuPage County first responders if you would like to use that as a reference guide with IDPH. I gave a copy to Monken last year, and he left his copy in the office, so I technically have an extra one for you to have. I think it is important that IEMA and IDPH come up with something together on this. James James K. Joseph, Director Illinois Emergency Management Agency 2200 S. Dirksen Pkwy. Springfield, IL 62703 P: 217-782-2700 E: james.joseph@illinois.gov Sent from my iPhone On Aug 31, 2015, at 4:55 PM, Rasch, Paul wrote: All Apologize for a second e-mail; IDPH just provided further information. In addition to my first e-mail: · · · · · Potable water system remediation is ongoing today Illinois EPA testing municipal water in Quincy today Four additional lab confirmed cases in the surrounding community (unclear at this point if they are sporadic cases, identified because of increased testing, or linked to outbreak) IDPH will coordinate shipping of additional lab specimens to CDC Mapping of community cases is ongoing Thanks! Paul Paul Rasch, Jr. Manager, State Emergency Operations Center Illinois Emergency Management Agency Office: 217.558.5127 Cell: 217.685.3708 From: Rasch, Paul Sent: Monday, August 31, 2015 4:39 PM To: Joseph, James; Klinger, Joe; Ricker, Jennifer; Thompson, Patti Cc: Felchner, Gene; Flemming, Robert Subject: UPDATE - Legionnaires Disease, Adams County All IDPH advises that the outbreak of Legionnaires Disease at the State Veteran’s Home in Quincy which they reported last week is expanding. At this point four deaths have been attributed to the disease and the total number of cases is up to twenty-nine. IDPH is remaining in close contact with the facility and local health officials to monitor the situation, and a CDC team will be at the Home tomorrow to evaluate the situation. As previously, they are just providing us with situational awareness and no action on our part is currently requested or required. Thanks Paul Paul Rasch, Jr. Manager, State Emergency Operations Center Illinois Emergency Management Agency Office: 217.558.5127 Cell: 217.685.3708 From: "Shay Drummond" To: Jeffries "Erica L" CC: "HOUSTON, CATHY" "VACA, BRUCE" "WINNICKI, LENARD F." Date: 9/1/2015 6:39:25 AM Subject: RE: CDC Hi Erica, I would say we would be heading your way around 8:30 – I will message you as soon as I have ETA. Thanks! Shay From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Tuesday, September 01, 2015 7:38 AM To: Shay Drummond Cc: HOUSTON, CATHY; VACA, BRUCE; WINNICKI, LENARD F. Subject: CDC Good morning, Shay, I know the CDC are planning to meet you at your office at 8am. What time do you plan to come to the Home? We want to be standing by to meet you all. Thanks so much. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 From: "Shay Drummond" To: Jeffries "Erica L" CC: "HOUSTON, CATHY" "VACA, BRUCE" "WINNICKI, LENARD F." Date: 9/1/2015 7:46:48 AM Subject: Re: CDC Heading your way Sent from my iPhone On Sep 1, 2015, at 7:37 AM, Jeffries, Erica L wrote: Good morning, Shay, I know the CDC are planning to meet you at your office at 8am. What time do you plan to come to the Home? We want to be standing by to meet you all. Thanks so much. Erica Jeffries Director Illinois Department of Veterans' Affairs Tel: 217-785-4114 From: "Shay Drummond" To: Austin Connie CC: Date: 9/1/2015 6:58:50 AM Subject: RE: Fatality Updates Did you get the faxes? From: Austin, Connie [mailto:Connie.Austin@Illinois.gov] Sent: Tuesday, September 01, 2015 7:55 AM To: Shay Drummond Subject: RE: Fatality Updates Shay, Thanks for sending info. We need to make sure these are Legionella cases and the families have been notified before forwarding to anyone. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 7:33 AM To: Arnold, Melaney; Austin, Connie; Conover, Craig; Echols, Fred; Shah, Nirav Cc: Jerrod Welch; Jon Campos Subject: Fatality Updates Importance: High We are starting the day on a sad note…Blessing Hospital called me this morning and we lost two over the evening and our death that we were waiting on lab results also came back positive. I am faxing over the information on all three. In addition over the evening we had labs come and and that put our total count of lab confirmed IVH at 37. Over the evening IVH had 2 more that they are treating with signs and symptoms. This is certainly going to be a tipping point on the media intensity. Thanks for your assistance on the messaging. Shay Shay L. Drummond MPH-EH, BSN, RN, EPHS Director of Clinical and Environmental Services Adams County Health Department 330 Vermont Quincy, IL 62301 Office: 217-222-8440 x148 FAX:217-222-8460 Cell: 217-316-2795 CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Shay Drummond" To: Meka Anu CC: "Jerrod Welch" "Triena Dietrich" Date: 9/1/2015 8:02:06 AM Subject: Re: Legionella - ACHD X thanks Avenue no supplies needed at this time. We will keep you posted if we need anything. Sent from my iPhone > On Sep 1, 2015, at 8:59 AM, Meka, Anu wrote: > > A quick question> Has IPhMAS request been sent out on any supplies of need if any? > Is your MRC being utilized for any at this point? > Pls don't hesitate to reach IDPH including Win if need be > Anu > Sent from my iPhone > >> On Sep 1, 2015, at 8:55 AM, "Meka, Anu" wrote: >> >> Hi Jarod, >> Just wanted to update you on the ongoing Legionellosis from IDPH side. There is a CDC team coming to IL to assist with this. See the image attached. Just came to know the death count now is 6. IDPHis coming to Blessing hosp to get some human specimens for lab testing. IDPH is setting up a virtual IMT, please reach out to us (me or Gina - Gina.swehla@illinois.gov) for any help. >> Keep me updated >> Thanks >> Anu >> >> Sent from my iPhone From: "Shay Drummond" To: Yantis Ryan CC: Date: 9/1/2015 4:33:50 AM Subject: Re: Legionnaires update Lol- yes, as are you! Want to get as much done before our teams start rolling in at 8. Today is going to get more interesting with media. As we formulate questions want to start going through numbers I'll forward them onto you and Melaney. Sent from my iPhone On Sep 1, 2015, at 5:27 AM, Yantis, Ryan wrote: ​thanks and good morning. You are up wayyyy too early. From: Shay Drummond Sent: Tuesday, September 1, 2015 5:26 AM To: Yantis, Ryan Subject: Re: Legionnaires update Thanks Ryan just to let you know to I had some confirmational calls from CNN and Reuters -confirming numbers. Sent from my iPhone On Sep 1, 2015, at 5:23 AM, Yantis, Ryan wrote: ​David - Thanks; I'll pass your request along to the CDC team in Quincy, and note your request for an update interview with Dir. Jeffries for next Tuesday, Sept. 8 Thanks Ryan​ From: David Adam Sent: Monday, August 31, 2015 10:45 PM To: Yantis, Ryan Subject: RE: Legionnaires update Ryan … because the situation isn’t stabilized, and Erica thought it might “be at least a week” before it is, could another interview be done Tuesday afternoon with Erica? Is it possible to talk with her and the people from the CDC? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Monday, August 31, 2015 2:16 PM To: David Adam Cc: Long, Edie E Subject: RE: Legionnaires update OK - I know The Director has a meeting on the situation that starts at 4 pm. Will 30 minutes be enough time? I’ll reduce the QHW query from two separate to one for my tracking At the Admin Building? From: David Adam [mailto:dadam@whig.com] Sent: Monday, August 31, 2015 2:09 PM To: Yantis, Ryan Subject: RE: Legionnaires update Actually, it would be Steve Eighinger, one of our reporters. How does 3:30 sound? Could we come out there to talk to her? And get a photo as well? (Doug had to change hats this morning to work on a different story. Kind of like tag-team wrestling. Doug’s out, Steve’s now in.) From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Monday, August 31, 2015 2:02 PM To: David Adam Subject: RE: Legionnaires update Yes – what time, and you, or you and Doug Wilson? From: David Adam [mailto:dadam@whig.com] Sent: Monday, August 31, 2015 1:45 PM To: Yantis, Ryan Subject: FW: Legionnaires update Ryan … can we talk to Erica this afternoon? From: Doug Wilson Sent: Monday, August 31, 2015 1:29 PM To: David Adam ; Stephen Eighinger Subject: FW: Legionnaires update From: "Yantis, Ryan" Date: Mon, 31 Aug 2015 18:12:01 +0000 To: QHW Newsroom Subject: RE: Legionnaires update Doug Sorry for the delay; very busy here. · Currently 29 individuals from the Veterans’ Home in Quincy have tested positive for Legionnaires’ disease; four have died.(as if noon, August 31) · Our thoughts and prayers go to the families of those who passed yesterday, and we offer our sincere condolences to their loved ones.​ · The Adams County Health Department, the Illinois Department of Public Health, the Illinois Department of Veterans’ Affairs, Quincy Veterans’ Home, Blessing Hospital, and other medical providers, with guidance from the Centers for Disease Control and Prevention, are working together very closely to track patients with respiratory illness who have a connection with the home. · Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires’ disease and are making sure residents receive prompt medical attention if needed. · Compounding the challenge of identifying and treating individuals with Legionnaires’ disease is that we typically see other respiratory issues in residents this time of year. Therefore, all residents presenting any respiratory, pneumonia–type symptoms will be treated as if they have Legionnaires’ diseaseuntil lab results confirm the individual is negative for the bacteria. · Environmental health and infectious disease staff continue to visit the home to investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources. · Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large airconditioning systems. · In order to be infected with the bacteria, a person must inhale contaminated water vapor. There is no evidence that Legionnaires’ disease is transmitted person-to-person. · Public and environmental health officials are working closely with home staff to implement control measures in order to prevent additional individuals from being infected. · The Illinois Veterans’ Home-Quincy has established a remediation plan including:  Cleaning hot water tanks  Cleaning the cooling tower  Using bottled water for residents and staff  Prepping a temporary chiller so the Home’s facility chiller could be certified by outside experts​  Certifying the Home’s facility chiller by outside experts  Keeping fountains and other potential sources of aerosolized water turned off  Removing possible/suspected Legionella-infected systems/devices from use until they can be specially treated and tested before use.  Working with IDPH and other experts to clean and certify systems. Please let me know ASAP if you want to interview anyone. Dir. Jeffries is at the Home, visiting with residents and staff, as well as coordination agency efforts. Ryan From: Yantis, Ryan Sent: Monday, August 31, 2015 8:07 AM To: 'Doug Wilson' Subject: RE: Legionnaires update Good morning Doug – As you might expect, we are working this morning to gather the numbers from the various agencies involved in helping the Home with this situation. Our focus over the weekend was in getting any residents or staff with symptoms the treatment to combat Legionnaire’s while waiting for lab results. Unfortunately there is a time difference between onset of symptoms and the confirming lab results - and the delay is one we cannot rush no matter what we want. It is a matter of how long it takes for the culture to mature for accurate results. I’ll pass your request to Home leadership and others to see if there’s someone available to talk with you. We were also very pleased with Matt’s Hopt’s reporting over the weekend. The real story remains one of a caring Home staff with an unfortunate situation, which he captured along with the spirit of our veterans and their families. We have also been working really, really well with IDPH, Adams County Health and local healthcare providers. Their active engagement and support for the Home is making a positive difference, and helping our residents. I’ll let you know what I hear. Thanks Ryan From: Doug Wilson [mailto:dwilson@whig.com] Sent: Monday, August 31, 2015 7:59 AM To: Yantis, Ryan Subject: Legionnaires update Ryan, I'm looking for any updates on the IVH-Quincy Legionnaires outbreak. Are there still 28 suspected cases? How many folks have been tested? Our Sunday story was about how families have lauded the home for its work. Are there comments from the director or Vaca about the efforts to find the cause? Anything you can pass along would be helpful. Thanks Doug Wilson Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. Doug Wilsnn Sent-r Writer 130 3. 51h Quincy. ?lfice: 21 FEET-33E Email: dw-Isnnm??whigcnm Twitter: HERALD-WHIG It?s Knnw! ?Ni @m l'l I Doing IIEFtiftii?rHIG SenE-rerfer -- 130 3. 51h Quincy. ?l?iicE: 21 FEET-33E Email: $m sun?whigcnm Twitter: @Dng?smWnug HERALD-WHIG It?s Knnw! I I I I I H?Ivlili m. From: "Shay Drummond" To: Yantis Ryan CC: Date: 9/1/2015 4:26:57 AM Subject: Re: Legionnaires update Thanks Ryan just to let you know to I had some confirmational calls from CNN and Reuters -confirming numbers. Sent from my iPhone On Sep 1, 2015, at 5:23 AM, Yantis, Ryan wrote: ​David - Thanks; I'll pass your request along to the CDC team in Quincy, and note your request for an update interview with Dir. Jeffries for next Tuesday, Sept. 8 Thanks Ryan​ From: David Adam Sent: Monday, August 31, 2015 10:45 PM To: Yantis, Ryan Subject: RE: Legionnaires update Ryan … because the situation isn’t stabilized, and Erica thought it might “be at least a week” before it is, could another interview be done Tuesday afternoon with Erica? Is it possible to talk with her and the people from the CDC? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Monday, August 31, 2015 2:16 PM To: David Adam Cc: Long, Edie E Subject: RE: Legionnaires update OK - I know The Director has a meeting on the situation that starts at 4 pm. Will 30 minutes be enough time? I’ll reduce the QHW query from two separate to one for my tracking At the Admin Building? From: David Adam [mailto:dadam@whig.com] Sent: Monday, August 31, 2015 2:09 PM To: Yantis, Ryan Subject: RE: Legionnaires update Actually, it would be Steve Eighinger, one of our reporters. How does 3:30 sound? Could we come out there to talk to her? And get a photo as well? (Doug had to change hats this morning to work on a different story. Kind of like tag-team wrestling. Doug’s out, Steve’s now in.) From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Monday, August 31, 2015 2:02 PM To: David Adam Subject: RE: Legionnaires update Yes – what time, and you, or you and Doug Wilson? From: David Adam [mailto:dadam@whig.com] Sent: Monday, August 31, 2015 1:45 PM To: Yantis, Ryan Subject: FW: Legionnaires update Ryan … can we talk to Erica this afternoon? From: Doug Wilson Sent: Monday, August 31, 2015 1:29 PM To: David Adam ; Stephen Eighinger Subject: FW: Legionnaires update From: "Yantis, Ryan" Date: Mon, 31 Aug 2015 18:12:01 +0000 To: QHW Newsroom Subject: RE: Legionnaires update Doug Sorry for the delay; very busy here. · Currently 29 individuals from the Veterans’ Home in Quincy have tested positive for Legionnaires’ disease; four have died.(as if noon, August 31) · Our thoughts and prayers go to the families of those who passed yesterday, and we offer our sincere condolences to their loved ones.​ · The Adams County Health Department, the Illinois Department of Public Health, the Illinois Department of Veterans’ Affairs, Quincy Veterans’ Home, Blessing Hospital, and other medical providers, with guidance from the Centers for Disease Control and Prevention, are working together very closely to track patients with respiratory illness who have a connection with the home. · Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires’ disease and are making sure residents receive prompt medical attention if needed. · Compounding the challenge of identifying and treating individuals with Legionnaires’ disease is that we typically see other respiratory issues in residents this time of year. Therefore, all residents presenting any respiratory, pneumonia–type symptoms will be treated as if they have Legionnaires’ diseaseuntil lab results confirm the individual is negative for the bacteria. · Environmental health and infectious disease staff continue to visit the home to investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources. · Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. · In order to be infected with the bacteria, a person must inhale contaminated water vapor. There is no evidence that Legionnaires’ disease is transmitted person-to-person. · Public and environmental health officials are working closely with home staff to implement control measures in order to prevent additional individuals from being infected. · The Illinois Veterans’ Home-Quincy has established a remediation plan including:  Cleaning hot water tanks  Cleaning the cooling tower  Using bottled water for residents and staff  Prepping a temporary chiller so the Home’s facility chiller could be certified by outside experts​  Certifying the Home’s facility chiller by outside experts  Keeping fountains and other potential sources of aerosolized water turned off  Removing possible/suspected Legionella-infected systems/devices from use until they can be specially treated and tested before use.  Working with IDPH and other experts to clean and certify systems. Please let me know ASAP if you want to interview anyone. Dir. Jeffries is at the Home, visiting with residents and staff, as well as coordination agency efforts. Ryan From: Yantis, Ryan Sent: Monday, August 31, 2015 8:07 AM To: 'Doug Wilson' Subject: RE: Legionnaires update Good morning Doug – As you might expect, we are working this morning to gather the numbers from the various agencies involved in helping the Home with this situation. Our focus over the weekend was in getting any residents or staff with symptoms the treatment to combat Legionnaire’s while waiting for lab results. Unfortunately there is a time difference between onset of symptoms and the confirming lab results - and the delay is one we cannot rush no matter what we want. It is a matter of how long it takes for the culture to mature for accurate results. I’ll pass your request to Home leadership and others to see if there’s someone available to talk with you. We were also very pleased with Matt’s Hopt’s reporting over the weekend. The real story remains one of a caring Home staff with an unfortunate situation, which he captured along with the spirit of our veterans and their families. We have also been working really, really well with IDPH, Adams County Health and local healthcare providers. Their active engagement and support for the Home is making a positive difference, and helping our residents. I’ll let you know what I hear. Thanks Ryan From: Doug Wilson [mailto:dwilson@whig.com] Sent: Monday, August 31, 2015 7:59 AM To: Yantis, Ryan Subject: Legionnaires update Ryan, I'm looking for any updates on the IVH-Quincy Legionnaires outbreak. Are there still 28 suspected cases? How many folks have been tested? Our Sunday story was about how families have lauded the home for its work. Are there comments from the director or Vaca about the efforts to find the cause? Anything you can pass along would be helpful. Thanks Doug Wilson Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. David Adam News C-aardinamr 1.3-3 3. 51h Clumqr. 2L 5213? ?ifiua: 21 Email: aadam?jiwhig. rn Twitler: HERMD-WHIG It?s Haw Tau Knnw! mania 51mm II-I- whamaurmm l'l HER Doug thsan Samar Wrifer 130 3. 51h Quincy. 52-3-3?: ?l?fiEE: 21 F-EET-SEFE Email: Twitter: @Dng?smWnug HERALD-WHIG It?s Knnw! l'l I EPWHIG - l'l I-li DDUQ Sen ia-r Wrifer 130 3. 51h Quincy. ?l?fiEE: 21 FEET-33E Email: Twitter: @Dng?smWnug HERALD-WHIG It?s Knnw! From: "Shay Drummond" To: Yantis Ryan Melaney CC: "VACA, BRUCE L" "WINNICKI, LENARD F" Date: 9/1/2015 11:20:32 AM Subject: RE: Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update This is a call from the Homes standpoint. Also I don’t want to create unnecessary concern over one area of the home or campus. This is based from OSHA and AFSCME both calling and visiting trying to get info. We could get a pic of them entering data at ACHD but that certainly is not the exciting field shot they are trying for. From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 12:16 PM To: Arnold, Melaney; Shay Drummond Cc: VACA, BRUCE L; WINNICKI, LENARD F Subject: FW: Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update Quincy Herald-Whig wants to have a photographer go w CDC to get images of them working/testing on the IVH-Q Campus. Any concerns? There would be an escort of sorts from the Home (I am in Chicago). Alison from CDC wants to ensure we are all good on this. No issues from IDVA and the Home. From: Albert, Alison P. (CDC/OID/NCIRD) [mailto:aqp0@cdc.gov] Sent: Tuesday, September 01, 2015 12:11 PM To: Yantis, Ryan Subject: Re: Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update Hi Ryan --- one more Q about the photography request. Are state and local HDs ok with it? And thanks for sending this! Sent from my BlackBerry 10 smartphone. From: Yantis, Ryan Sent: Tuesday, September 1, 2015 1:04 PM To: Yantis, Ryan Subject: Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update For Immediate Release Sept. 1, 2015 CONTACTS: See Below Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of a total of seven residents at the Illinois Veterans’ Home-Quincy. The seven residents, all of whom had underlying medical conditions, were among the 39 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “While saddened by the loss of our residents, having been at the Home and talking with the staff and our residents, I am impressed with their resilience and spirit,” said IDVA Director Erica Jeffries. “We remain vigilant in monitoring our residents and we continue to follow the guidance of our interagency partners to implement remediation efforts across our Home. The safety and quality of care for our residents and staff are our primary concerns.” “We continue to work diligently with our public health and Veterans’ Affairs partners to get immediate medical care to residents or staff at the Home who are experiencing respiratory illness,” said IDPH Director Nirav D. Shah, M.D., J.D. “Unfortunately, we expect to see additional cases and possibly additional deaths because the incubation period for Legionnaires’ disease can be up to two weeks, and because patients with underlying medical conditions are at increased risk of more severe illness.” On August 30, 2015, IDPH requested aid from the U.S. Centers for Disease Control and Prevention (CDC) for epidemiology and environmental health assistance. Yesterday, three CDC Epidemic Intelligence Service Officers and one environmental health specialist arrived at the Illinois Veterans’ Home – Quincy to work with IDVA and IDPH in investigating the Legionnaires’ disease outbreak. CDC will also provide laboratory support from its headquarters in Atlanta, GA. IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Due to the nature of the bacteria, test results can take up to two weeks. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. For more information about Legionnaires’ disease, visit the IDPH website. For media seeking additional information, please contact: IDVA / IVH-Q: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d)217-222-8440 x148 (c)217-316-2795 sdrummond@co.adams.il.us From: "Shay Drummond" To: Morgan Jodi CC: "Jon Campos" "Jerrod Welch" "Cox, Robert F." Date: 9/1/2015 8:36:16 AM Subject: Re: OPR assistance We have it ready. Sent from my iPhone On Sep 1, 2015, at 8:48 AM, Morgan, Jodi wrote: They are en route to pick up the urine specimens. From: Moomey, Tammy Sent: Tuesday, September 01, 2015 8:46 AM To: Morgan, Jodi Cc: Culp, David; Mitchell, Joe; Swehla, Gina; Austin, Connie; Rawls, Winfred; Patterson, Tricia; Johnson, Bernard T.; Holmes, Tal; Echols, Fred; Cox, Robert F. Subject: Re: OPR assistance Brian Kieninger, RN, EMS coordinator is headed to Quincy/Adams Co now. His ETA is 11 a.m. Who is the point of contact at Adams Co? Sent from my iPhone On Aug 31, 2015, at 8:07 PM, Moomey, Tammy wrote: Ok, we will make the arrangements and will advise specifics in the morning. Sent from my iPhone On Aug 31, 2015, at 6:21 PM, Morgan, Jodi wrote: I spoke with Shay and they will have the specimens ready for pick up at the local health department. They have some to pick up at the IVH and hospital, so they should have them all at the LHD by 10AM. Adams County Health Dept 330 Vermont St Quincy 217-222-8440 Thank you very much!! Jodi From: Culp, David Sent: Monday, August 31, 2015 5:20 PM To: Moomey, Tammy; Mitchell, Joe; Swehla, Gina; Austin, Connie; Morgan, Jodi Cc: Rawls, Winfred; Patterson, Tricia; Johnson, Bernard T.; Holmes, Tal; Echols, Fred Subject: RE: OPR assistance Importance: High Excellent Tammy Connie Austin and Jodi Morgan from Division of Infectious Diseases can provide informational assistance per your request Dave From: Moomey, Tammy Sent: Monday, August 31, 2015 5:18 PM To: Mitchell, Joe; Swehla, Gina Cc: Rawls, Winfred; Culp, David; Patterson, Tricia Subject: RE: OPR assistance Importance: High Joe – we were making arrangements to coordinate the pick up of the samples from Quincy hospital. The lab supervisor at the hospital said they do not have any samples for pick up tomorrow and are unaware of any coming in. We can cover this, but need to verify the information. Please advise. Thanks, Tammy From: Mitchell, Joe Sent: Monday, August 31, 2015 3:53 PM To: Swehla, Gina; Moomey, Tammy Cc: Rawls, Winfred; Culp, David; Patterson, Tricia Subject: FW: OPR assistance Gina and Tammy, As part of the Legionella response related to the Quincy Veterans Home, the DID CD section is requesting OPR logistics support for transport of specimens to the IDPH Lab. We appreciate any assistance you can provide. Let me know if you have any questions. Thanks, Joe Joe Mitchell Section Chief, Environmental Health Services Division of Environmental Health Illinois Department of Public Health 525 West Jefferson Street, 3rd Floor Springfield, IL 62761 Phone: 217/785-3176 E-mail: joe.mitchell@illinois.gov If you’re interested in more information about the outbreak response, there is a daily afternoon briefing starting today at 4pm. Please Dial: 888-494-4032 Access Code: 801-0680-889 From: Morgan, Jodi Sent: Monday, August 31, 2015 3:42 PM To: Mitchell, Joe Cc: Culp, David; Austin, Connie Subject: OPR assistance 1. Tuesday: Transport two urine specimens from Blessing Hospital in Quincy to IDPH lab in Springfield. Blessing Hospital: 1005 Broadway St, Quincy, IL 62301 (217) 223-8400 2. Wednesday morning: Transport specimens from Bloomington coroner’s office to IDPH lab. Dry ice will be needed for some of the specimens, will advise further tomorrow after confirming details with IDPH lab. McLean County Coroner’s office: 104 W Front St, Bloomington, IL 61701 (309) 888-5210 Thank you!!! Jodi Jodi Morgan, RN BSN CIC Infection Prevention & Control Communicable Disease Control Section Office of Health Protection Illinois Department of Public Health 525 W. Jefferson Springfield, IL 62761-0001 T: 217-782-2016 F: 217-524-0962 Jodi.Morgan@illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Shay Drummond" To: Morgan Jodi CC: Date: 9/1/2015 9:10:45 AM Subject: RE: OPR assistance Hi, Yes you are correct and the others are the labs that were taken less than 48 hours after onset of symptoms that Connie had faxed me the list of to re sample. From: Morgan, Jodi [mailto:Jodi.Morgan@illinois.gov] Sent: Tuesday, September 01, 2015 10:03 AM To: Shay Drummond Subject: RE: OPR assistance I thought we only had 5 discordant? From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 10:01 AM To: Morgan, Jodi Subject: Re: OPR assistance No it is at least nine burins were sending for that are discordant labs and then the balance are the urines that were taken less than 48 hours after onset of symptoms that we were retesting. Sent from my iPhone On Sep 1, 2015, at 9:57 AM, Morgan, Jodi wrote: Do you have a total of 12 urines you are sending? Thanks, jodi From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 9:36 AM To: Morgan, Jodi Cc: Jon Campos; Jerrod Welch; Cox, Robert F. Subject: Re: OPR assistance We have it ready. Sent from my iPhone On Sep 1, 2015, at 8:48 AM, Morgan, Jodi wrote: They are en route to pick up the urine specimens. From: Moomey, Tammy Sent: Tuesday, September 01, 2015 8:46 AM To: Morgan, Jodi Cc: Culp, David; Mitchell, Joe; Swehla, Gina; Austin, Connie; Rawls, Winfred; Patterson, Tricia; Johnson, Bernard T.; Holmes, Tal; Echols, Fred; Cox, Robert F. Subject: Re: OPR assistance Brian Kieninger, RN, EMS coordinator is headed to Quincy/Adams Co now. His ETA is 11 a.m. Who is the point of contact at Adams Co? Sent from my iPhone On Aug 31, 2015, at 8:07 PM, Moomey, Tammy wrote: Ok, we will make the arrangements and will advise specifics in the morning. Sent from my iPhone On Aug 31, 2015, at 6:21 PM, Morgan, Jodi wrote: I spoke with Shay and they will have the specimens ready for pick up at the local health department. They have some to pick up at the IVH and hospital, so they should have them all at the LHD by 10AM. Adams County Health Dept 330 Vermont St Quincy 217-222-8440 Thank you very much!! Jodi From: Culp, David Sent: Monday, August 31, 2015 5:20 PM To: Moomey, Tammy; Mitchell, Joe; Swehla, Gina; Austin, Connie; Morgan, Jodi Cc: Rawls, Winfred; Patterson, Tricia; Johnson, Bernard T.; Holmes, Tal; Echols, Fred Subject: RE: OPR assistance Importance: High Excellent Tammy Connie Austin and Jodi Morgan from Division of Infectious Diseases can provide informational assistance per your request Dave From: Moomey, Tammy Sent: Monday, August 31, 2015 5:18 PM To: Mitchell, Joe; Swehla, Gina Cc: Rawls, Winfred; Culp, David; Patterson, Tricia Subject: RE: OPR assistance Importance: High Joe – we were making arrangements to coordinate the pick up of the samples from Quincy hospital. The lab supervisor at the hospital said they do not have any samples for pick up tomorrow and are unaware of any coming in. We can cover this, but need to verify the information. Please advise. Thanks, Tammy From: Mitchell, Joe Sent: Monday, August 31, 2015 3:53 PM To: Swehla, Gina; Moomey, Tammy Cc: Rawls, Winfred; Culp, David; Patterson, Tricia Subject: FW: OPR assistance Gina and Tammy, As part of the Legionella response related to the Quincy Veterans Home, the DID CD section is requesting OPR logistics support for transport of specimens to the IDPH Lab. We appreciate any assistance you can provide. Let me know if you have any questions. Thanks, Joe Joe Mitchell Section Chief, Environmental Health Services Division of Environmental Health Illinois Department of Public Health 525 West Jefferson Street, 3rd Floor Springfield, IL 62761 Phone: 217/785-3176 E-mail: joe.mitchell@illinois.gov If you’re interested in more information about the outbreak response, there is a daily afternoon briefing starting today at 4pm. Please Dial: 888-494-4032 Access Code: 801-0680-889 From: Morgan, Jodi Sent: Monday, August 31, 2015 3:42 PM To: Mitchell, Joe Cc: Culp, David; Austin, Connie Subject: OPR assistance 1. Tuesday: Transport two urine specimens from Blessing Hospital in Quincy to IDPH lab in Springfield. Blessing Hospital: 1005 Broadway St, Quincy, IL 62301 (217) 223-8400 2. Wednesday morning: Transport specimens from Bloomington coroner’s office to IDPH lab. Dry ice will be needed for some of the specimens, will advise further tomorrow after confirming details with IDPH lab. McLean County Coroner’s office: 104 W Front St, Bloomington, IL 61701 (309) 888-5210 Thank you!!! Jodi Jodi Morgan, RN BSN CIC Infection Prevention & Control Communicable Disease Control Section Office of Health Protection Illinois Department of Public Health 525 W. Jefferson Springfield, IL 62761-0001 T: 217-782-2016 F: 217-524-0962 Jodi.Morgan@illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Shay Drummond" To: Morgan Jodi CC: Date: 9/1/2015 9:00:43 AM Subject: Re: OPR assistance No it is at least nine burins were sending for that are discordant labs and then the balance are the urines that were taken less than 48 hours after onset of symptoms that we were retesting. Sent from my iPhone On Sep 1, 2015, at 9:57 AM, Morgan, Jodi wrote: Do you have a total of 12 urines you are sending? Thanks, jodi From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 9:36 AM To: Morgan, Jodi Cc: Jon Campos; Jerrod Welch; Cox, Robert F. Subject: Re: OPR assistance We have it ready. Sent from my iPhone On Sep 1, 2015, at 8:48 AM, Morgan, Jodi wrote: They are en route to pick up the urine specimens. From: Moomey, Tammy Sent: Tuesday, September 01, 2015 8:46 AM To: Morgan, Jodi Cc: Culp, David; Mitchell, Joe; Swehla, Gina; Austin, Connie; Rawls, Winfred; Patterson, Tricia; Johnson, Bernard T.; Holmes, Tal; Echols, Fred; Cox, Robert F. Subject: Re: OPR assistance Brian Kieninger, RN, EMS coordinator is headed to Quincy/Adams Co now. His ETA is 11 a.m. Who is the point of contact at Adams Co? Sent from my iPhone On Aug 31, 2015, at 8:07 PM, Moomey, Tammy wrote: Ok, we will make the arrangements and will advise specifics in the morning. Sent from my iPhone On Aug 31, 2015, at 6:21 PM, Morgan, Jodi wrote: I spoke with Shay and they will have the specimens ready for pick up at the local health department. They have some to pick up at the IVH and hospital, so they should have them all at the LHD by 10AM. Adams County Health Dept 330 Vermont St Quincy 217-222-8440 Thank you very much!! Jodi From: Culp, David Sent: Monday, August 31, 2015 5:20 PM To: Moomey, Tammy; Mitchell, Joe; Swehla, Gina; Austin, Connie; Morgan, Jodi Cc: Rawls, Winfred; Patterson, Tricia; Johnson, Bernard T.; Holmes, Tal; Echols, Fred Subject: RE: OPR assistance Importance: High Excellent Tammy Connie Austin and Jodi Morgan from Division of Infectious Diseases can provide informational assistance per your request Dave From: Moomey, Tammy Sent: Monday, August 31, 2015 5:18 PM To: Mitchell, Joe; Swehla, Gina Cc: Rawls, Winfred; Culp, David; Patterson, Tricia Subject: RE: OPR assistance Importance: High Joe – we were making arrangements to coordinate the pick up of the samples from Quincy hospital. The lab supervisor at the hospital said they do not have any samples for pick up tomorrow and are unaware of any coming in. We can cover this, but need to verify the information. Please advise. Thanks, Tammy From: Mitchell, Joe Sent: Monday, August 31, 2015 3:53 PM To: Swehla, Gina; Moomey, Tammy Cc: Rawls, Winfred; Culp, David; Patterson, Tricia Subject: FW: OPR assistance Gina and Tammy, As part of the Legionella response related to the Quincy Veterans Home, the DID CD section is requesting OPR logistics support for transport of specimens to the IDPH Lab. We appreciate any assistance you can provide. Let me know if you have any questions. Thanks, Joe Joe Mitchell Section Chief, Environmental Health Services Division of Environmental Health Illinois Department of Public Health 525 West Jefferson Street, 3rd Floor Springfield, IL 62761 Phone: 217/785-3176 E-mail: joe.mitchell@illinois.gov If you’re interested in more information about the outbreak response, there is a daily afternoon briefing starting today at 4pm. Please Dial: 888-494-4032 Access Code: 801-0680-889 From: Morgan, Jodi Sent: Monday, August 31, 2015 3:42 PM To: Mitchell, Joe Cc: Culp, David; Austin, Connie Subject: OPR assistance 1. Tuesday: Transport two urine specimens from Blessing Hospital in Quincy to IDPH lab in Springfield. Blessing Hospital: 1005 Broadway St, Quincy, IL 62301 (217) 223-8400 2. Wednesday morning: Transport specimens from Bloomington coroner’s office to IDPH lab. Dry ice will be needed for some of the specimens, will advise further tomorrow after confirming details with IDPH lab. McLean County Coroner’s office: 104 W Front St, Bloomington, IL 61701 (309) 888-5210 Thank you!!! Jodi Jodi Morgan, RN BSN CIC Infection Prevention & Control Communicable Disease Control Section Office of Health Protection Illinois Department of Public Health 525 W. Jefferson Springfield, IL 62761-0001 T: 217-782-2016 F: 217-524-0962 Jodi.Morgan@illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Shay Drummond" To: Arnold Melaney CC: "Yantis, Ryan" durrie@umsl.edu Date: 9/1/2015 12:08:24 PM Subject: Re: St. Louis Public Radio - Health on IVH-Q situation Welcome to answer local questions you may have. Thanks, Shay Sent from my iPhone On Sep 1, 2015, at 12:52 PM, Arnold, Melaney wrote: Hi Durrie ~ What are your questions and I’ll see if I can help. Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH From: Yantis, Ryan Sent: Tuesday, September 01, 2015 11:39 AM To: durrie@umsl.edu Cc: Arnold, Melaney; Shay Drummond Subject: RE: St. Louis Public Radio - Health on IVH-Q situation Resending to corrected email From: Yantis, Ryan Sent: Tuesday, September 01, 2015 10:49 AM To: 'durrie@iumsl.edu' Cc: Arnold, Melaney; Shay Drummond Subject: St. Louis Public Radio - Health on IVH-Q situation Durrie – Thanks for your call and invite to discuss the situation at the Illinois Veterans’ Home – Quincy. As I mentioned, we are compiling our update and I don’t want to give you information that will soon be out of date. Also, I am looping in Melaney from Illinois Dept. of Public Health and Shay Drummond from Adams County Health Dept. They are also good sources on this situation. Please call or email after noon (12:00) and we should have an update to share. Meanwhile, here is some general I’ve been sharing with media. General Statement (as if noon, August 31 – we will be updating number shortly) ​: Currently 29 individuals from the Illinois Veterans’ Home in Quincy have tested positive for Legionnaires’ disease, and sadly, four have died. Our thoughts and prayers go to the families of those who passed yesterday, and we offer our sincere condolences to their loved ones.​ The Adams County Health Department, the Illinois Department of Public Health, the Illinois Department of Veterans’ Affairs, Quincy Veterans’ Home, Blessing Hospital, and other medical providers, with guidance from the Centers for Disease Control and Prevention, are working together very closely to track patients with respiratory illness who have a connection with the home. Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires’ disease and are making sure residents receive prompt medical attention if needed. ​Compounding the challenge of identifying and treating individuals with Legionnaires’ disease is that we typically see other respiratory issues in residents this time of year. Therefore, all residents presenting any respiratory, pneumonia–type symptoms will be treated as if they have Legionnaires’ disease until lab results confirm the individual is negative for the bacteria. Environmental health and infectious disease staff continue to visit the home to investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources. Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. There is no evidence that Legionnaires’ disease is transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures in order to prevent additional individuals from being infected. The Illinois Veterans’ Home-Quincy has established a remediation plan including: - Cleaning hot water tanks - Cleaning the cooling tower - Using bottled water for residents and staff - Prepping a temporary chiller so the Home’s facility chiller could be certified by outside experts​ - Certifying the Home’s facility chiller by outside experts - Keeping fountains and other potential sources of aerosolized water turned off - Removing possible/suspected Legionella-infected systems/devices from use until they can be specially treated and tested before use. - Working with IDPH and other experts to clean and certify systems. We will update as we can. Our focus is on providing great care for our residents; keeping them, our staff, and those impacted by this situation informed and engaged; and working with our partner agencies, providers, and team to resolve this a quickly as possible. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Shay Drummond" To: HOUSTON CATHY CC: Date: 9/1/2015 2:44:33 PM Subject: RE: Tracking LD S&S Great, any new changes? From: HOUSTON, CATHY [mailto:CATHY.S.HOUSTON@illinois.gov] Sent: Tuesday, September 01, 2015 3:44 PM To: Shay Drummond Subject: Tracking LD S&S Updated……still working on CXRs and Antibiotics getting them all listed and double checked. Will have on tomorrow’s. Cathy Houston DON Illinois Veterans Home Quincy 1707 North 12th Street Quincy, IL 62301 217-222-8641 Extension 358 CATHY.S.HOUSTON@illinois.gov From: "Shay Drummond" To: Yantis Ryan Melaney "CATHY S" CC: Date: 9/1/2015 10:04:12 AM Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Just, did. Ryan is there going to be a formal press release or are we free to release numbers? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 11:03 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. In convo with Cathy this AM, the Home has a solid notification protocol for change in status of residents if/when symptomatic, or there is a change in condition. The staff call and brief the family (POA power of attorney or ICE designates), and should a resident get a confirming test result, then the Infectious Disease Nurse at the Home talks to the family. This is all charted. Generally the families are in attendance if a resident is expectant/in comfort care/hospice, but notification is made if the family is not present. Again, all charted. While not answering for Blessing, Cathy was very positive about their standards of notification and family communication. Blessing would handle any notification for residents under their care. We might want to loop in the Blessing PR folks… From: Arnold, Melaney Sent: Tuesday, September 01, 2015 10:55 AM To: 'Shay Drummond'; Yantis, Ryan; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Not yet. Connie said she was going to talk with you at 11:15 and we would have numbers by 11:30. Also – do you know if the families have been notified? I know you’ve been busy. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 10:50 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Hi have you gotten the updates from Fred? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Shay Drummond" To: Arnold Melaney Ryan CC: Date: 9/1/2015 10:29:36 AM Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Thanks and an FYI am getting inquiries from OSHA and AFSCME!!! From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Tuesday, September 01, 2015 11:18 AM To: Yantis, Ryan; Shay Drummond; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Updated numbers. Also attached is the final news release, which will be sent to media at noon today. Thank you. From: Yantis, Ryan Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Shay Drummond" To: Yantis Ryan Melaney "CATHY S" CC: Date: 9/1/2015 9:50:25 AM Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Hi have you gotten the updates from Fred? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Shay Drummond" To: Arnold Melaney Ryan "CATHY S" CC: Date: 9/1/2015 10:07:00 AM Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Thanks I will wait for your release. Shay From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Tuesday, September 01, 2015 11:05 AM To: Shay Drummond; Yantis, Ryan; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. We will issue the news release at noon today. I’m still waiting one final approval. I’ll get you the release BEFORE it goes out. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 11:04 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Just, did. Ryan is there going to be a formal press release or are we free to release numbers? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 11:03 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. In convo with Cathy this AM, the Home has a solid notification protocol for change in status of residents if/when symptomatic, or there is a change in condition. The staff call and brief the family (POA power of attorney or ICE designates), and should a resident get a confirming test result, then the Infectious Disease Nurse at the Home talks to the family. This is all charted. Generally the families are in attendance if a resident is expectant/in comfort care/hospice, but notification is made if the family is not present. Again, all charted. While not answering for Blessing, Cathy was very positive about their standards of notification and family communication. Blessing would handle any notification for residents under their care. We might want to loop in the Blessing PR folks… From: Arnold, Melaney Sent: Tuesday, September 01, 2015 10:55 AM To: 'Shay Drummond'; Yantis, Ryan; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Not yet. Connie said she was going to talk with you at 11:15 and we would have numbers by 11:30. Also – do you know if the families have been notified? I know you’ve been busy. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 10:50 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Hi have you gotten the updates from Fred? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) 312-520-6958 (cell) Rvan. From: "Shay Drummond" To: Arnold Melaney CC: "Yantis, Ryan" "HOUSTON, CATHY S" Date: 9/1/2015 10:00:24 AM Subject: Re: Updated TP Q&A 2015-09-01 1000 AM for staffing. All have been notified Sent from my iPhone On Sep 1, 2015, at 10:54 AM, Arnold, Melaney wrote: Not yet. Connie said she was going to talk with you at 11:15 and we would have numbers by 11:30. Also – do you know if the families have been notified? I know you’ve been busy. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 10:50 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Hi have you gotten the updates from Fred? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Storrs, Carrie" To: "amymccallister@hchd1.org; Andrea <" "\(awinkingrn@warrencohealth.com\);>" "Michele \(Michele.Bar@mcleancountyil.gov\); Barb Long \(blong@vchd.org\); Beth Thomas; Cathy Ebert \(cebert@kankakeehealth.org\); Cathy Hayden; Chris Kelley; Crystal Hardesty; Crystal Ingram \(cirn@cumberlandhealth.org\); Cynthia Sheffler; Debra Hammer; Dee Ann Schippert \(dschippert@co.iroquois.il.us\); Deena Keys; DianneTavenner; Jackie Dever; Jane Jones \(jane.jones@douglascountyil.com\); Jean Bellisario; Jennifer Chacon \(JChacon@c-uphd.org\); Jessica Hand; Joan Bostrom; Judy Bailey; Judy Cultra; Judy McCurdy; Julie St. Clair; Karen Trimble; Kathleen Arrington; Kay Godby\(kgodby@lchd.us\); Kenda Jones; Kerri Allen; Lynda McKeo "\(wendy.bigham@mchdept.org\)>" CC: "Carol Searcy" "Crystal Schutzbach" "Phyllis Jefferson" "Jennifer Beeson" "Sue Berryman" "Kimberly Swinford" "Rebecca Durbin" "Renae Graham" amanda.lahr@christiancountyyealth.org shannon.brauer@christiancountyhealth.org "Darnall, Elaine" "Stephens, Debra" D ate: 9/1/2015 2:57:16 PM S u b j e c t : Save the Date! Regional TB Meeting December 2 Greetings Local TB Programs! The 2015 Central Region TB Meeting will be held W ednesday, December 2 at the McLean County Health Department in Bloomington, IL. Join your colleagues for a day of TB education and networking. Application will be made for nursing continuing education credits. Lunch will be provided. No registration fee! Preliminary agenda topics include a new TB outbreak in central Illinois, an XDR-TB case in Illinois, interjurisdictional investigations and transfers, and the Stop the Stigma campaign. If you have ideas for topics and/or speakers, please let me know – this is your day, and we want it to be useful and meaningful. Please mark your calendars and save the date! Carrie Carrie Storrs RN, MPH, CPH TB Program Illinois Department of Public Health 2125 South First Street Champaign, IL 61820 217-278-5928 phone 217-278-5959 fax carrie.storrs@illinois.gov From: "Yantis, Ryan" To: Arnold "Melaney ;Shay Drummond" CC: "VACA, BRUCE L" "WINNICKI, LENARD F" Date: 9/1/2015 11:15:34 AM Subject: FW: Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update Quincy Herald-Whig wants to have a photographer go w CDC to get images of them working/testing on the IVH-Q Campus. Any concerns? There would be an escort of sorts from the Home (I am in Chicago). Alison from CDC wants to ensure we are all good on this. No issues from IDVA and the Home. From: Albert, Alison P. (CDC/OID/NCIRD) [mailto:aqp0@cdc.gov] Sent: Tuesday, September 01, 2015 12:11 PM To: Yantis, Ryan Subject: Re: Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update Hi Ryan --- one more Q about the photography request. Are state and local HDs ok with it? And thanks for sending this! Sent from my BlackBerry 10 smartphone. From: Yantis, Ryan Sent: Tuesday, September 1, 2015 1:04 PM To: Yantis, Ryan Subject: Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update For Immediate Release Sept. 1, 2015 CONTACTS: See Below Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of a total of seven residents at the Illinois Veterans’ Home-Quincy. The seven residents, all of whom had underlying medical conditions, were among the 39 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “While saddened by the loss of our residents, having been at the Home and talking with the staff and our residents, I am impressed with their resilience and spirit,” said IDVA Director Erica Jeffries. “We remain vigilant in monitoring our residents and we continue to follow the guidance of our interagency partners to implement remediation efforts across our Home. The safety and quality of care for our residents and staff are our primary concerns.” “We continue to work diligently with our public health and Veterans’ Affairs partners to get immediate medical care to residents or staff at the Home who are experiencing respiratory illness,” said IDPH Director Nirav D. Shah, M.D., J.D. “Unfortunately, we expect to see additional cases and possibly additional deaths because the incubation period for Legionnaires’ disease can be up to two weeks, and because patients with underlying medical conditions are at increased risk of more severe illness.” On August 30, 2015, IDPH requested aid from the U.S. Centers for Disease Control and Prevention (CDC) for epidemiology and environmental health assistance. Yesterday, three CDC Epidemic Intelligence Service Officers and one environmental health specialist arrived at the Illinois Veterans’ Home – Quincy to work with IDVA and IDPH in investigating the Legionnaires’ disease outbreak. CDC will also provide laboratory support from its headquarters in Atlanta, GA. IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Due to the nature of the bacteria, test results can take up to two weeks. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. For more information about Legionnaires’ disease, visit the IDPH website. For media seeking additional information, please contact: IDVA / IVH-Q: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d)217-222-8440 x148 (c)217-316-2795 sdrummond@co.adams.il.us From: "Yantis, Ryan" To: Yantis Ryan CC: Date: 9/1/2015 11:03:48 AM Subject: Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update For Immediate Release Sept. 1, 2015 CONTACTS: See Below Legionnaires’ Disease Outbreak at Illinois Veterans’ Home-Quincy Update Quincy, IL - The Illinois Department of Veterans’ Affairs (IDVA) and the Illinois Department of Public Health (IDPH) today announced the deaths of a total of seven residents at the Illinois Veterans’ Home-Quincy. The seven residents, all of whom had underlying medical conditions, were among the 39 individuals who had been diagnosed with Legionnaires’ disease to date. Test results are currently pending for other residents. “While saddened by the loss of our residents, having been at the Home and talking with the staff and our residents, I am impressed with their resilience and spirit,” said IDVA Director Erica Jeffries. “We remain vigilant in monitoring our residents and we continue to follow the guidance of our interagency partners to implement remediation efforts across our Home. The safety and quality of care for our residents and staff are our primary concerns.” “We continue to work diligently with our public health and Veterans’ Affairs partners to get immediate medical care to residents or staff at the Home who are experiencing respiratory illness,” said IDPH Director Nirav D. Shah, M.D., J.D. “Unfortunately, we expect to see additional cases and possibly additional deaths because the incubation period for Legionnaires’ disease can be up to two weeks, and because patients with underlying medical conditions are at increased risk of more severe illness.” On August 30, 2015, IDPH requested aid from the U.S. Centers for Disease Control and Prevention (CDC) for epidemiology and environmental health assistance. Yesterday, three CDC Epidemic Intelligence Service Officers and one environmental health specialist arrived at the Illinois Veterans’ Home – Quincy to work with IDVA and IDPH in investigating the Legionnaires’ disease outbreak. CDC will also provide laboratory support from its headquarters in Atlanta, GA. IDVA and IDPH continue to work closely with the Adams County Health Department to identify and mitigate possible sources of the Legionella bacteria. Due to the nature of the bacteria, test results can take up to two weeks. Public and environmental health officials are working closely with home staff to implement control measures at the home in order to prevent additional individuals from being infected. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. Legionnaires’ disease cannot be transmitted person-to-person. For more information about Legionnaires’ disease, visit the IDPH website. For media seeking additional information, please contact: IDVA / IVH-Q: Ryan Yantis, IDVA PIO (d) 312-814-0778 (c) 312-520-6958 ryan.yantis@illinois.gov IDPH: Melaney Arnold, IDPH PIO (d) 217-558-0500 (c) 217-836-6438 melaney.arnold@illinois.gov Adams Co. Health Dept.: Shay Drummond, (d)217-222-8440 x148 (c)217-316-2795 sdrummond@co.adams.il.us From: "Yantis, Ryan" To: "Shay Drummond" CC: Date: 9/1/2015 4:27:44 AM Subject: Re: Legionnaires update ​thanks and good morning. You are up wayyyy too early. From: Shay Drummond Sent: Tuesday, September 1, 2015 5:26 AM To: Yantis, Ryan Subject: Re: Legionnaires update Thanks Ryan just to let you know to I had some confirmational calls from CNN and Reuters -confirming numbers. Sent from my iPhone On Sep 1, 2015, at 5:23 AM, Yantis, Ryan wrote: ​David Thanks; I'll pass your request along to the CDC team in Quincy, and note your request for an update interview with Dir. Jeffries for next Tuesday, Sept. 8 Thanks Ryan​ From: David Adam Sent: Monday, August 31, 2015 10:45 PM To: Yantis, Ryan Subject: RE: Legionnaires update Ryan … because the situation isn’t stabilized, and Erica thought it might “be at least a week” before it is, could another interview be done Tuesday afternoon with Erica? Is it possible to talk with her and the people from the CDC? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Monday, August 31, 2015 2:16 PM To: David Adam Cc: Long, Edie E Subject: RE: Legionnaires update OK - I know The Director has a meeting on the situation that starts at 4 pm. Will 30 minutes be enough time? I’ll reduce the QHW query from two separate to one for my tracking At the Admin Building? From: David Adam [mailto:dadam@whig.com] Sent: Monday, August 31, 2015 2:09 PM To: Yantis, Ryan Subject: RE: Legionnaires update Actually, it would be Steve Eighinger, one of our reporters. How does 3:30 sound? Could we come out there to talk to her? And get a photo as well? (Doug had to change hats this morning to work on a different story. Kind of like tag-team wrestling. Doug’s out, Steve’s now in.) From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Monday, August 31, 2015 2:02 PM To: David Adam Subject: RE: Legionnaires update Yes – what time, and you, or you and Doug Wilson? From: David Adam [mailto:dadam@whig.com] Sent: Monday, August 31, 2015 1:45 PM To: Yantis, Ryan Subject: FW: Legionnaires update Ryan … can we talk to Erica this afternoon? From: Doug Wilson Sent: Monday, August 31, 2015 1:29 PM To: David Adam ; Stephen Eighinger Subject: FW: Legionnaires update From: "Yantis, Ryan" Date: Mon, 31 Aug 2015 18:12:01 +0000 To: QHW Newsroom Subject: RE: Legionnaires update Doug Sorry for the delay; very busy here. · Currently 29 individuals from the Veterans’ Home in Quincy have tested positive for Legionnaires’ disease; four have died.(as if noon, August 31) · Our thoughts and prayers go to the families of those who passed yesterday, and we offer our sincere condolences to their loved ones.​ · The Adams County Health Department, the Illinois Department of Public Health, the Illinois Department of Veterans’ Affairs, Quincy Veterans’ Home, Blessing Hospital, and other medical providers, with guidance from the Centers for Disease Control and Prevention, are working together very closely to track patients with respiratory illness who have a connection with the home. · Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires’ disease and are making sure residents receive prompt medical attention if needed. · Compounding the challenge of identifying and treating individuals with Legionnaires’ disease is that we typically see other respiratory issues in residents this time of year. Therefore, all residents presenting any respiratory, pneumonia–type symptoms will be treated as if they have Legionnaires’ diseaseuntil lab results confirm the individual is negative for the bacteria. · Environmental health and infectious disease staff continue to visit the home to investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources. · Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. · In order to be infected with the bacteria, a person must inhale contaminated water vapor. There is no evidence that Legionnaires’ disease is transmitted person-to-person. · Public and environmental health officials are working closely with home staff to implement control measures in order to prevent additional individuals from being infected. · The Illinois Veterans’ Home-Quincy has established a remediation plan including:  Cleaning hot water tanks  Cleaning the cooling tower  Using bottled water for residents and staff  Prepping a temporary chiller so the Home’s facility chiller could be certified by outside experts​  Certifying the Home’s facility chiller by outside experts  Keeping fountains and other potential sources of aerosolized water turned off  Removing possible/suspected Legionella-infected systems/devices from use until they can be specially treated and tested before use.  Working with IDPH and other experts to clean and certify systems. Please let me know ASAP if you want to interview anyone. Dir. Jeffries is at the Home, visiting with residents and staff, as well as coordination agency efforts. Ryan From: Yantis, Ryan Sent: Monday, August 31, 2015 8:07 AM To: 'Doug Wilson' Subject: RE: Legionnaires update Good morning Doug – As you might expect, we are working this morning to gather the numbers from the various agencies involved in helping the Home with this situation. Our focus over the weekend was in getting any residents or staff with symptoms the treatment to combat Legionnaire’s while waiting for lab results. Unfortunately there is a time difference between onset of symptoms and the confirming lab results - and the delay is one we cannot rush no matter what we want. It is a matter of how long it takes for the culture to mature for accurate results. I’ll pass your request to Home leadership and others to see if there’s someone available to talk with you. We were also very pleased with Matt’s Hopt’s reporting over the weekend. The real story remains one of a caring Home staff with an unfortunate situation, which he captured along with the spirit of our veterans and their families. We have also been working really, really well with IDPH, Adams County Health and local healthcare providers. Their active engagement and support for the Home is making a positive difference, and helping our residents. I’ll let you know what I hear. Thanks Ryan From: Doug Wilson [mailto:dwilson@whig.com] Sent: Monday, August 31, 2015 7:59 AM To: Yantis, Ryan Subject: Legionnaires update Ryan, I'm looking for any updates on the IVH-Quincy Legionnaires outbreak. Are there still 28 suspected cases? How many folks have been tested? Our Sunday story was about how families have lauded the home for its work. Are there comments from the director or Vaca about the efforts to find the cause? Anything you can pass along would be helpful. Thanks Doug Wilson Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Yantis, Ryan" To: "Shay Drummond" CC: Date: 9/1/2015 5:45:32 AM Subject: Re: Legionnaires update Good to go. Thanks Sent from my iPhone On Sep 1, 2015, at 5:33 AM, Shay Drummond wrote: Lol- yes, as are you! Want to get as much done before our teams start rolling in at 8. Today is going to get more interesting with media. As we formulate questions want to start going through numbers I'll forward them onto you and Melaney. Sent from my iPhone On Sep 1, 2015, at 5:27 AM, Yantis, Ryan wrote: ​thanks and good morning. You are up wayyyy too early. From: Shay Drummond Sent: Tuesday, September 1, 2015 5:26 AM To: Yantis, Ryan Subject: Re: Legionnaires update Thanks Ryan just to let you know to I had some confirmational calls from CNN and Reuters -confirming numbers. Sent from my iPhone On Sep 1, 2015, at 5:23 AM, Yantis, Ryan wrote: ​David - Thanks; I'll pass your request along to the CDC team in Quincy, and note your request for an update interview with Dir. Jeffries for next Tuesday, Sept. 8 Thanks Ryan​ From: David Adam Sent: Monday, August 31, 2015 10:45 PM To: Yantis, Ryan Subject: RE: Legionnaires update Ryan … because the situation isn’t stabilized, and Erica thought it might “be at least a week” before it is, could another interview be done Tuesday afternoon with Erica? Is it possible to talk with her and the people from the CDC? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Monday, August 31, 2015 2:16 PM To: David Adam Cc: Long, Edie E Subject: RE: Legionnaires update OK - I know The Director has a meeting on the situation that starts at 4 pm. Will 30 minutes be enough time? I’ll reduce the QHW query from two separate to one for my tracking At the Admin Building? From: David Adam [mailto:dadam@whig.com] Sent: Monday, August 31, 2015 2:09 PM To: Yantis, Ryan Subject: RE: Legionnaires update Actually, it would be Steve Eighinger, one of our reporters. How does 3:30 sound? Could we come out there to talk to her? And get a photo as well? (Doug had to change hats this morning to work on a different story. Kind of like tag-team wrestling. Doug’s out, Steve’s now in.) From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Monday, August 31, 2015 2:02 PM To: David Adam Subject: RE: Legionnaires update Yes – what time, and you, or you and Doug Wilson? From: David Adam [mailto:dadam@whig.com] Sent: Monday, August 31, 2015 1:45 PM To: Yantis, Ryan Subject: FW: Legionnaires update Ryan … can we talk to Erica this afternoon? From: Doug Wilson Sent: Monday, August 31, 2015 1:29 PM To: David Adam ; Stephen Eighinger Subject: FW: Legionnaires update From: "Yantis, Ryan" Date: Mon, 31 Aug 2015 18:12:01 +0000 To: QHW Newsroom Subject: RE: Legionnaires update Doug Sorry for the delay; very busy here. · Currently 29 individuals from the Veterans’ Home in Quincy have tested positive for Legionnaires’ disease; four have died.(as if noon, August 31) · Our thoughts and prayers go to the families of those who passed yesterday, and we offer our sincere condolences to their loved ones.​ · The Adams County Health Department, the Illinois Department of Public Health, the Illinois Department of Veterans’ Affairs, Quincy Veterans’ Home, Blessing Hospital, and other medical providers, with guidance from the Centers for Disease Control and Prevention, are working together very closely to track patients with respiratory illness who have a connection with the home. · Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires’ disease and are making sure residents receive prompt medical attention if needed. · Compounding the challenge of identifying and treating individuals with Legionnaires’ disease is that we typically see other respiratory issues in residents this time of year. Therefore, all residents presenting any respiratory, pneumonia–type symptoms will be treated as if they have Legionnaires’ diseaseuntil lab results confirm the individual is negative for the bacteria. · Environmental health and infectious disease staff continue to visit the home to investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources. · Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large airconditioning systems. · In order to be infected with the bacteria, a person must inhale contaminated water vapor. There is no evidence that Legionnaires’ disease is transmitted person-to-person. · Public and environmental health officials are working closely with home staff to implement control measures in order to prevent additional individuals from being infected. · The Illinois Veterans’ Home-Quincy has established a remediation plan including:  Cleaning hot water tanks  Cleaning the cooling tower  Using bottled water for residents and staff  Prepping a temporary chiller so the Home’s facility chiller could be certified by outside experts​  Certifying the Home’s facility chiller by outside experts  Keeping fountains and other potential sources of aerosolized water turned off  Removing possible/suspected Legionella-infected systems/devices from use until they can be specially treated and tested before use.  Working with IDPH and other experts to clean and certify systems. Please let me know ASAP if you want to interview anyone. Dir. Jeffries is at the Home, visiting with residents and staff, as well as coordination agency efforts. Ryan From: Yantis, Ryan Sent: Monday, August 31, 2015 8:07 AM To: 'Doug Wilson' Subject: RE: Legionnaires update Good morning Doug – As you might expect, we are working this morning to gather the numbers from the various agencies involved in helping the Home with this situation. Our focus over the weekend was in getting any residents or staff with symptoms the treatment to combat Legionnaire’s while waiting for lab results. Unfortunately there is a time difference between onset of symptoms and the confirming lab results - and the delay is one we cannot rush no matter what we want. It is a matter of how long it takes for the culture to mature for accurate results. I’ll pass your request to Home leadership and others to see if there’s someone available to talk with you. We were also very pleased with Matt’s Hopt’s reporting over the weekend. The real story remains one of a caring Home staff with an unfortunate situation, which he captured along with the spirit of our veterans and their families. We have also been working really, really well with IDPH, Adams County Health and local healthcare providers. Their active engagement and support for the Home is making a positive difference, and helping our residents. I’ll let you know what I hear. Thanks Ryan From: Doug Wilson [mailto:dwilson@whig.com] Sent: Monday, August 31, 2015 7:59 AM To: Yantis, Ryan Subject: Legionnaires update Ryan, I'm looking for any updates on the IVH-Quincy Legionnaires outbreak. Are there still 28 suspected cases? How many folks have been tested? Our Sunday story was about how families have lauded the home for its work. Are there comments from the director or Vaca about the efforts to find the cause? Anything you can pass along would be helpful. Thanks Doug Wilson Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Yantis, Ryan" To: "David Adam" CC: Date: 9/1/2015 4:23:38 AM Subject: Re: Legionnaires update ​David Thanks; I'll pass your request along to the CDC team in Quincy, and note your request for an update interview with Dir. Jeffries for next Tuesday, Sept. 8 Thanks Ryan​ From: David Adam Sent: Monday, August 31, 2015 10:45 PM To: Yantis, Ryan Subject: RE: Legionnaires update Ryan … because the situation isn’t stabilized, and Erica thought it might “be at least a week” before it is, could another interview be done Tuesday afternoon with Erica? Is it possible to talk with her and the people from the CDC? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Monday, August 31, 2015 2:16 PM To: David Adam Cc: Long, Edie E Subject: RE: Legionnaires update OK - I know The Director has a meeting on the situation that starts at 4 pm. Will 30 minutes be enough time? I’ll reduce the QHW query from two separate to one for my tracking At the Admin Building? From: David Adam [mailto:dadam@whig.com] Sent: Monday, August 31, 2015 2:09 PM To: Yantis, Ryan Subject: RE: Legionnaires update Actually, it would be Steve Eighinger, one of our reporters. How does 3:30 sound? Could we come out there to talk to her? And get a photo as well? (Doug had to change hats this morning to work on a different story. Kind of like tag-team wrestling. Doug’s out, Steve’s now in.) From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Monday, August 31, 2015 2:02 PM To: David Adam Subject: RE: Legionnaires update Yes – what time, and you, or you and Doug Wilson? From: David Adam [mailto:dadam@whig.com] Sent: Monday, August 31, 2015 1:45 PM To: Yantis, Ryan Subject: FW: Legionnaires update Ryan … can we talk to Erica this afternoon? From: Doug Wilson Sent: Monday, August 31, 2015 1:29 PM To: David Adam ; Stephen Eighinger Subject: FW: Legionnaires update From: "Yantis, Ryan" Date: Mon, 31 Aug 2015 18:12:01 +0000 To: QHW Newsroom Subject: RE: Legionnaires update Doug Sorry for the delay; very busy here. · Currently 29 individuals from the Veterans’ Home in Quincy have tested positive for Legionnaires’ disease; four have died.(as if noon, August 31) · Our thoughts and prayers go to the families of those who passed yesterday, and we offer our sincere condolences to their loved ones.​ · The Adams County Health Department, the Illinois Department of Public Health, the Illinois Department of Veterans’ Affairs, Quincy Veterans’ Home, Blessing Hospital, and other medical providers, with guidance from the Centers for Disease Control and Prevention, are working together very closely to track patients with respiratory illness who have a connection with the home. · Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires’ disease and are making sure residents receive prompt medical attention if needed. · Compounding the challenge of identifying and treating individuals with Legionnaires’ disease is that we typically see other respiratory issues in residents this time of year. Therefore, all residents presenting any respiratory, pneumonia–type symptoms will be treated as if they have Legionnaires’ diseaseuntil lab results confirm the individual is negative for the bacteria. · Environmental health and infectious disease staff continue to visit the home to investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources. · Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. · In order to be infected with the bacteria, a person must inhale contaminated water vapor. There is no evidence that Legionnaires’ disease is transmitted person-to-person. · Public and environmental health officials are working closely with home staff to implement control measures in order to prevent additional individuals from being infected. · The Illinois Veterans’ Home-Quincy has established a remediation plan including:  Cleaning hot water tanks  Cleaning the cooling tower  Using bottled water for residents and staff  Prepping a temporary chiller so the Home’s facility chiller could be certified by outside experts​  Certifying the Home’s facility chiller by outside experts  Keeping fountains and other potential sources of aerosolized water turned off  Removing possible/suspected Legionella-infected systems/devices from use until they can be specially treated and tested before use.  Working with IDPH and other experts to clean and certify systems. Please let me know ASAP if you want to interview anyone. Dir. Jeffries is at the Home, visiting with residents and staff, as well as coordination agency efforts. Ryan From: Yantis, Ryan Sent: Monday, August 31, 2015 8:07 AM To: 'Doug Wilson' Subject: RE: Legionnaires update Good morning Doug – As you might expect, we are working this morning to gather the numbers from the various agencies involved in helping the Home with this situation. Our focus over the weekend was in getting any residents or staff with symptoms the treatment to combat Legionnaire’s while waiting for lab results. Unfortunately there is a time difference between onset of symptoms and the confirming lab results - and the delay is one we cannot rush no matter what we want. It is a matter of how long it takes for the culture to mature for accurate results. I’ll pass your request to Home leadership and others to see if there’s someone available to talk with you. We were also very pleased with Matt’s Hopt’s reporting over the weekend. The real story remains one of a caring Home staff with an unfortunate situation, which he captured along with the spirit of our veterans and their families. We have also been working really, really well with IDPH, Adams County Health and local healthcare providers. Their active engagement and support for the Home is making a positive difference, and helping our residents. I’ll let you know what I hear. Thanks Ryan From: Doug Wilson [mailto:dwilson@whig.com] Sent: Monday, August 31, 2015 7:59 AM To: Yantis, Ryan Subject: Legionnaires update Ryan, I'm looking for any updates on the IVH-Quincy Legionnaires outbreak. Are there still 28 suspected cases? How many folks have been tested? Our Sunday story was about how families have lauded the home for its work. Are there comments from the director or Vaca about the efforts to find the cause? Anything you can pass along would be helpful. Thanks Doug Wilson Quincy and its subsidiaries do not discriminate in the sale of advertising in any medium (broadcast, print, or interactive), and will accept no advertising which is placed with an intent to discriminate on the basis of race or ethnicity. From: "Yantis, Ryan" To: durrie@umsl.edu CC: "Arnold, Melaney" "Shay Drummond" Date: 9/1/2015 10:39:08 AM Subject: RE: St. Louis Public Radio - Health on IVH-Q situation Resending to corrected email From: Yantis, Ryan Sent: Tuesday, September 01, 2015 10:49 AM To: 'durrie@iumsl.edu' Cc: Arnold, Melaney; Shay Drummond Subject: St. Louis Public Radio - Health on IVH-Q situation Durrie – Thanks for your call and invite to discuss the situation at the Illinois Veterans’ Home – Quincy. As I mentioned, we are compiling our update and I don’t want to give you information that will soon be out of date. Also, I am looping in Melaney from Illinois Dept. of Public Health and Shay Drummond from Adams County Health Dept. They are also good sources on this situation. Please call or email after noon (12:00) and we should have an update to share. Meanwhile, here is some general I’ve been sharing with media. General Statement (as if noon, August 31 – we will be updating number shortly) ​: Currently 29 individuals from the Illinois Veterans’ Home in Quincy have tested positive for Legionnaires’ disease, and sadly, four have died. Our thoughts and prayers go to the families of those who passed yesterday, and we offer our sincere condolences to their loved ones.​ The Adams County Health Department, the Illinois Department of Public Health, the Illinois Department of Veterans’ Affairs, Quincy Veterans’ Home, Blessing Hospital, and other medical providers, with guidance from the Centers for Disease Control and Prevention, are working together very closely to track patients with respiratory illness who have a connection with the home. Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires’ disease and are making sure residents receive prompt medical attention if needed. ​Compounding the challenge of identifying and treating individuals with Legionnaires’ disease is that we typically see other respiratory issues in residents this time of year. Therefore, all residents presenting any respiratory, pneumonia–type symptoms will be treated as if they have Legionnaires’ disease until lab results confirm the individual is negative for the bacteria. Environmental health and infectious disease staff continue to visit the home to investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources. Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. There is no evidence that Legionnaires’ disease is transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures in order to prevent additional individuals from being infected. The Illinois Veterans’ Home-Quincy has established a remediation plan including: - Cleaning hot water tanks - Cleaning the cooling tower - Using bottled water for residents and staff - Prepping a temporary chiller so the Home’s facility chiller could be certified by outside experts​ - Certifying the Home’s facility chiller by outside experts - Keeping fountains and other potential sources of aerosolized water turned off - Removing possible/suspected Legionella-infected systems/devices from use until they can be specially treated and tested before use. - Working with IDPH and other experts to clean and certify systems. We will update as we can. Our focus is on providing great care for our residents; keeping them, our staff, and those impacted by this situation informed and engaged; and working with our partner agencies, providers, and team to resolve this a quickly as possible. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Yantis, Ryan" To: Arnold "Melaney ;'Shay Drummond" "CATHY S" CC: Date: 9/1/2015 10:02:58 AM Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. In convo with Cathy this AM, the Home has a solid notification protocol for change in status of residents if/when symptomatic, or there is a change in condition. The staff call and brief the family (POA power of attorney or ICE designates), and should a resident get a confirming test result, then the Infectious Disease Nurse at the Home talks to the family. This is all charted. Generally the families are in attendance if a resident is expectant/in comfort care/hospice, but notification is made if the family is not present. Again, all charted. While not answering for Blessing, Cathy was very positive about their standards of notification and family communication. Blessing would handle any notification for residents under their care. We might want to loop in the Blessing PR folks… From: Arnold, Melaney Sent: Tuesday, September 01, 2015 10:55 AM To: 'Shay Drummond'; Yantis, Ryan; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Not yet. Connie said she was going to talk with you at 11:15 and we would have numbers by 11:30. Also – do you know if the families have been notified? I know you’ve been busy. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 10:50 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Hi have you gotten the updates from Fred? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Yantis, Ryan" To: "Shay Drummond" Melaney CC: Date: 9/1/2015 11:31:20 AM Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. AFSCME local president sent a letter to IDVA We used talking points to formulate a response. Once it’s sent, I can see about providing you a copy. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 11:30 AM To: Arnold, Melaney; Yantis, Ryan Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Thanks and an FYI am getting inquiries from OSHA and AFSCME!!! From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Tuesday, September 01, 2015 11:18 AM To: Yantis, Ryan; Shay Drummond; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Updated numbers. Also attached is the final news release, which will be sent to media at noon today. Thank you. From: Yantis, Ryan Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Yantis, Ryan" To: "Shay Drummond" Melaney "CATHY S" CC: Date: 9/1/2015 10:13:35 AM Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. KHQA-TV wants an interview with Dir. J; which I’ve kicked until after the release is out. They are looking for someone for Live at 5, which the Director cannot do… Also, St. Louis Public Radio health reporter (Durrie) is asking for a on-record, recorded interview. I’ll send her the release and follow up From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 11:07 AM To: Arnold, Melaney; Yantis, Ryan; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Thanks I will wait for your release. Shay From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Tuesday, September 01, 2015 11:05 AM To: Shay Drummond; Yantis, Ryan; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. We will issue the news release at noon today. I’m still waiting one final approval. I’ll get you the release BEFORE it goes out. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 11:04 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Just, did. Ryan is there going to be a formal press release or are we free to release numbers? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 11:03 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. In convo with Cathy this AM, the Home has a solid notification protocol for change in status of residents if/when symptomatic, or there is a change in condition. The staff call and brief the family (POA power of attorney or ICE designates), and should a resident get a confirming test result, then the Infectious Disease Nurse at the Home talks to the family. This is all charted. Generally the families are in attendance if a resident is expectant/in comfort care/hospice, but notification is made if the family is not present. Again, all charted. While not answering for Blessing, Cathy was very positive about their standards of notification and family communication. Blessing would handle any notification for residents under their care. We might want to loop in the Blessing PR folks… From: Arnold, Melaney Sent: Tuesday, September 01, 2015 10:55 AM To: 'Shay Drummond'; Yantis, Ryan; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Not yet. Connie said she was going to talk with you at 11:15 and we would have numbers by 11:30. Also – do you know if the families have been notified? I know you’ve been busy. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 10:50 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Hi have you gotten the updates from Fred? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Yantis, Ryan" To: Arnold "Melaney ;Shay Drummond" "CATHY S" CC: Date: 9/1/2015 10:19:45 AM Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Thanks Melaney – you are awesome. Ryan From: Arnold, Melaney Sent: Tuesday, September 01, 2015 11:18 AM To: Yantis, Ryan; Shay Drummond; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Updated numbers. Also attached is the final news release, which will be sent to media at noon today. Thank you. From: Yantis, Ryan Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) 312-520-6958 (cell) Rvan. From: "Yantis, Ryan" To: "Shay Drummond" Melaney "CATHY S" CC: Date: 9/1/2015 10:04:57 AM Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Deferring to IDPH. I know we are staffing a release…. they have our inputs, I think. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 11:04 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Just, did. Ryan is there going to be a formal press release or are we free to release numbers? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 11:03 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. In convo with Cathy this AM, the Home has a solid notification protocol for change in status of residents if/when symptomatic, or there is a change in condition. The staff call and brief the family (POA power of attorney or ICE designates), and should a resident get a confirming test result, then the Infectious Disease Nurse at the Home talks to the family. This is all charted. Generally the families are in attendance if a resident is expectant/in comfort care/hospice, but notification is made if the family is not present. Again, all charted. While not answering for Blessing, Cathy was very positive about their standards of notification and family communication. Blessing would handle any notification for residents under their care. We might want to loop in the Blessing PR folks… From: Arnold, Melaney Sent: Tuesday, September 01, 2015 10:55 AM To: 'Shay Drummond'; Yantis, Ryan; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Not yet. Connie said she was going to talk with you at 11:15 and we would have numbers by 11:30. Also – do you know if the families have been notified? I know you’ve been busy. From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Tuesday, September 01, 2015 10:50 AM To: Yantis, Ryan; Arnold, Melaney; HOUSTON, CATHY S Subject: RE: Updated TP Q&A 2015-09-01 1000 AM for staffing. Hi have you gotten the updates from Fred? From: Yantis, Ryan [mailto:Ryan.Yantis@Illinois.gov] Sent: Tuesday, September 01, 2015 10:46 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Yantis, Ryan" To: durrie@iumsl.edu CC: "Arnold, Melaney" "Shay Drummond" Date: 9/1/2015 9:49:00 AM S u b j ect: St. Louis Public Radio - Health on IVH-Q situation Durrie – Thanks for your call and invite to discuss the situation at the Illinois Veterans’ Home – Quincy. As I mentioned, we are compiling our update and I don’t want to give you information that will soon be out of date. Also, I am looping in Melaney from Illinois Dept. of Public Health and Shay Drummond from Adams County Health Dept. They are also good sources on this situation. Please call or email after noon (12:00) and we should have an update to share. Meanwhile, here is some general I’ve been sharing with media. General Statement (as if noon, August 31 – we will be updating number shortly) ​: Currently 29 individuals fromthe Illinois Veterans’ Homein Quincyhave tested positivefor Legionnaires’ disease, and sadly, four have died. Our thoughts and prayers go to the families of those who passed yesterday, and we offer our sincere condolences totheir loved ones.​ The Adams County Health Department, the Illinois Department of Public Health, the Illinois Department of Veterans’ Affairs, Quincy Veterans’ Home, Blessing Hospital, and other medical providers, with guidance from the Centers for Disease Control and Prevention, are working together very closely to track patients with respiratoryillness who have a connection with the home. Staff members at the home are monitoring residents carefully for symptoms that might indicate Legionnaires’ disease and are making sure residents receive prompt medical attention if needed. ​Compounding the challenge of identifying and treating individuals with Legionnaires’ disease is that we typicallysee other respiratory issues in residents this time of year. Therefore, all residents presenting any respiratory, pneumonia–type symptoms will be treated as if they have Legionnaires’ disease until lab results confirmthe individual is negative for the bacteria. Environmental health and infectious disease staff continue to visit the home to investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources. Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems. In order to be infected with the bacteria, a person must inhale contaminated water vapor. There is no evidence that Legionnaires’ disease is transmitted person-to-person. Public and environmental health officials are working closely with home staff to implement control measures in order to prevent additional individuals from being infected. The Illinois Veterans’ Home-Quincy has established a remediation plan including: - Cleaning hot water tanks - Cleaning the cooling tower - Using bottled water for residents and staff - Prepping a temporary chiller so the Home’s facility chiller couldbe certified by outside experts​ - Certifying the Home’s facility chiller by outside experts - Keeping fountains and other potential sources of aerosolized water turned off - Removing possible/suspected Legionella-infected systems/devices from use until they can be specially treated and tested before use. - Working with IDPH and other experts to clean and certify systems. We will update as we can. Our focus is on providing great care for our residents; keeping them, our staff, and those impacted by this situation informed and engaged; and working with our partner agencies, providers, and team to resolve this a quickly as possible. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Yantis, Ryan" To: Arnold "Melaney ;Shay Drummond" "CATHY S" CC: Date: 9/1/2015 9:46:03 AM Subject: Updated TP Q&A 2015-09-01 1000 AM for staffing. Attachments: Legionella TP QA 2015-09-01-1000 AM.docx I know this needs to be updated for overall numbers. I added Q&A 10 on resident hygiene with little/no water. Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Arnold, Melaney" To: "Jerrod Welch" CC: Date: 9/2/2015 11:11:36 AM S u b j e c t : FW: Fox TV St Louis - 1:30 today Jerrod ~ I don’t have any specifics about the interview other than what’s below. If you would like to chat, give me a call at 217-558-0500, or let me know when is a good time to call you. Thanks Melaney From: Yantis, Ryan Sent: Wednesday, September 02, 2015 11:34 AM To: Shay Drummond Cc: Arnold, Melaney; HOUSTON, CATHY S; WINNICKI, LENARD F; VACA, BRUCE L Subject: RE: Fox TV St Louis - 1:30 today Great Shay! – can you call her and make arrangements? Thanks From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, September 02, 2015 11:31 AM To: Yantis, Ryan Cc: Arnold, Melaney; HOUSTON, CATHY S; WINNICKI, LENARD F; VACA, BRUCE L Subject: Re: Fox TV St Louis - 1:30 today I am available if needed Sent from my iPhone On Sep 2, 2015, at 10:56 AM, Yantis, Ryan wrote: All – Betsey Bruce and a camera crew are coming to IVH-Q at about 1:30 this afternoon to update coverage of the situation at the Home. She’s likely to want to have an on-camera with Cathy Houston, IDPH's Assistant Director, Michelle Gentry-Wiseman, and perhaps Shay or the CDC folks. Can we please make folks available? Her number is 314-917-1105; email Betsey.bruce@tvstl.com Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Arnold, Melaney" To: jgoodwin@wmbd.com CC: "jarrod welch Adams County" Date: 9/2/2015 5:56:23 PM Subject: Legionnaires cases There are 4 cases in the community, which are not connected to the veterans home and are not part of the 45 count. One of the 4 cases has died. Total for the veterans home - 45 cases including 7 deaths. Quincy - 4 cases including 1 death. We keep the numbers separate because they are not connected. Thanks ------ Original message-----From: Jenny Goodman Date: Wed, Sep 2, 2015 6:27 PM To: Jerrod Welch; Subject:Legionnaires cases Hi! I am looking to confirm information that there are 4 new cases of the disease in Quincy. Also, did one of those 4 patients die and make the death count rise to 8? Thank you for any help you can give! Jenny Goodman l Managing Editor WMBD l WYZZ l Bounce Central Illinois 3131 N. University Peoria, IL 61604 Office: 309.686.9455 l Fax: 309.686.8658 www.ciproud.com Follow us on Facebook From: "Arnold, Melaney" To: Yantis "Ryan ;Shay Drummond" "CATHY S" "LENARD F" "BRUCE L" CC: Date: 9/2/2015 10:25:04 AM Subject: RE: Fox TV St Louis - 1:30 today Unfortunately, Asst Director Michelle Gentry-Wiseman has to leave Quincy before the reporter gets there. Shay or CDC? Sorry From: Yantis, Ryan Sent: Wednesday, September 02, 2015 10:56 AM To: Arnold, Melaney; Shay Drummond; HOUSTON, CATHY S; WINNICKI, LENARD F; VACA, BRUCE L Subject: Fox TV St Louis - 1:30 today All – Betsey Bruce and a camera crew are coming to IVH-Q at about 1:30 this afternoon to update coverage of the situation at the Home. She’s likely to want to have an on-camera with Cathy Houston, IDPH's Assistant Director, Michelle Gentry-Wiseman, and perhaps Shay or the CDC folks. Can we please make folks available? Her number is 314-917-1105; email Betsey.bruce@tvstl.com Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Arnold, Melaney" To: "Jerrod Welch" CC: Date: 9/2/2015 5:38:34 PM Subject: Re: Legionnaires cases I can field. I will cc you On Sep 2, 2015, at 6:28 PM, Jerrod Welch wrote: Can you field this or shall I. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Jenny Goodman Date: Wed, Sep 2, 2015 6:27 PM To: Jerrod Welch; Subject:Legionnaires cases Hi! I am looking to confirm information that there are 4 new cases of the disease in Quincy. Also, did one of those 4 patients die and make the death count rise to 8? Thank you for any help you can give! Jenny Goodman l Managing Editor WMBD l WYZZ l Bounce Central Illinois 3131 N. University Peoria, IL 61604 Office: 309.686.9455 l Fax: 309.686.8658 www.ciproud.com Follow us on Facebook Nexstar Broadcasting Group, Inc. provides services for WYZZ-TV through an Outsourcing Agreement. STATEMENT OF CONFIDENTIALITY This electronic message may contain privileged or confidential information. If you are not the intended recipient of this email, please delete it from your system and advise the sender. From: "Arnold, Melaney" To: "Jerrod Welch" CC: Date: 9/2/2015 5:40:05 PM Subject: Re: Legionnaires cases Although her email address is not popping up on my phone. Do you have it? On Sep 2, 2015, at 6:28 PM, Jerrod Welch wrote: Can you field this or shall I. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----F r o m : Jenny Goodman Date: Wed, Sep 2, 2015 6:27 PM To: Jerrod Welch; S u b j e c t : Legionnaires cases Hi! I am looking to confirm information that there are 4 new cases of the disease in Quincy. Also, did one of those 4 patients die and make the death count rise to 8? Thank you for any help you can give! Jenny Goodman l Managing Editor WMBD l WYZZ l Bounce Central Illinois 3131 N. University Peoria, IL 61604 Office: 309.686.9455 l Fax: 309.686.8658 www.ciproud.com Follow us on Facebook Nexstar Broadcasting Group, Inc. provides services for WYZZ-TV through an Outsourcing Agreement. STATEMENT OF CONFIDENTIALITY This electronic message may contain privileged or confidential information. If you are not the intended recipient of this email, please delete it from your system and advise the sender. From: "Arnold, Melaney" To: "Jerrod Welch" CC: "Shah, Nirav" "Gentry-Wiseman, Michelle" "Shay Drummond" Date: 9/2/2015 1:07:20 PM Subject: RE: Media 2015 – 4 cases 2014 - ??? 2013 – 1 2012 – 0 2011 – 0 2010 – 1 We don’t have record of that 2014 case. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:58 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Re: Media Good. I had Emily forward our olgi. Are you guys prepared to release as a press release once we clear the numbers. We can tell you 4 of 6 includes 2015, so 10, 13, 14 and 15. 14 is the discrepancy we need to resolve. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 1:53 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond; Subject:RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW From: "Arnold, Melaney" To: "Jerrod Welch" CC: Date: 9/2/2015 2:52:43 PM Subject: RE: Media Attachments: 09.02.15 Quincy Legionnaires.docx Final release I’ve asked it to be sent to media a.s.a.p., but feel free to send it out on your own. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:43 PM To: Arnold, Melaney Subject: Re: Media 2173166100 Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:40 PM To: Jerrod Welch; Subject:RE: Media To remain consistent – do you want your quote to say said ACHD Administrator Jerrod Welch, M.P.A., C.P.H.A From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:38 PM To: Arnold, Melaney Subject: Re: Media 2228440 Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:36 PM To: Jerrod Welch; Subject:RE: Media What number? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:36 PM To: Arnold, Melaney Subject: Re: Media Me Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:35 PM To: Arnold, Melaney;Jerrod Welch; Subject:RE: Media Shay or you? From: Arnold, Melaney Sent: Wednesday, September 02, 2015 3:31 PM To: 'Jerrod Welch' Subject: RE: Media Who do you want listed as the PIO contact and what number? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:30 PM To: Arnold, Melaney Subject: RE: Media Nope, you are correct. Lets go with the original text. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:29 PM To: Jerrod Welch Subject: RE: Media Why are we just now announcing it? That’s what the media will ask. We can say we’ve investigated the cases as we normally would, but our focus has been on vets home. I can change it to - SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death in Quincy. These cases have occurred over sporadically since the end of July. At this time there is no evidence they are connected to the Illinois Veterans’ Home-Quincy. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:27 PM To: Arnold, Melaney Subject: RE: Media The earliest one is July 24, a second on July 29, the other two are more current From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:25 PM To: Jerrod Welch Subject: RE: Media What’s the time frame? When did they happen? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:23 PM To: Arnold, Melaney Subject: RE: Media Melanie, Shay is concerned about the first statement. In re-reading it, it does appear to say that these are sudden and new. You are the expert, so we’ll defer to you on it, but her read was a bit different than mine, and in rereading it, I see where she’s coming from. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:09 PM To: Jerrod Welch Subject: RE: Media I’ll do my best, but I have to get IDPH approval and GO From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:08 PM To: Arnold, Melaney Subject: Re: Media We are good with it. Get your oks as dfast as possible and release it. Thank you so much for tackling it quuckly Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:05 PM To: Jerrod Welch; Subject:RE: Media This is my train of thought. It’s being circulated around IDPH. It’s based on your talking points. Legionnaires’ Disease Cases in Quincy SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death, in Quincy that are not connected to the Illinois Veterans’ Home-Quincy. “As part of our investigation of the Legionnaires’ disease outbreak at the Illinois Veterans’ Home-Quincy, we asked our local health care providers to help us with surveillance of the disease and test individuals in the community who have symptoms that can be related to Legionnaires’ disease,” said ACHD Administrator Jerrod Welch. “We have thoroughly investigated each confirmed case for a connection with the outbreak, as well as any possible connection to one another. At this time, we have found no connections.” Because of the increase in testing, public health officials expect to find more cases than during a non-outbreak situation. Legionella bacteria occurs naturally in the environment. Approximately 200 cases are reported each year in Illinois, most unassociated with any outbreak and considered isolated exposures. Adams County has reported cases of Legionnaires’ disease in three of the past six years. “We do not believe there is an increased risk of Legionnaires’ disease to the Quincy community after talking with the individuals who became ill,” said IDPH Director Nirav D. Shah, M.D., J.D. “We continue to focus on the outbreak at the Illinois Veterans’ Home-Quincy and investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources.” Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, but also to broken air conditioners or small decorative yard fountains. Legionnaires’ disease is not known to be transmitted person to person. ### From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:57 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond; Austin, Connie Subject: Re: Media Call from mayor ofqcy asking usto get info out asap as they are receiving high volumes of calls on water supply. The home also called and is pushing for a rebuttal from them to the coroners issued statement. So now the sooner the better in the release. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 2:08 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond;Austin, Connie; Subject:RE: Media Can Jon reach out to Connie Austin? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:02 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Re: Media Jon is working on 2014. He is confident we have that case. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 1:53 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond; Subject:RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW From: "Arnold, Melaney" To: "Jerrod Welch" CC: Date: 9/2/2015 2:40:08 PM Subject: RE: Media To remain consistent – do you want your quote to say said ACHD Administrator Jerrod Welch, M.P.A., C.P.H.A From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:38 PM To: Arnold, Melaney Subject: Re: Media 2228440 Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:36 PM To: Jerrod Welch; Subject:RE: Media What number? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:36 PM To: Arnold, Melaney Subject: Re: Media Me Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:35 PM To: Arnold, Melaney;Jerrod Welch; Subject:RE: Media Shay or you? From: Arnold, Melaney Sent: Wednesday, September 02, 2015 3:31 PM To: 'Jerrod Welch' Subject: RE: Media Who do you want listed as the PIO contact and what number? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:30 PM To: Arnold, Melaney Subject: RE: Media Nope, you are correct. Lets go with the original text. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:29 PM To: Jerrod Welch Subject: RE: Media Why are we just now announcing it? That’s what the media will ask. We can say we’ve investigated the cases as we normally would, but our focus has been on vets home. I can change it to - SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death in Quincy. These cases have occurred over sporadically since the end of July. At this time there is no evidence they are connected to the Illinois Veterans’ Home-Quincy. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:27 PM To: Arnold, Melaney Subject: RE: Media The earliest one is July 24, a second on July 29, the other two are more current From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:25 PM To: Jerrod Welch Subject: RE: Media What’s the time frame? When did they happen? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:23 PM To: Arnold, Melaney Subject: RE: Media Melanie, Shay is concerned about the first statement. In re-reading it, it does appear to say that these are sudden and new. You are the expert, so we’ll defer to you on it, but her read was a bit different than mine, and in rereading it, I see where she’s coming from. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:09 PM To: Jerrod Welch Subject: RE: Media I’ll do my best, but I have to get IDPH approval and GO From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:08 PM To: Arnold, Melaney Subject: Re: Media We are good with it. Get your oks as dfast as possible and release it. Thank you so much for tackling it quuckly Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:05 PM To: Jerrod Welch; Subject:RE: Media This is my train of thought. It’s being circulated around IDPH. It’s based on your talking points. Legionnaires’ Disease Cases in Quincy SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death, in Quincy that are not connected to the Illinois Veterans’ Home-Quincy. “As part of our investigation of the Legionnaires’ disease outbreak at the Illinois Veterans’ Home-Quincy, we asked our local health care providers to help us with surveillance of the disease and test individuals in the community who have symptoms that can be related to Legionnaires’ disease,” said ACHD Administrator Jerrod Welch. “We have thoroughly investigated each confirmed case for a connection with the outbreak, as well as any possible connection to one another. At this time, we have found no connections.” Because of the increase in testing, public health officials expect to find more cases than during a non-outbreak situation. Legionella bacteria occurs naturally in the environment. Approximately 200 cases are reported each year in Illinois, most unassociated with any outbreak and considered isolated exposures. Adams County has reported cases of Legionnaires’ disease in three of the past six years. “We do not believe there is an increased risk of Legionnaires’ disease to the Quincy community after talking with the individuals who became ill,” said IDPH Director Nirav D. Shah, M.D., J.D. “We continue to focus on the outbreak at the Illinois Veterans’ Home-Quincy and investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources.” Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, but also to broken air conditioners or small decorative yard fountains. Legionnaires’ disease is not known to be transmitted person to person. ### From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:57 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond; Austin, Connie Subject: Re: Media Call from mayor ofqcy asking usto get info out asap as they are receiving high volumes of calls on water supply. The home also called and is pushing for a rebuttal from them to the coroners issued statement. So now the sooner the better in the release. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 2:08 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond;Austin, Connie; Subject:RE: Media Can Jon reach out to Connie Austin? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:02 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Re: Media Jon is working on 2014. He is confident we have that case. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 1:53 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond; Subject:RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW From: "Arnold, Melaney" To: "Jerrod Welch" CC: "Shah, Nirav" "Gentry-Wiseman, Michelle" "Shay Drummond" "Austin, Connie" Date: 9/2/2015 1:07:46 PM Subject: RE: Media Can Jon reach out to Connie Austin? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:02 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Re: Media Jon is working on 2014. He is confident we have that case. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 1:53 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond; Subject:RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW MM qt?) Jerrod C. Weleh, MFA, CPHA Public Health Administrator Adams Cauritif Health Department 330 He rr?nant St, Quincy, IL 52301 2223440 From: "Arnold, Melaney" To: "Jerrod Welch" CC: Date: 9/2/2015 2:30:35 PM Subject: RE: Media Who do you want listed as the PIO contact and what number? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:30 PM To: Arnold, Melaney Subject: RE: Media Nope, you are correct. Lets go with the original text. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:29 PM To: Jerrod Welch Subject: RE: Media Why are we just now announcing it? That’s what the media will ask. We can say we’ve investigated the cases as we normally would, but our focus has been on vets home. I can change it to - SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death in Quincy. These cases have occurred over sporadically since the end of July. At this time there is no evidence they are connected to the Illinois Veterans’ Home-Quincy. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:27 PM To: Arnold, Melaney Subject: RE: Media The earliest one is July 24, a second on July 29, the other two are more current From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:25 PM To: Jerrod Welch Subject: RE: Media What’s the time frame? When did they happen? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:23 PM To: Arnold, Melaney Subject: RE: Media Melanie, Shay is concerned about the first statement. In re-reading it, it does appear to say that these are sudden and new. You are the expert, so we’ll defer to you on it, but her read was a bit different than mine, and in rereading it, I see where she’s coming from. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:09 PM To: Jerrod Welch Subject: RE: Media I’ll do my best, but I have to get IDPH approval and GO From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:08 PM To: Arnold, Melaney Subject: Re: Media We are good with it. Get your oks as dfast as possible and release it. Thank you so much for tackling it quuckly Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message------ From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:05 PM To: Jerrod Welch; Subject:RE: Media This is my train of thought. It’s being circulated around IDPH. It’s based on your talking points. Legionnaires’ Disease Cases in Quincy SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death, in Quincy that are not connected to the Illinois Veterans’ Home-Quincy. “As part of our investigation of the Legionnaires’ disease outbreak at the Illinois Veterans’ Home-Quincy, we asked our local health care providers to help us with surveillance of the disease and test individuals in the community who have symptoms that can be related to Legionnaires’ disease,” said ACHD Administrator Jerrod Welch. “We have thoroughly investigated each confirmed case for a connection with the outbreak, as well as any possible connection to one another. At this time, we have found no connections.” Because of the increase in testing, public health officials expect to find more cases than during a non-outbreak situation. Legionella bacteria occurs naturally in the environment. Approximately 200 cases are reported each year in Illinois, most unassociated with any outbreak and considered isolated exposures. Adams County has reported cases of Legionnaires’ disease in three of the past six years. “We do not believe there is an increased risk of Legionnaires’ disease to the Quincy community after talking with the individuals who became ill,” said IDPH Director Nirav D. Shah, M.D., J.D. “We continue to focus on the outbreak at the Illinois Veterans’ Home-Quincy and investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources.” Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, but also to broken air conditioners or small decorative yard fountains. Legionnaires’ disease is not known to be transmitted person to person. ### From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:57 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond; Austin, Connie Subject: Re: Media Call from mayor ofqcy asking usto get info out asap as they are receiving high volumes of calls on water supply. The home also called and is pushing for a rebuttal from them to the coroners issued statement. So now the sooner the better in the release. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 2:08 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond;Austin, Connie; Subject:RE: Media Can Jon reach out to Connie Austin? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:02 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Re: Media Jon is working on 2014. He is confident we have that case. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 1:53 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond; Subject:RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW From: "Arnold, Melaney" To: "Jerrod Welch" CC: Date: 9/2/2015 2:28:40 PM Subject: RE: Media Why are we just now announcing it? That’s what the media will ask. We can say we’ve investigated the cases as we normally would, but our focus has been on vets home. I can change it to - SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death in Quincy. These cases have occurred over sporadically since the end of July. At this time there is no evidence they are connected to the Illinois Veterans’ Home-Quincy. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:27 PM To: Arnold, Melaney Subject: RE: Media The earliest one is July 24, a second on July 29, the other two are more current From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:25 PM To: Jerrod Welch Subject: RE: Media What’s the time frame? When did they happen? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:23 PM To: Arnold, Melaney Subject: RE: Media Melanie, Shay is concerned about the first statement. In re-reading it, it does appear to say that these are sudden and new. You are the expert, so we’ll defer to you on it, but her read was a bit different than mine, and in re- reading it, I see where she’s coming from. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:09 PM To: Jerrod Welch Subject: RE: Media I’ll do my best, but I have to get IDPH approval and GO From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:08 PM To: Arnold, Melaney Subject: Re: Media We are good with it. Get your oks as dfast as possible and release it. Thank you so much for tackling it quuckly Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:05 PM To: Jerrod Welch; Subject:RE: Media This is my train of thought. It’s being circulated around IDPH. It’s based on your talking points. Legionnaires’ Disease Cases in Quincy SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death, in Quincy that are not connected to the Illinois Veterans’ Home-Quincy. “As part of our investigation of the Legionnaires’ disease outbreak at the Illinois Veterans’ Home-Quincy, we asked our local health care providers to help us with surveillance of the disease and test individuals in the community who have symptoms that can be related to Legionnaires’ disease,” said ACHD Administrator Jerrod Welch. “We have thoroughly investigated each confirmed case for a connection with the outbreak, as well as any possible connection to one another. At this time, we have found no connections.” Because of the increase in testing, public health officials expect to find more cases than during a non-outbreak situation. Legionella bacteria occurs naturally in the environment. Approximately 200 cases are reported each year in Illinois, most unassociated with any outbreak and considered isolated exposures. Adams County has reported cases of Legionnaires’ disease in three of the past six years. “We do not believe there is an increased risk of Legionnaires’ disease to the Quincy community after talking with the individuals who became ill,” said IDPH Director Nirav D. Shah, M.D., J.D. “We continue to focus on the outbreak at the Illinois Veterans’ Home-Quincy and investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources.” Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, but also to broken air conditioners or small decorative yard fountains. Legionnaires’ disease is not known to be transmitted person to person. ### From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:57 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond; Austin, Connie Subject: Re: Media Call from mayor ofqcy asking usto get info out asap as they are receiving high volumes of calls on water supply. The home also called and is pushing for a rebuttal from them to the coroners issued statement. So now the sooner the better in the release. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 2:08 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond;Austin, Connie; Subject:RE: Media Can Jon reach out to Connie Austin? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:02 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Re: Media Jon is working on 2014. He is confident we have that case. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 1:53 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond; Subject:RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW Jerrod C. Welth, Public Health Administrator Adams County Health Department 330 we rr?nant St, Quincy, IL 62301 223mm From: "Arnold, Melaney" To: Arnold "Melaney ;'Jerrod Welch" CC: Date: 9/2/2015 2:35:06 PM Subject: RE: Media Shay or you? From: Arnold, Melaney Sent: Wednesday, September 02, 2015 3:31 PM To: 'Jerrod Welch' Subject: RE: Media Who do you want listed as the PIO contact and what number? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:30 PM To: Arnold, Melaney Subject: RE: Media Nope, you are correct. Lets go with the original text. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:29 PM To: Jerrod Welch Subject: RE: Media Why are we just now announcing it? That’s what the media will ask. We can say we’ve investigated the cases as we normally would, but our focus has been on vets home. I can change it to - SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death in Quincy. These cases have occurred over sporadically since the end of July. At this time there is no evidence they are connected to the Illinois Veterans’ Home-Quincy. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:27 PM To: Arnold, Melaney Subject: RE: Media The earliest one is July 24, a second on July 29, the other two are more current From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:25 PM To: Jerrod Welch Subject: RE: Media What’s the time frame? When did they happen? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:23 PM To: Arnold, Melaney Subject: RE: Media Melanie, Shay is concerned about the first statement. In re-reading it, it does appear to say that these are sudden and new. You are the expert, so we’ll defer to you on it, but her read was a bit different than mine, and in rereading it, I see where she’s coming from. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:09 PM To: Jerrod Welch Subject: RE: Media I’ll do my best, but I have to get IDPH approval and GO From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:08 PM To: Arnold, Melaney Subject: Re: Media We are good with it. Get your oks as dfast as possible and release it. Thank you so much for tackling it quuckly Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:05 PM To: Jerrod Welch; Subject:RE: Media This is my train of thought. It’s being circulated around IDPH. It’s based on your talking points. Legionnaires’ Disease Cases in Quincy SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death, in Quincy that are not connected to the Illinois Veterans’ Home-Quincy. “As part of our investigation of the Legionnaires’ disease outbreak at the Illinois Veterans’ Home-Quincy, we asked our local health care providers to help us with surveillance of the disease and test individuals in the community who have symptoms that can be related to Legionnaires’ disease,” said ACHD Administrator Jerrod Welch. “We have thoroughly investigated each confirmed case for a connection with the outbreak, as well as any possible connection to one another. At this time, we have found no connections.” Because of the increase in testing, public health officials expect to find more cases than during a non-outbreak situation. Legionella bacteria occurs naturally in the environment. Approximately 200 cases are reported each year in Illinois, most unassociated with any outbreak and considered isolated exposures. Adams County has reported cases of Legionnaires’ disease in three of the past six years. “We do not believe there is an increased risk of Legionnaires’ disease to the Quincy community after talking with the individuals who became ill,” said IDPH Director Nirav D. Shah, M.D., J.D. “We continue to focus on the outbreak at the Illinois Veterans’ Home-Quincy and investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources.” Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, but also to broken air conditioners or small decorative yard fountains. Legionnaires’ disease is not known to be transmitted person to person. ### From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:57 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond; Austin, Connie Subject: Re: Media Call from mayor ofqcy asking usto get info out asap as they are receiving high volumes of calls on water supply. The home also called and is pushing for a rebuttal from them to the coroners issued statement. So now the sooner the better in the release. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 2:08 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond;Austin, Connie; Subject:RE: Media Can Jon reach out to Connie Austin? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:02 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Re: Media Jon is working on 2014. He is confident we have that case. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 1:53 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond; Subject:RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW From: "Arnold, Melaney" To: "Jerrod Welch" CC: Date: 9/2/2015 2:24:37 PM Subject: RE: Media What’s the time frame? When did they happen? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:23 PM To: Arnold, Melaney Subject: RE: Media Melanie, Shay is concerned about the first statement. In re-reading it, it does appear to say that these are sudden and new. You are the expert, so we’ll defer to you on it, but her read was a bit different than mine, and in rereading it, I see where she’s coming from. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:09 PM To: Jerrod Welch Subject: RE: Media I’ll do my best, but I have to get IDPH approval and GO From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:08 PM To: Arnold, Melaney Subject: Re: Media We are good with it. Get your oks as dfast as possible and release it. Thank you so much for tackling it quuckly Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:05 PM To: Jerrod Welch; Subject:RE: Media This is my train of thought. It’s being circulated around IDPH. It’s based on your talking points. Legionnaires’ Disease Cases in Quincy SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death, in Quincy that are not connected to the Illinois Veterans’ Home-Quincy. “As part of our investigation of the Legionnaires’ disease outbreak at the Illinois Veterans’ Home-Quincy, we asked our local health care providers to help us with surveillance of the disease and test individuals in the community who have symptoms that can be related to Legionnaires’ disease,” said ACHD Administrator Jerrod Welch. “We have thoroughly investigated each confirmed case for a connection with the outbreak, as well as any possible connection to one another. At this time, we have found no connections.” Because of the increase in testing, public health officials expect to find more cases than during a non-outbreak situation. Legionella bacteria occurs naturally in the environment. Approximately 200 cases are reported each year in Illinois, most unassociated with any outbreak and considered isolated exposures. Adams County has reported cases of Legionnaires’ disease in three of the past six years. “We do not believe there is an increased risk of Legionnaires’ disease to the Quincy community after talking with the individuals who became ill,” said IDPH Director Nirav D. Shah, M.D., J.D. “We continue to focus on the outbreak at the Illinois Veterans’ Home-Quincy and investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources.” Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, but also to broken air conditioners or small decorative yard fountains. Legionnaires’ disease is not known to be transmitted person to person. ### From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:57 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond; Austin, Connie Subject: Re: Media Call from mayor ofqcy asking usto get info out asap as they are receiving high volumes of calls on water supply. The home also called and is pushing for a rebuttal from them to the coroners issued statement. So now the sooner the better in the release. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 2:08 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond;Austin, Connie; Subject:RE: Media Can Jon reach out to Connie Austin? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:02 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Re: Media Jon is working on 2014. He is confident we have that case. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 1:53 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond; Subject:RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW From: "Arnold, Melaney" To: "Jerrod Welch" CC: Date: 9/2/2015 2:05:52 PM Subject: RE: Media This is my train of thought. It’s being circulated around IDPH. It’s based on your talking points. Legionnaires’ Disease Cases in Quincy SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death, in Quincy that are not connected to the Illinois Veterans’ Home-Quincy. “As part of our investigation of the Legionnaires’ disease outbreak at the Illinois Veterans’ Home-Quincy, we asked our local health care providers to help us with surveillance of the disease and test individuals in the community who have symptoms that can be related to Legionnaires’ disease,” said ACHD Administrator Jerrod Welch. “We have thoroughly investigated each confirmed case for a connection with the outbreak, as well as any possible connection to one another. At this time, we have found no connections.” Because of the increase in testing, public health officials expect to find more cases than during a non-outbreak situation. Legionella bacteria occurs naturally in the environment. Approximately 200 cases are reported each year in Illinois, most unassociated with any outbreak and considered isolated exposures. Adams County has reported cases of Legionnaires’ disease in three of the past six years. “We do not believe there is an increased risk of Legionnaires’ disease to the Quincy community after talking with the individuals who became ill,” said IDPH Director Nirav D. Shah, M.D., J.D. “We continue to focus on the outbreak at the Illinois Veterans’ Home-Quincy and investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources.” Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, but also to broken air conditioners or small decorative yard fountains. Legionnaires’ disease is not known to be transmitted person to person. ### From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:57 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond; Austin, Connie Subject: Re: Media Call from mayor ofqcy asking usto get info out asap as they are receiving high volumes of calls on water supply. The home also called and is pushing for a rebuttal from them to the coroners issued statement. So now the sooner the better in the release. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 2:08 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond;Austin, Connie; Subject:RE: Media Can Jon reach out to Connie Austin? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:02 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Re: Media Jon is working on 2014. He is confident we have that case. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 1:53 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond; Subject:RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW From: "Arnold, Melaney" To: "Jerrod Welch" CC: Date: 9/2/2015 4:15:38 PM Subject: RE: Media Did Betsy Bruce ask you about the date of death for the community case? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 5:06 PM To: Arnold, Melaney Subject: RE: Media Just to bring you up on the local side, I’ve fielded calls from both news channels, the local paper, the local radio station, as well as non-local reporters from WGN and from the AP. I wonder where you are on the community report side as well? Thanks, JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:53 PM To: Jerrod Welch Subject: RE: Media Final release I’ve asked it to be sent to media a.s.a.p., but feel free to send it out on your own. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:43 PM To: Arnold, Melaney Subject: Re: Media 2173166100 Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:40 PM To: Jerrod Welch; Subject:RE: Media To remain consistent – do you want your quote to say said ACHD Administrator Jerrod Welch, M.P.A., C.P.H.A From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:38 PM To: Arnold, Melaney Subject: Re: Media 2228440 Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:36 PM To: Jerrod Welch; Subject:RE: Media What number? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:36 PM To: Arnold, Melaney Subject: Re: Media Me Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:35 PM To: Arnold, Melaney;Jerrod Welch; Subject:RE: Media Shay or you? From: Arnold, Melaney Sent: Wednesday, September 02, 2015 3:31 PM To: 'Jerrod Welch' Subject: RE: Media Who do you want listed as the PIO contact and what number? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:30 PM To: Arnold, Melaney Subject: RE: Media Nope, you are correct. Lets go with the original text. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:29 PM To: Jerrod Welch Subject: RE: Media Why are we just now announcing it? That’s what the media will ask. We can say we’ve investigated the cases as we normally would, but our focus has been on vets home. I can change it to - SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death in Quincy. These cases have occurred over sporadically since the end of July. At this time there is no evidence they are connected to the Illinois Veterans’ Home-Quincy. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:27 PM To: Arnold, Melaney Subject: RE: Media The earliest one is July 24, a second on July 29, the other two are more current From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:25 PM To: Jerrod Welch Subject: RE: Media What’s the time frame? When did they happen? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:23 PM To: Arnold, Melaney Subject: RE: Media Melanie, Shay is concerned about the first statement. In re-reading it, it does appear to say that these are sudden and new. You are the expert, so we’ll defer to you on it, but her read was a bit different than mine, and in rereading it, I see where she’s coming from. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:09 PM To: Jerrod Welch Subject: RE: Media I’ll do my best, but I have to get IDPH approval and GO From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:08 PM To: Arnold, Melaney Subject: Re: Media We are good with it. Get your oks as dfast as possible and release it. Thank you so much for tackling it quuckly Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:05 PM To: Jerrod Welch; Subject:RE: Media This is my train of thought. It’s being circulated around IDPH. It’s based on your talking points. Legionnaires’ Disease Cases in Quincy SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death, in Quincy that are not connected to the Illinois Veterans’ Home-Quincy. “As part of our investigation of the Legionnaires’ disease outbreak at the Illinois Veterans’ Home-Quincy, we asked our local health care providers to help us with surveillance of the disease and test individuals in the community who have symptoms that can be related to Legionnaires’ disease,” said ACHD Administrator Jerrod Welch. “We have thoroughly investigated each confirmed case for a connection with the outbreak, as well as any possible connection to one another. At this time, we have found no connections.” Because of the increase in testing, public health officials expect to find more cases than during a non-outbreak situation. Legionella bacteria occurs naturally in the environment. Approximately 200 cases are reported each year in Illinois, most unassociated with any outbreak and considered isolated exposures. Adams County has reported cases of Legionnaires’ disease in three of the past six years. “We do not believe there is an increased risk of Legionnaires’ disease to the Quincy community after talking with the individuals who became ill,” said IDPH Director Nirav D. Shah, M.D., J.D. “We continue to focus on the outbreak at the Illinois Veterans’ Home-Quincy and investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources.” Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, but also to broken air conditioners or small decorative yard fountains. Legionnaires’ disease is not known to be transmitted person to person. ### From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:57 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond; Austin, Connie Subject: Re: Media Call from mayor ofqcy asking usto get info out asap as they are receiving high volumes of calls on water supply. The home also called and is pushing for a rebuttal from them to the coroners issued statement. So now the sooner the better in the release. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 2:08 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond;Austin, Connie; Subject:RE: Media Can Jon reach out to Connie Austin? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:02 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Re: Media Jon is working on 2014. He is confident we have that case. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 1:53 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond; Subject:RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW From: "Arnold, Melaney" To: "Jerrod Welch" CC: Date: 9/2/2015 2:36:55 PM Subject: RE: Media What number? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:36 PM To: Arnold, Melaney Subject: Re: Media Me Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:35 PM To: Arnold, Melaney;Jerrod Welch; Subject:RE: Media Shay or you? From: Arnold, Melaney Sent: Wednesday, September 02, 2015 3:31 PM To: 'Jerrod Welch' Subject: RE: Media Who do you want listed as the PIO contact and what number? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:30 PM To: Arnold, Melaney Subject: RE: Media Nope, you are correct. Lets go with the original text. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:29 PM To: Jerrod Welch Subject: RE: Media Why are we just now announcing it? That’s what the media will ask. We can say we’ve investigated the cases as we normally would, but our focus has been on vets home. I can change it to - SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death in Quincy. These cases have occurred over sporadically since the end of July. At this time there is no evidence they are connected to the Illinois Veterans’ Home-Quincy. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:27 PM To: Arnold, Melaney Subject: RE: Media The earliest one is July 24, a second on July 29, the other two are more current From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:25 PM To: Jerrod Welch Subject: RE: Media What’s the time frame? When did they happen? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:23 PM To: Arnold, Melaney Subject: RE: Media Melanie, Shay is concerned about the first statement. In re-reading it, it does appear to say that these are sudden and new. You are the expert, so we’ll defer to you on it, but her read was a bit different than mine, and in rereading it, I see where she’s coming from. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:09 PM To: Jerrod Welch Subject: RE: Media I’ll do my best, but I have to get IDPH approval and GO From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:08 PM To: Arnold, Melaney Subject: Re: Media We are good with it. Get your oks as dfast as possible and release it. Thank you so much for tackling it quuckly Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:05 PM To: Jerrod Welch; Subject:RE: Media This is my train of thought. It’s being circulated around IDPH. It’s based on your talking points. Legionnaires’ Disease Cases in Quincy SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death, in Quincy that are not connected to the Illinois Veterans’ Home-Quincy. “As part of our investigation of the Legionnaires’ disease outbreak at the Illinois Veterans’ Home-Quincy, we asked our local health care providers to help us with surveillance of the disease and test individuals in the community who have symptoms that can be related to Legionnaires’ disease,” said ACHD Administrator Jerrod Welch. “We have thoroughly investigated each confirmed case for a connection with the outbreak, as well as any possible connection to one another. At this time, we have found no connections.” Because of the increase in testing, public health officials expect to find more cases than during a non-outbreak situation. Legionella bacteria occurs naturally in the environment. Approximately 200 cases are reported each year in Illinois, most unassociated with any outbreak and considered isolated exposures. Adams County has reported cases of Legionnaires’ disease in three of the past six years. “We do not believe there is an increased risk of Legionnaires’ disease to the Quincy community after talking with the individuals who became ill,” said IDPH Director Nirav D. Shah, M.D., J.D. “We continue to focus on the outbreak at the Illinois Veterans’ Home-Quincy and investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources.” Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, but also to broken air conditioners or small decorative yard fountains. Legionnaires’ disease is not known to be transmitted person to person. ### From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:57 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond; Austin, Connie Subject: Re: Media Call from mayor ofqcy asking usto get info out asap as they are receiving high volumes of calls on water supply. The home also called and is pushing for a rebuttal from them to the coroners issued statement. So now the sooner the better in the release. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 2:08 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond;Austin, Connie; Subject:RE: Media Can Jon reach out to Connie Austin? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:02 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Re: Media Jon is working on 2014. He is confident we have that case. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 1:53 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond; Subject:RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW Jerrod C. Welth, Public Health Administrator Adams County Health Department 330 we rr?nant St, Quincy, IL 62301 223mm From: "Arnold, Melaney" To: "Jerrod Welch" CC: "Shah, Nirav" "Gentry-Wiseman, Michelle" "Shay Drummond" Date: 9/2/2015 12:52:54 PM Subject: RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW From: "Arnold, Melaney" To: "Jerrod Welch" CC: Date: 9/2/2015 4:12:23 PM Subject: RE: Media I’ve got messages from: - WGEM, Travis - WGN, Kim Gordon - WTAD, Scott Hardy - Fox 2, Betsy Bruce - Reuters, Suzanna Gonzales From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 5:06 PM To: Arnold, Melaney Subject: RE: Media Just to bring you up on the local side, I’ve fielded calls from both news channels, the local paper, the local radio station, as well as non-local reporters from WGN and from the AP. I wonder where you are on the community report side as well? Thanks, JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:53 PM To: Jerrod Welch Subject: RE: Media Final release I’ve asked it to be sent to media a.s.a.p., but feel free to send it out on your own. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:43 PM To: Arnold, Melaney Subject: Re: Media 2173166100 Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:40 PM To: Jerrod Welch; Subject:RE: Media To remain consistent – do you want your quote to say said ACHD Administrator Jerrod Welch, M.P.A., C.P.H.A From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:38 PM To: Arnold, Melaney Subject: Re: Media 2228440 Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:36 PM To: Jerrod Welch; Subject:RE: Media What number? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:36 PM To: Arnold, Melaney Subject: Re: Media Me Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:35 PM To: Arnold, Melaney;Jerrod Welch; Subject:RE: Media Shay or you? From: Arnold, Melaney Sent: Wednesday, September 02, 2015 3:31 PM To: 'Jerrod Welch' Subject: RE: Media Who do you want listed as the PIO contact and what number? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:30 PM To: Arnold, Melaney Subject: RE: Media Nope, you are correct. Lets go with the original text. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:29 PM To: Jerrod Welch Subject: RE: Media Why are we just now announcing it? That’s what the media will ask. We can say we’ve investigated the cases as we normally would, but our focus has been on vets home. I can change it to - SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death in Quincy. These cases have occurred over sporadically since the end of July. At this time there is no evidence they are connected to the Illinois Veterans’ Home-Quincy. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:27 PM To: Arnold, Melaney Subject: RE: Media The earliest one is July 24, a second on July 29, the other two are more current From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:25 PM To: Jerrod Welch Subject: RE: Media What’s the time frame? When did they happen? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:23 PM To: Arnold, Melaney Subject: RE: Media Melanie, Shay is concerned about the first statement. In re-reading it, it does appear to say that these are sudden and new. You are the expert, so we’ll defer to you on it, but her read was a bit different than mine, and in rereading it, I see where she’s coming from. JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 3:09 PM To: Jerrod Welch Subject: RE: Media I’ll do my best, but I have to get IDPH approval and GO From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:08 PM To: Arnold, Melaney Subject: Re: Media We are good with it. Get your oks as dfast as possible and release it. Thank you so much for tackling it quuckly Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:05 PM To: Jerrod Welch; Subject:RE: Media This is my train of thought. It’s being circulated around IDPH. It’s based on your talking points. Legionnaires’ Disease Cases in Quincy SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death, in Quincy that are not connected to the Illinois Veterans’ Home-Quincy. “As part of our investigation of the Legionnaires’ disease outbreak at the Illinois Veterans’ Home-Quincy, we asked our local health care providers to help us with surveillance of the disease and test individuals in the community who have symptoms that can be related to Legionnaires’ disease,” said ACHD Administrator Jerrod Welch. “We have thoroughly investigated each confirmed case for a connection with the outbreak, as well as any possible connection to one another. At this time, we have found no connections.” Because of the increase in testing, public health officials expect to find more cases than during a non-outbreak situation. Legionella bacteria occurs naturally in the environment. Approximately 200 cases are reported each year in Illinois, most unassociated with any outbreak and considered isolated exposures. Adams County has reported cases of Legionnaires’ disease in three of the past six years. “We do not believe there is an increased risk of Legionnaires’ disease to the Quincy community after talking with the individuals who became ill,” said IDPH Director Nirav D. Shah, M.D., J.D. “We continue to focus on the outbreak at the Illinois Veterans’ Home-Quincy and investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources.” Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, but also to broken air conditioners or small decorative yard fountains. Legionnaires’ disease is not known to be transmitted person to person. ### From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:57 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond; Austin, Connie Subject: Re: Media Call from mayor ofqcy asking usto get info out asap as they are receiving high volumes of calls on water supply. The home also called and is pushing for a rebuttal from them to the coroners issued statement. So now the sooner the better in the release. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 2:08 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond;Austin, Connie; Subject:RE: Media Can Jon reach out to Connie Austin? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:02 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Re: Media Jon is working on 2014. He is confident we have that case. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 1:53 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond; Subject:RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW From: "Arnold, Melaney" To: "Jerrod Welch" CC: Date: 9/2/2015 2:08:56 PM Subject: RE: Media I’ll do my best, but I have to get IDPH approval and GO From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 3:08 PM To: Arnold, Melaney Subject: Re: Media We are good with it. Get your oks as dfast as possible and release it. Thank you so much for tackling it quuckly Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 3:05 PM To: Jerrod Welch; Subject:RE: Media This is my train of thought. It’s being circulated around IDPH. It’s based on your talking points. Legionnaires’ Disease Cases in Quincy SPRINGFIELD – The Illinois Department of Public Health (IDPH) and the Adams County Health Department (ACHD) are reporting four confirmed cases of Legionnaires’ disease, including one death, in Quincy that are not connected to the Illinois Veterans’ Home-Quincy. “As part of our investigation of the Legionnaires’ disease outbreak at the Illinois Veterans’ Home-Quincy, we asked our local health care providers to help us with surveillance of the disease and test individuals in the community who have symptoms that can be related to Legionnaires’ disease,” said ACHD Administrator Jerrod Welch. “We have thoroughly investigated each confirmed case for a connection with the outbreak, as well as any possible connection to one another. At this time, we have found no connections.” Because of the increase in testing, public health officials expect to find more cases than during a non-outbreak situation. Legionella bacteria occurs naturally in the environment. Approximately 200 cases are reported each year in Illinois, most unassociated with any outbreak and considered isolated exposures. Adams County has reported cases of Legionnaires’ disease in three of the past six years. “We do not believe there is an increased risk of Legionnaires’ disease to the Quincy community after talking with the individuals who became ill,” said IDPH Director Nirav D. Shah, M.D., J.D. “We continue to focus on the outbreak at the Illinois Veterans’ Home-Quincy and investigate possible sources of the Legionella bacteria and make recommendations on how to eliminate the bacteria in any potential sources.” Legionella bacteria grow in areas of warm water. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, but also to broken air conditioners or small decorative yard fountains. Legionnaires’ disease is not known to be transmitted person to person. ### From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:57 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond; Austin, Connie Subject: Re: Media Call from mayor ofqcy asking usto get info out asap as they are receiving high volumes of calls on water supply. The home also called and is pushing for a rebuttal from them to the coroners issued statement. So now the sooner the better in the release. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 2:08 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond;Austin, Connie; Subject:RE: Media Can Jon reach out to Connie Austin? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:02 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Re: Media Jon is working on 2014. He is confident we have that case. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 1:53 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond; Subject:RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW Jerrod C. Welth, Public Health Administrator Adams County Health Department 330 we rr?nant St, Quincy, IL 62301 223mm From: "Arnold, Melaney" To: "Jerrod Welch" CC: "Shah, Nirav" "Gentry-Wiseman, Michelle" "Shay Drummond" Date: 9/2/2015 12:40:29 PM Subject: RE: Media I think these are great. I’ll run them by our CD staff. I’ve been working on a Q&A, but I think your responses are more succinct. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW From: "Arnold, Melaney" To: "Jerrod Welch" Ryan CC: "Shay Drummond" "Gentry-Wiseman, Michelle" Date: 9/2/2015 9:43:04 AM S u b j e c t : RE: Quick Base Touching Thinking on this now. These are the number IDPH has for the number of Legionnaires’ cases in Quincy over the past several years. Does this match your data? 2005 – 0 2006 – 0 2007 – 0 2008 – 0 2009 – 0 2010 – 1 2011 – 0 2012 – 0 2013 – 1 2014 – 0 From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 10:17 AM To: Arnold, Melaney; Yantis, Ryan Cc: Shay Drummond; Gentry-Wiseman, Michelle Subject: Quick Base Touching Melaney, I’m glad that you are already aware from your conversation with Michelle, but just to be sure we are all aware. Jim Keller, the Adams County Coroner, informed me that the family of the individual who we have not linked to this incident from another nursing home setting is reaching out to the local media regarding that case. I am not advocating a response to this, and actually would defer to your opinions. However, just so you are on top of this possibility, we may be in a position where it comes up. Thanks and let me know what you think and what we can do to facilitate if needed. JCW From: "Austin, Connie" To: Echols Fred; Jodi; Nirav; Michelle; Erik; Craig; "David; ;" Kyle; Melaney; Divya CC: "Kelly-Shannon, Kate D." "Holmes, Tal" "McCann, Ken" "Bryars, Debra" "Clegg, Whitney" "Albertson, Justin" "DeWitt, Justin" "Rawls, Winfred" "Johnson, Bernard T." "Charles, Matt" "Bryars, Debra" "Martin, Aaron" "Beron, Andrew" xzj3@cdc.gov "Ward, Peter" "Arbise, Ben" kli0@cdc.gov "Kutty, Preeta \(CDC/OID/NCIRD\)" "Shay Drummond" jwelch@co.adams.il.us "Jon Campos" Date: 9/2/2015 6:19:41 PM Subject: Health Update: Legionella Adams County IVH, September 2 pm Attachments: cdcs_Legionella_ppt_sept12015.pptx Submitted by (email): · Alert Level: Division of Infectious Disease Health Update 9/2 Type of Event : Outbreak/ Legionella Location: Illinois Veterans Home, Quincy, Adams Co Setting: Long Term Care Facility · · · Objective Information: Epidemiology Power point attached. There are 45 laboratory confirmed cases. Four of the confirmed cases are persons who work at the IVH campus. Onsets are from July 24 through August 29 (these latest are not yet in the epi curve because we got the onsets later in the day). · Seven fatalities have been reported in residents of the IVH who are laboratory confirmed with legionellosis. · No human isolate has been obtained yet. · Environmental · The potable water system remediation is very complex and will take time to accomplish correctly so this will not be done until next week but the potable water restrictions are still in place. The cooling plastic media in the cooling tower will be replaced once the supplies can be ordered. There are four laboratory confirmed cases in the surrounding community area and a press release was issued about these cases today. One community case from a LTC facility (Sunset Home) died with legionella. The IDPH Env team requested the facility turn off the decorative fountain outside the Sunset Home and collected samples. · PCR results should be interpreted as preliminary with Culture Results as confirmatory Today’s PCR positive results indicate the presence of Legionella pneumophila organisms in the heating tanks, along with a tub and shower head all of which are part of the facility’s potable water system No presence of Legionella was found in the cooling tower via PCR Testing; culture sample results are pending Legionella was found in the fountains by PCR, but not the L. pneumophila species that is associated with the greater majority of Legionellosis illnesses; culture sample results are also pending for the fountains · Assessment: · Next Steps: Legionella case numbers for the IVH facility are rising more slowly with no more fatalities reported. The number of persons hospitalized is decreasing. These are positive signs. Due to the incubation period for Legionella of up to 14 days, cases can be expected for 14 days after the source has been remediated (approximately September 11). However, the typical incubation period is 4-5 days. The first step of remediation of the cooling tower was on August 27 and potable water restrictions were put in place on Wednesday, August 26. Four community cases have been identified. At this point preliminary results support the hypothesis of potable water system as a plausible source of Legionella infection and support current environmental mitigation efforts. However, the PCR testing results will not be released publicly until the confirmatory culture results are available. o Await human and environmental testing results o IDPH Env Health, IVH employees, CDC employees and IEPA employees are working at the facility on remediation issues. o Continue maintaining the database with updated information o Coordinate with LHD and CDC on epidemiologic issues. --Health Alert: provides vital, time-sensitive information for a specific incident or situation; warrants immediate action or attention by health officials, laboratorians, clinicians, and members of the public; and conveys the highest level of importance. --Health Advisory: provides important information for a specific incident or situation; contains recommendations or actionable items to be performed by public health officials, laboratorians, and/or clinicians; may not require immediate action. --Health Update: provides updated information regarding an incident or situation; unlikely to require immediate action. PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Austin, Connie" To: Echols Fred; Jodi; Nirav; Michelle; Erik; Craig; David; Kyle; Melaney; Divya CC: "Kelly-Shannon, Kate D." "Holmes, Tal" "McCann, Ken" "Bryars, Debra" "Clegg, Whitney" "Albertson, Justin" "DeWitt, Justin" "Rawls, Winfred" "Johnson, Bernard T." "Charles, Matt" "Bryars, Debra" "Martin, Aaron" "Beron, Andrew" xzj3@cdc.gov "Ward, Peter" "Arbise, Ben" kli0@cdc.gov "Kutty, Preeta \(CDC/OID/NCIRD\)" "Shay Drummond" jwelch@co.adams.il.us "Jon Campos" Date: 9/2/2015 6:19:41 PM Subject: Health Update: Legionella Adams County IVH, September 2 pm Attachments: cdcs_Legionella_ppt_sept12015.pptx Submitted by (email): · Alert Level: Division of Infectious Disease Health Update 9/2 Type of Event : Outbreak/ Legionella Location: Illinois Veterans Home, Quincy, Adams Co Setting: Long Term Care Facility · · · Objective Information: Epidemiology Power point attached. There are 45 laboratory confirmed cases. Four of the confirmed cases are persons who work at the IVH campus. Onsets are from July 24 through August 29 (these latest are not yet in the epi curve because we got the onsets later in the day). · Seven fatalities have been reported in residents of the IVH who are laboratory confirmed with legionellosis. · No human isolate has been obtained yet. · Environmental · The potable water system remediation is very complex and will take time to accomplish correctly so this will not be done until next week but the potable water restrictions are still in place. The cooling plastic media in the cooling tower will be replaced once the supplies can be ordered. There are four laboratory confirmed cases in the surrounding community area and a press release was issued about these cases today. One community case from a LTC facility (Sunset Home) died with legionella. The IDPH Env team requested the facility turn off the decorative fountain outside the Sunset Home and collected samples. · PCR results should be interpreted as preliminary with Culture Results as confirmatory Today’s PCR positive results indicate the presence of Legionella pneumophila organisms in the heating tanks, along with a tub and shower head all of which are part of the facility’s potable water system No presence of Legionella was found in the cooling tower via PCR Testing; culture sample results are pending Legionella was found in the fountains by PCR, but not the L. pneumophila species that is associated with the greater majority of Legionellosis illnesses; culture sample results are also pending for the fountains · Assessment: · Next Steps: Legionella case numbers for the IVH facility are rising more slowly with no more fatalities reported. The number of persons hospitalized is decreasing. These are positive signs. Due to the incubation period for Legionella of up to 14 days, cases can be expected for 14 days after the source has been remediated (approximately September 11). However, the typical incubation period is 4-5 days. The first step of remediation of the cooling tower was on August 27 and potable water restrictions were put in place on Wednesday, August 26. Four community cases have been identified. At this point preliminary results support the hypothesis of potable water system as a plausible source of Legionella infection and support current environmental mitigation efforts. However, the PCR testing results will not be released publicly until the confirmatory culture results are available. o Await human and environmental testing results o IDPH Env Health, IVH employees, CDC employees and IEPA employees are working at the facility on remediation issues. o Continue maintaining the database with updated information o Coordinate with LHD and CDC on epidemiologic issues. --Health Alert: provides vital, time-sensitive information for a specific incident or situation; warrants immediate action or attention by health officials, laboratorians, clinicians, and members of the public; and conveys the highest level of importance. --Health Advisory: provides important information for a specific incident or situation; contains recommendations or actionable items to be performed by public health officials, laboratorians, and/or clinicians; may not require immediate action. --Health Update: provides updated information regarding an incident or situation; unlikely to require immediate action. PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. Thank you. From: "Austin, Connie" To: Echols "Fred ;;Arnold>" "Melaney ;; Shah>" Nirav CC: "Conover, Craig" "DeWitt, Justin" "Holmes, Tal" "Culp, David" "Albertson, Justin" "Clegg, Whitney" "Beron, Andrew" Date: 9/2/2015 9:07:45 AM Subject: RE: Legionellosis Outbreak & Cluster Case Count Update (9/2/2015) Sorry one correction, there was a duplicate positive today So should be case total 45 41 residents Includes 7 deaths to residents 4 IVH staff. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Echols, Fred Sent: Wednesday, September 02, 2015 9:31 AM To: sdrummond@co.adams.il.us; Arnold, Melaney; jwelch@co.adams.il.us; Shah, Nirav Cc: Austin, Connie; Conover, Craig; DeWitt, Justin; Holmes, Tal; Culp, David; Albertson, Justin; Clegg, Whitney; Beron, Andrew Subject: RE: Legionellosis Outbreak & Cluster Case Count Update (9/2/2015) To All, Today’s case count summary for the Legionellosis outbreak in Adams County is provided below: · IVH Outbreak o Case total: 46  42 residents · Includes 7 deaths of laboratory confirmed cases  4 IVH staff Please let me know if you have any questions or concerns. Thanks. Respectfully Yours, Fredrick L. Echols, MD Chief,Communicable Diseases Illinois Department of Public Health Phone: 217-782-2016 Fax: 217-524-0962 Email: Fred.Echols@Illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "Austin, Connie" To: Arnold "Melaney ;'Jerrod Welch" CC: "Shay Drummond" Date: 9/2/2015 1:09:03 PM Subject: Since 2005, these are the only 2 cases we have countedfor Adams County. Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: Arnold, Melaney Sent: Wednesday, September 02, 2015 2:08 PM To: 'Jerrod Welch' Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond; Austin, Connie Subject: RE: Media Can Jon reach out to Connie Austin? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 2:02 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Re: Media Jon is working on 2014. He is confident we have that case. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 1:53 PM To: Jerrod Welch; Cc: Shah, Nirav;Gentry-Wiseman, Michelle;Shay Drummond; Subject:RE: Media Our edits 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures. 3 – In Adams County, we have reported cases of Legionella in 4 of the last six years (IDPH has different numbers so if Shay can call Connie, that would help), so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. (IDPH reports 2 cases since 2010 – not including 2015 of course.) 4 – During the IVH Legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to Legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for Legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of Legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring Legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, September 02, 2015 1:28 PM To: Arnold, Melaney Cc: Shah, Nirav; Gentry-Wiseman, Michelle; Shay Drummond Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW From: "Austin, Connie" To: sdrummond@co.adams.il.us CC: Date: 9/2/2015 12:52:46 PM Subject: we cannot confirm your count numbers for Legionellaby year using INEDSS Connie Austin State public health veterinarian Division of Infectious Disease Illinois Department of Public Health 525 W Jefferson St WorK: 217-785-7165 Fax: 217-557-4049 Connie.austin@illinois.gov From: "Echols, Fred" To: ;Arnold "Melaney ;; Shah>" Nirav CC: "Austin, Connie" "Conover, Craig" "DeWitt, Justin" "Holmes, Tal" "Culp, David" "Albertson, Justin" "Clegg, Whitney" "Beron, Andrew" Date: 9/2/2015 8:30:55 AM S u b j e c t : RE: Legionellosis Outbreak & Cluster Case Count Update (9/2/2015) To All, Today’s case count summary for the Legionellosis outbreak in Adams County is provided below: · IVH Outbreak o Case total: 46  42 residents · Includes 7 deaths of laboratory confirmed cases  4 IVH staff Please let me know if you have any questions or concerns. Thanks. Respectfully Yours, Fredrick L. Echols, MD Chief,Communicable Diseases Illinois Department of Public Health Phone: 217-782-2016 Fax: 217-524-0962 Email: Fred.Echols@Illinois.gov PRIVILEGED & CONFIDENTIALITY NOTICE: This email transmission (and/or the documents accompanying such) may contain privileged/confidential information. Such information is intended only for the use of the individual or entity above. If you are not the named or intended recipient, you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of such information is strictly prohibited. If you have received this transmission in error, please immediately notify the sender by telephone to arrange for the secure return of the document. From: "Jerrod Welch" To: Arnold Melaney CC: Date: 9/2/2015 5:28:56 PM Subject: Fw: Legionnaires cases Can you field this or shall I. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Jenny Goodman Date: Wed, Sep 2, 2015 6:27 PM To: Jerrod Welch; Subject:Legionnaires cases Hi! I am looking to confirm information that there are 4 new cases of the disease in Quincy. Also, did one of those 4 patients die and make the death count rise to 8? Thank you for any help you can give! Jenny Goodman l Managing Editor WMBD l WYZZ l Bounce Central Illinois 3131 N. University Peoria, IL 61604 Office: 309.686.9455 l Fax: 309.686.8658 www.ciproud.com Follow us on Facebook Nexstar Broadcasting Group, Inc. provides services for WYZZ-TV through an Outsourcing Agreement. STATEMENT OF CONFIDENTIALITY This electronic message may contain privileged or confidential information. If you are not the intended recipient of this email, please delete it from your system and advise the sender. From: "Jerrod Welch" To: Arnold "Melaney <" "\(Melaney.Arnold@Illinois.gov\);>" CC: "Shah, Nirav \(Nirav.Shah@illinois.gov\) \(Nirav.Shah@illinois.gov\)" michelle.gentrywiseman@illinois.gov "Shay Drummond" Date: 9/2/2015 12:28:21 PM Subject: Media Melaney, Regarding this discussion, we previously had a 2:30 media interview scheduled with the local channel that has inquired regarding this case. So, that’s the timeframe in which we believe we have to work to have a message crafted and released regarding this. Here are my thoughts from a local viewpoint. 1 – we remain focused on the outbreak situation occurring at the Illinois Veterans Home. Any cases incidental to this are reviewed in the context of association with the facility. Those where no connection is able to be made are considered to be community acquired cases. 2 – Legionella bacteria occurs naturally in the environment. Illinois reports approximately 200 cases per year, mainly unassociated with any outbreak and considered isolated exposures (you can certainly vet this statement). 3 – In Adams County, we have reported cases of legionella in 4 of the last six years, so we know that the bacteria and exposure through isolated environmental sources occurs routinely in our area. 4 – During the IVH legionella outbreak, we have asked that local providers act as surveillance for us, testing individuals who have any symptoms that can be related to legionella disease. Because of the massive increase in testing, we would expect to find more cases than we would during a non-outbreak situation. Further, the laboratory specimen for legionella that we utilize during this investigation is a urine antigen. Legionella disease in urine testing is detectable for a period of more than 6 months, meaning that a urine antigen test may indicate present or past disease. 5 – Each reported case is thoroughly investigated for a connection with the IVH outbreak, as well as any possible connection to one another. 6 – At this time, we have had 4 community acquired cases of legionella in 2015, all of which have occurred during the timeframe of the ongoing IVH outbreak surveillance and investigation. All cases have been thus far unassociated with IVH or with one another. 7 – We do not believe that there is any increased community risk of acquiring legionella, and reiterate that the harder we look during an investigation, the more individual cases we would expect. JCW From: "Jerrod Welch" To: Arnold Melaney CC: Date: 9/2/2015 11:22:43 AM Subject: RE: Fox TV St Louis - 1:30 today OK, thank you. I don’t think we need to talk at this time. I appreciate the info. Did you get our number of cases from Jon? I know he’s been busy. If not, we had 1 in 2010, 1 in 2013 and 1 in 2014 according to our most recent annual report. I’m not sure what the discrepancy in numbers from yours are in 2014, but those are numbers I put together earlier this year based on the CD section’s info, so I’d consider them accurate. Thanks, JCW From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Wednesday, September 02, 2015 12:12 PM To: Jerrod Welch Subject: FW: Fox TV St Louis - 1:30 today Jerrod ~ I don’t have any specifics about the interview other than what’s below. If you would like to chat, give me a call at 217-558-0500, or let me know when is a good time to call you. Thanks Melaney From: Yantis, Ryan Sent: Wednesday, September 02, 2015 11:34 AM To: Shay Drummond Cc: Arnold, Melaney; HOUSTON, CATHY S; WINNICKI, LENARD F; VACA, BRUCE L Subject: RE: Fox TV St Louis - 1:30 today Great Shay! – can you call her and make arrangements? Thanks From: Shay Drummond [mailto:sdrummond@co.adams.il.us] Sent: Wednesday, September 02, 2015 11:31 AM To: Yantis, Ryan Cc: Arnold, Melaney; HOUSTON, CATHY S; WINNICKI, LENARD F; VACA, BRUCE L Subject: Re: Fox TV St Louis - 1:30 today I am available if needed Sent from my iPhone On Sep 2, 2015, at 10:56 AM, Yantis, Ryan wrote: All – Betsey Bruce and a camera crew are coming to IVH-Q at about 1:30 this afternoon to update coverage of the situation at the Home. She’s likely to want to have an on-camera with Cathy Houston, IDPH's Assistant Director, Michelle Gentry-Wiseman, and perhaps Shay or the CDC folks. Can we please make folks available? Her number is 314-917-1105; email Betsey.bruce@tvstl.com Ryan Yantis Communications Manager Illinois Department of Veterans’ Affairs 312-814-0778 (desk) Ryan.yantis@illinois.gov 312-520-6958 (cell) From: "Jerrod Welch" To: Meka Anu CC: "Triena Dietrich" "Shay Drummond" Date: 9/2/2015 8:05:30 AM Subject: RE: Legionella - ACHD Thanks, JCW -----Original Message----From: Meka, Anu [mailto:Anu.Meka@Illinois.gov] Sent: Tuesday, September 01, 2015 8:55 AM To: Jerrod Welch Cc: Triena Dietrich; Shay Drummond Subject: Legionella - ACHD Hi Jarod, Just wanted to update you on the ongoing Legionellosis from IDPH side. There is a CDC team coming to IL to assist with this. See the image attached. Just came to know the death count now is 6. IDPHis coming to Blessing hosp to get some human specimens for lab testing. IDPH is setting up a virtual IMT, please reach out to us (me or Gina - Gina.swehla@illinois.gov) for any help. Keep me updated Thanks Anu From: "Jerrod Welch" To: Melaney.Arnold@Illinois.gov CC: Date: 9/2/2015 5:42:41 PM Subject: Re: Legionnaires cases Jgoodwin@wmbd.com. reversed letters. This is the right one Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 6:40 PM To: Jerrod Welch; Subject:Re: Legionnaires cases Although her email address is not popping up on my phone. Do you have it? On Sep 2, 2015, at 6:28 PM, Jerrod Welch wrote: Can you field this or shall I. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Jenny Goodman Date: Wed, Sep 2, 2015 6:27 PM To: Jerrod Welch; Subject:Legionnaires cases Hi! I am looking to confirm information that there are 4 new cases of the disease in Quincy. Also, did one of those 4 patients die and make the death count rise to 8? Thank you for any help you can give! Jenny Goodman l Managing Editor WMBD l WYZZ l Bounce Central Illinois 3131 N. University Peoria, IL 61604 Office: 309.686.9455 l Fax: 309.686.8658 www.ciproud.com Follow us on Facebook Nexstar Broadcasting Group, Inc. provides services for WYZZ-TV through an Outsourcing Agreement. STATEMENT OF CONFIDENTIALITY This electronic message may contain privileged or confidential information. If you are not the intended recipient of this email, please delete it from your system and advise the sender. From: "Jerrod Welch" To: Melaney.Arnold@Illinois.gov CC: Date: 9/2/2015 5:40:24 PM Subject: Re: Legionnaires cases Thx Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Arnold, Melaney Date: Wed, Sep 2, 2015 6:38 PM To: Jerrod Welch; Subject:Re: Legionnaires cases I can field. I will cc you On Sep 2, 2015, at 6:28 PM, Jerrod Welch wrote: Can you field this or shall I. Jerrod Welch, MPA CPHA Public Health Administrator ------ Original message-----From: Jenny Goodman Date: Wed, Sep 2, 2015 6:27 PM To: Jerrod Welch; Subject:Legionnaires cases Hi! I am looking to confirm information that there are 4 new cases of the disease in Quincy. Also, did one of those 4 patients die and make the death count rise to 8? Thank you for any help you can give! Jenny Goodman l Managing Editor WMBD l WYZZ l Bounce Central Illinois 3131 N. University Peoria, IL 61604 Office: 309.686.9455 l Fax: 309.686.8658 www.ciproud.com Follow us on Facebook Nexstar Broadcasting Group, Inc. provides services for WYZZ-TV through an Outsourcing Agreement. STATEMENT OF CONFIDENTIALITY This electronic message may contain privileged or confidential information. If you are not the intended recipient of this email, please delete it from your system and advise the sender. From: To: Subject: Date: Attachments: Jon Campos "Kauerauf, Judy" CDC Trip Reports Friday, February 2, 2018 2:45:00 PM image001.png image002.jpg image003.jpg Hi Judy, Can you please send me copies of the 2015, 2016 and if there is a 2017 CDC trip report? Thanks, Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: jcampos@co.adams.il.us Sent time: 12/21/2017 11:42:52 AM To: jjimenez@co.adams.il.us Subject: Contacts Attachments: CD Contacts (2).xlsx Jon Campos, RN Communicable Disease Coordinator Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: tdede@co.adams.il.us Sent time: 02/16/2018 11:13:52 AM To: Environmental@co.adams.il.us Cc: evonderheide@co.adams.il.us Subject: EH Weekly Meeting Minutes--2-16-2018 Attachments: EH Staff Meeting 2018_02_16.pdf See the attached minutes for today's meeting Tony Dede, LEHP Environmental Health Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 124 Fax (217) 222-8460 tdede@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: Subject: Date: Attachments: Kelley, Lindsey Jon Campos Emailing - Resident Case Report Form.pdf Thursday, February 15, 2018 11:43:39 AM Resident Case Report Form.pdf Staff Case Report Form.pdf State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Cc: Subject: Date: Kauerauf, Judy Kelley, Lindsey Jon Campos Exposure questions Tuesday, February 13, 2018 12:43:05 PM Lindsey: Could you please let us know: 1) Are either roommates ill? 2) Could we get an up-to-date line list with any other ill residents with UATs pending from Friday's list? 3) Are you seeing any increase in residents of Elmore with respiratory illness? If we could get daily updates, that would be great 4) What is IVHQ advising roommate and other residents of Elmore to do? Judy Kauerauf, MPH Communicable Disease Control Section Chief Illinois Department of Public Health 525 West Jefferson Springfield, IL 62761 Phone: 217-785-8375 Cell: 217-622-2886 State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: "Kauerauf, Donald" To: "Jerrod Welch" CC: Date: 12/21/2017 4:24:37 PM Subject: FW: FYI - news release Attachments: 12.21.17 CDC reports.pdf Jerrod, Please see today's press release. Donald G. Kauerauf Assistant Director Illinois Department of Public Health 535 West Jefferson Street, 5th Floor Springfield, IL 62761 Donald.Kauerauf@illinois.gov O) 217/524-3915 C) 217/685-6716 From: Arnold, Melaney Sent: Thursday, December 21, 2017 3:16 PM To: DeWitt, Justin ; McCann, Ken ; Austin, Connie ; Kauerauf, Judy ; Arnold, Melaney ; Bryant, William ; Bryars, Debra ; Ciavarella, Emma ; Clow, Bryan ; Dart, Bill ; Dworkin, Tanya ; Halloway, Veronica ; Hasara, Ted ; Johnson, Siobhan ; Kauerauf, Donald ; Kim, Amanda J ; Lamb, Molly ; Lane, Brandy ; Layden, Jennifer E. ; Lightner, Shannon ; Little, Divya Mohan ; McCarten, Michael ; Meints, Joel A. ; Moody, Conny ; Musgrave, Shirley ; Pho, Mai T. ; Rawls, Winfred ; Rayman, Erik ; Shah, Nirav ; Stone, Kyle Subject: FYI - news release IDPH Posts Legionnaires' Disease Reports SPRINGFIELD - The Illinois Department of Public Health (IDPH) has posted two Centers for Disease Control and Prevention (CDC) reports addressing the Legionnaires' disease outbreaks at the Illinois Veterans Home in Quincy (IVHQ). CDC generated the reports after two visits by environmental health and infectious disease specialists to IVHQ. IDPH requested Epidemiologic Assistance (Epi-Aid) from the CDC after confirming an increase in Legionella cases in August 2015, and again in 2016. The CDC also visited IVHQ earlier this month and a summary of that visit is pending. These reports address the complexities of a Legionnaires' disease outbreak and how the State of Illinois has taken appropriate action. The CDC describes the State's diligent response and efforts to help protect the health and safety of veterans and IVHQ staff and visitors, noting: . . . . IVHQ has a well-established clinical infection surveillance and prevention program in place. From the identification of the outbreak, IVHQ clinical staff performed checks on all residents in skilled care every four hours, and twice daily for all residents in independent living. Per established IVHQ protocol, any resident developing symptoms consistent with a lower respiratory infection had a chest x-ray performed immediately for pneumonia diagnosis. Since the 2015 outbreak, significant remediation efforts undertaken by the Quincy Veteran's Home have substantially reduced the presence of Legionella in the potable water system. Based on observations during the Epi-Aid investigation, the water management program was fully implemented, followed, and continuously reviewed by the water management team to optimize the water systems. The reports can be found on the IDPH website. ### Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: evonderheide@co.adams.il.us Sent time: 02/12/2018 08:56:12 AM To: tlarsen@co.adams.il.us; jledford@co.adams.il.us Subject: FW: In the News: FDA Calls Kratom An Opioid From: Partnership News Service from the Partnership for Drug-Free Kids [mailto:thepartnership@drugfree.org] Sent: Thursday, February 08, 2018 12:23 PM To: Ellen Vonderheide Subject: In the News: FDA Calls Kratom An Opioid News Top Drug & Alcohol News of the Week FEATURED NEWS: Naloxone Administration May Lead to Complications There seem to be a growing number of cases of high amounts of fluid in the lungs following administration of the opioid overdose antidote naloxone, experts said at a recent meeting of the New York Society of Addiction Medicine annual meeting. Read More FDA Calls Kratom An Opioid The Food and Drug Administration is warning that the supplement known as "kratom" is an opioid and has been linked with 44 deaths, The Washington Post reports. Read More "Deaths of Despair" Caused by Opioids, Alcohol and Suicides: Report The increasing rate of deaths due to opioids, alcohol and suicides are part of a public health crisis described as "deaths of despair" in a new report published this week. Read More Help Us Continue to Empower Families: Donate Now Tell a Friend Fetal Alcohol Disorders May Be Much More Common Than Previously Thought A new study suggests up to 10 percent of U.S. children may have fetal alcohol spectrum disorders, much more than previously thought. Read More State and Local Law Enforcement Officials Protest Cut to Drug Prevention Program State and local law enforcement officials came to Capitol Hill last week to protest a Trump Administration proposal to move oversight of a drug prevention program from the Office of National Drug Control Policy to the Justice Department. Read More Treating Depression May Help Patients Stop Long-Term Prescription Opioid Use Patients with long-term opioid prescriptions and depression who take antidepressants are more likely to stop using opioids, a new study concludes. Read More Other Headlines of Interest Kellyanne Conway's 'opioid cabinet' sidelines drug czar's experts (Politico) In drug crisis hotbed, hoping for action on Trump's words (Associated Press) Understanding The Struggle Against Opioid Addiction (NPR) Why the opioid epidemic may have fueled America's murder spike (Vox) How addicts and their loved ones find 'strength' in online community (Good Morning America) Do Hangovers Get Worse as We Age? (The New York Times) Editorial: How Trump Can Keep His Vows on Opioids and Infrastructure (The New York Times) I Lost My Best Friend To Opioids. Yet As A Surgeon, I Overprescribed Them (Forbes) Man busted for selling huge shipments of drugs to college students for bitcoin, authorities say (ABC News) Military veterans defy Jeff Sessions, fight for medical marijuana to kick opioid addiction (CNBC) Parent Toll-Free Helpline: 1-855-DRUGFREE drugfree.org (C) Partnership for Drug-Free Kids 352 Park Ave South | 9th Floor | New York, NY 10010 privacy policy | manage email preferences From: jcampos@co.adams.il.us Sent time: 01/26/2018 10:38:09 AM To: jwelch@co.adams.il.us; evonderheide@co.adams.il.us Subject: FW: IVHQ Working Groups FYI From: Jeffries, Erica L [mailto:Erica.L.Jeffries@illinois.gov] Sent: Friday, January 26, 2018 10:31 AM To: CLIFFORD, DAVE; Winnicki, Lenard F.; Diehl, Gwen; Culbertson, Troy D.; Kelley, Lindsey; WHITCOMB, DAWN; Eddington, Matt P.; DeWitt, Justin; Martin, Aaron; McCann, Ken; McMillan, Dave; Cook, David; MacGibbon, Chris; Wright, Ron; Wilson, Mike A; Mattingly, Lisa; Kimble, Carl; Marty Detmer; Jon Campos; Tony Dede; wkbainter@yahoo.com; Robertson, Lester E.; Whitmer, Sherri L; Simmons, Angela D.; Togarepi, Julia; Miller, Shelly R.; Williams, Laurie A.; McLaughlin, Bill; O'Day, Jaclyn; Martin, Kathryn; Joerger, Marcy; Behnke, Gus; Evans, Amber Cc: Shah, Nirav; Romano, Amy; Messina, Alec; Jerrod Welch; Sawyer, Harry; Brown, Renysha Y; Womack, Crystal L; MacDonna, Dave; Murphy, Eric M Subject: IVHQ Working Groups Team, As you know, the Governor is going to be announcing two Task Forces to address water management and infrastructure investment at the Veterans' Homes (specifically Quincy). Underneath each TF will be a working group - which, of course, is where all the real work will be getting done! The Water Management Working Group will be led by Dave Clifford, Chief Engineer at IVHQ and the Infrastructure Investment team will be led by Len Winnicki, IDVA Senior Homes Administrator. Our task is to begin drafting plans for phased approaches to address the needs of each working group. The Water Management WG will look very much like our current water management team - and it can, in fact, double as this new Working Group. The focus of the Water Management team will be to produce an evolved plan for remediation of water at IVHQ. The remediation plan might include new plumbing, a new water source, new flushing protocols, new technologies for testing - Whatever options are explored that make sense. This plan will be presented to the IL General Assembly with a request for appropriations to implement. The Infrastructure Investment WG will focus on the design, build, and construction requirements for projects at IVHQ - and the other Homes, as needed. This is our opportunity to think broadly and innovatively about what the future of care will look like for our Illinois veterans. The ideas produced for the Quincy Home can and will also be used to create new ideas for our other Homes as well. The plan produced by the Infrastructure Investment WG might include new projects (like roofs or renovations), but could also include an entirely new design for a new building or buildings on the campus. The Infrastructure Investment WG will need to take into account the needs that our veterans will have in the next 5, 10, or 20 years - and beyond. This plan will also be presented to the IL General Assembly with a request for appropriations to implement. Our objective is to have drafts of each plan by March 31st - with the expectation of delivering a final plan to the General Assembly by 1 May. The members of the Water Management team are as follows - if there are others you think should be added, please let me know: Dave Clifford Chief Engineer IVHQ Senior Homes Len Winnicki Administrator Gwen Diehl Homes Coordinator Quincy Home Troy Culbertson Administrator Lindsey Kelley IVHQ Dawn Whitcomb IVHQ Matt Eddington Dpty General Counsel IDVA Justin DeWitt IDPH Aaron Martin IDPH Ken McCann IDPH Dave McMillan IEPA David Cook IEPA Adams County Public Tony Dede Health Adams County Public Jon Campos Health Bill Bainter Certified Water Operator Marty Detmer Phigenics Advisor Chris MacGibbon CDB Ron Wright CDB Mike Wilson CDB Lisa Mattingly CDB Carl Kimble CDB The members of the Infrastructure Investment team are as follows - if there are others you think should be added, please let me know: Len Winnicki Senior Homes Administrator Gwen Diehl IDVA Homes Coordinator Troy Culbertson IVHQ Administrator Lester Robertson IVHM Administrator Sherri Whitmer IVHL Administrator Angela Simmons IVHA Administrator Dave Clifford Chief Engineer IVHQ Julia Togarepi Director of Nursing IVHQ Shelly Miller Director of Nursing IVHA Laurie Williams Asst. DON IVHM Bill McLaughlin Chief Engineer IVHM Justin DeWitt IDPH Aaron Martin IDPH Amy Romano CDB Jackyn O'Day CDB Chris MacGibbon CDB Kathryn Martin CDB Mike Wilson CDB Ron Wright CDB Lisa Mattingly CDB Marcy Joerger CDB Gus Behnke CDB Carl Kimble CDB Amber Evans CDB Again, thank you for taking the time to join the call this morning and my sincere thanks to all of you for your support and assistance over the last 2 1/2 years and now into the future. We appreciate your collaboration, insight, and expertise and look forward to establishing plans that will ensure we are meeting the needs of our veterans and their families for generations to come. Please don't hesitate to reach out with any questions. Erica L. Jeffries Director Illinois Department of Veterans' Affairs (IDVA) 217-785-4114 http://www.illinois.gov/veterans Crystal Womack Executive Assistant 217-785-4114 Crystal.Womack@illinois.gov State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Subject: Date: Attachments: Jerrod Welch Josh Jones FW: Just some of my thoughts Friday, February 16, 2018 10:13:00 AM image001.png FYI, IDPH does not intend to release the buildings that the most recent cases are from. These were released in previous cases with the publishing of the CDC reports, but after some time had elapsed. The time elapsing was the logic for it no longer being considered identifying information. I wanted you to know this and let me know if we would feel differently. There is an individual asking, though not in the form of a request, just an email inquiry. The person asked IDPH and was denied, so they asked us. IDPH sent the following as their logic for not releasing. I agree that during the midst of the individuals seeking treatment, the building would be a potentially identifying piece of information. However, I wanted to see if you believed differently and thought this would not be protected. From: Arnold, Melaney [mailto:Melaney.Arnold@Illinois.gov] Sent: Friday, February 16, 2018 9:30 AM To: Jerrod Welch Subject: Just some of my thoughts In my opinion, I found the following insightful. Not sure if this is helpful, but it's what I was thinking. ftp://www.ilga.gov/jcar/admincode/077/077006900C02000R.html TITLE 77: PUBLIC HEALTH CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER k: COMMUNICABLE DISEASE CONTROL AND IMMUNIZATIONS PART 690 CONTROL OF COMMUNICABLE DISEASES CODE SECTION 690.200 REPORTING Section 690.200 Reporting d) Confidentiality 1) The Department will maintain the confidentiality of information that would identify individual patients. 2) Whenever any medical practitioner or other person is required by statute, regulation, ordinance or resolution to report cases of communicable disease to any government agency or officer, the communicable disease reports shall be confidential. Any medical practitioner or other person who provides a report of communicable disease in good faith shall have immunity from suit for slander or libel for statements made in the report. The identity of any individual contained in a report of communicable disease or foodborne illness or an investigation conducted pursuant to a report of a communicable disease or foodborne illness shall be confidential, and the individual's identity shall not be disclosed publicly in an action of any kind in any court or before any tribunal, board or agency. The individual, his/her legal guardian or his/her estate, with proper consent, may have his/her information released as requested. 3) As outlined in the Privacy Rule (Standards for Privacy of Individually Identifiable Health Information) of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), health information may be disclosed to public health authorities when required by federal, tribal, state, or local laws. This includes the requirements set forth in this Part that provide for reporting disease or conducting public health surveillance, investigation, or intervention. For disclosures not required by law, a public health authority may collect or receive information for the purpose of preventing or controlling disease. 4) To prevent the spread of a contagious or infectious disease, the Department, local boards of health, and local public health authorities may share confidential health information contained in surveillance reports and other individually identifiable health information with each other. In addition, the Department and local public health authorities may share confidential health information contained in surveillance reports and other individually identifiable health information with health care facilities and health care providers, to the extent necessary for treatment, prevention and control of a contagious disease or a dangerously contagious or infectious disease. The Department will share the information in a manner that protects the confidentiality of the protected health information. 5) Subsections (d)(1) through (3) of this Section shall not prevent the Director or authorized personnel of the Department from furnishing what the Department determines to be appropriate information to a physician or institution providing examination or treatment to a person suspected of or affected with a disease or condition, including carrier status, of public health interest, or to any person or institution when necessary for the protection of public health. Only the minimum information necessary for the intended purpose shall be disclosed. A person or institution to whom information is furnished or to whom access to records has been given shall not divulge any part of the information so as to disclose the identity of the person to whom the information or record relates, except as necessary for the treatment of a case or carrier or for the protection of the health of others. 6) To prevent the spread of a contagious disease, or a dangerously contagious or infectious disease, the Department, local boards of health, and local public health authorities shall have emergency access to medical or health information or records or data upon the condition that the Department, local boards of health, and local public health authorities protect the privacy and confidentiality of any medical or health information or records or data obtained pursuant to Section 2 of the Department of Public Health Act, in accordance with federal and State law. Any medical or health information or records or data shall be exempt from inspection and copying under the Freedom of Information Act. Any person, facility, institution, or agency that provides emergency access to health information and data shall have immunity from any civil or criminal liability, or any other type of liability that might result, except in the event of willful and wanton misconduct. The privileged quality of communication between any professional person or any facility shall not constitute grounds for failure to provide emergency access. 7) The Department will provide information pertaining to human or animal cases of zoonotic disease to another State or federal agency only if the disease is reportable to the agency or if another agency is assisting with control of an outbreak. 8) Information contained in I-NEDSS and other Department registries shall be confidential and not subject to inspection by persons other than authorized personnel or agents of the Department, certified local health authorities, and other authorized persons or agencies authorized in this Part. A) B) In accordance with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule permitting a health care provider to disclose protected health information about an individual, without the individual's authorization, to another health care provider for that provider's health care treatment of the individual (see HIPAA 45 CFR 164.506 and the definition of "treatment" at HIPAA 45 CFR 164.501), the Department may disclose information contained in INEDSS and other Department registries, and the Department may permit access to the information by a licensed health care worker or health care institution that is treating or testing the individual to whom the information relates for the protection of the individual's health or the public's health, including prevention purposes. The Department may also disclose what it considers to be appropriate and necessary information from I-NEDSS and other Department registries to a licensed health care provider or health care institution when: i) the licensed health care provider or health care institution has received security approval from the Department to access INEDSS or the other registries and provides identifying information satisfactory to the Department to determine that the person to whom the information relates is currently being treated by or under the care of the licensed health care provider or health care institution; and ii) the disclosure of the I-NEDSS or other registries' information is in the best interests of the person to whom treatment or care is being provided or will contribute to the protection of the public health. C) Disclosure may take place using electronic means compliant with HIPAA security and privacy standards. The Department will prescribe the use of a health information exchange to achieve these purposes when a health information exchange is available. D) A person or institution to whom information is furnished or to whom access to records has been given shall not divulge any part of the records so as to disclose the identity of the person to whom the information or record relates, except as necessary for the treatment of a case or carrier or for the protection of the health of others. Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: jcampos@co.adams.il.us Sent time: 01/05/2018 10:45:49 AM To: jwelch@co.adams.il.us Subject: FW: Legionellosis/Legionnaires' Disease Attachments: Attachment-4 It went out as an email and not saved as a document. Jon Campos, RN Communicable Disease Coordinator Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Jon Campos Sent: Monday, August 24, 2015 1:48 PM To: Paul Davis; Manley, Linda; Vickie.Robers@blessinghealthsystem.org; Daniels (jdaniels@siumed.edu); tmiller@siumed.edu; Richard Schlepphorst, MD Cc: Shay Drummond Subject: Legionellosis/Legionnaires' Disease MEMORANDUM TO: Adams County Providers FROM: Adams County Health Department, Clinical and Environmental Services DATE: 8/24/15 RE: Legionellosis/Legionnaires' Disease INFORMATION: Recently the Adams County Health Department (ACHD), in conjunction with Illinois Department of Public Health (IDPH), has confirmed multiple cases of legionellosis in Adams County. The majority of these cases were residents at long term care facility in Quincy, IL. At this time, the source of legionellosis is not known. IDPH will begin testing possible environmental sources today (8/24/15). ACHD and IDPH request that all providers monitor and test any patients that are symptomatic. Those that live/work at a long term care facility may be at higher risk of contracting. Legionnaires' disease is a severe form of pneumonia caused by the Legionella bacterium. Symptoms of Legionnaires' disease include: rapid onset of high fever 39?- 40.5?C (102?-105?F), chills, nonproductive progressing to productive cough, anorexia, malaise, headache, and sometimes abdominal pain and diarrhea. A chest x-ray will show evidence of pneumonia. The incubation period is 2-10 days (most often 5-6 days, but may be as long as 14 days). Pontiac fever manifestations are similar but are not associated with pneumonia. Patients with Pontiac fever have a self-limiting illness that will typically resolve in 2-5 days. Legionella are found naturally in the environment and are present at low levels in many water systems. However, background levels of Legionella are not known to be a significant risk when associated with proper water quality. Maintaining proper water quality suppresses the growth of Legionella bacteria and inhibits development of biofilms which support growth of the bacteria. Furthermore, there are no response guidelines for low levels of Legionella in water supplies, except remediation to non-detect levels. Such responses may be unwarranted and are usually expensive to execute. When proper water quality is not maintained, even for a short period of time, Legionella may flourish and then be present in sufficient concentrations to be a significant health risk. Exposure to Legionella occurs when aerosolized water particles containing large numbers of the bacteria are inhaled. Most people exposed to the bacteria do not become ill. Elderly people, smokers, and people with chronic lung disease or weakened immune systems are more vulnerable to resulting illness. The disease is not contagious and cannot be transmitted from one person to another. Please report any suspect cases to the Adams County Health Department as soon as possible. Please contact our 24/7 with any questions. Contact Information: 24/7 Number: 217-214-4000 Use this number to report any of the Illinois reportable diseases - or suspected cases or for any inquires related to lab testing. General CD questions can be directed to 217-222-8440x163. From: jwelch@co.adams.il.us Sent time: 01/10/2018 11:12:55 AM To: ryanniekamp@gamil.com Subject: FW: Legionnaires Ryan, I have some time in parts of next week. Let me know if you would like to work on setting a specific time then. JCW From: Jerrod Welch Sent: Thursday, January 4, 2018 9:42 AM To: Ryan Niekamp Subject: RE: Legionnaires Hello Ryan, If you want to, we can sit down and discuss. I am very wrapped up for the next few weeks, so I would need to set something late in January or early in February. Let me know a few dates you'd be interested in discussing. Thanks, JCW From: Ryan Niekamp [ryanniekamp@gmail.com] Sent: Thursday, January 04, 2018 9:22 AM To: Jerrod Welch Subject: Legionnaires Jerrod, I read a recent article published my NBC, I think it was, which read that as a nation there has been an increase of Legionella Pneumophila bacteria being discovered throughout our Country. This makes me ponder the question, has there been more out breaks in Adams County than just the Illinois Veteran's Home? Have any of the other long-term care facilities found Legionnaires on their campuses? Once a case is found, is the institution and/or Doctor requires to report the case to the ACHD? Any insight you can provide that would make me better understand the County's role is appreciated. Thank you, RN Ryan A. Niekamp Adams County Board, Illinois District Two Sent from my iPhone From: To: Subject: Date: Attachments: Jerrod Welch Jon Campos; Ellen Vonderheide FW: New Contact Monday, February 5, 2018 7:49:00 AM image001.png Please Reply to this. Our annual reports have the local data. State and national trends will need to be directed out. JCW From: cubbygirl_8@yahoo.com [mailto:cubbygirl_8@yahoo.com] Sent: Saturday, February 3, 2018 12:44 PM To: Jerrod Welch Subject: New Contact From: Christina Kelly Message: Good afternoon, I wanted to know if you can direct me to a link that would provide me with information related to the incidence and prevalence of Legionnaires' disease in Adams County, the state of Illinois, and the United States? I looked at information on your website related to communicable diseases and I didn't find any information about Legionnaires'. Thank you for your time. Christina Email: cubbygirl_8@yahoo.com Phone: From: jwelch@co.adams.il.us Sent time: 01/25/2018 12:56:37 PM To: dlaird@co.adams.il.us; evonderheide@co.adams.il.us; leonard@co.adams.il.us; atippey@co.adams.il.us Subject: FW: Next Staff Meeting All, Any opposition to cancelling this one? If not, that would be fine. I'm starting to ponder moving them to bi-monthly anyway. We can discuss that as well at our next directors meeting. However, we'll need to hear from anyone if there's opposition to cancelling February before that, so please reply. JCW From: Deb Laird Sent: Thursday, January 25, 2018 12:55 PM To: Jerrod Welch Subject: Re: Next Staff Meeting Jerrod- could we skip this meeting? Dental staff will all be in computer training. Sent from my U.S.Cellular(C) Smartphone ------ Original message-----From: Jerrod Welch Date: Thu, Jan 25, 2018 12:52 PM To: Ellen Vonderheide;Deb Laird;Leonard Schnellbecker;Alaina Tippey; Cc: Subject:Next Staff Meeting All, I will be in Springfield providing testimony to the General Assembly on our Legionella response on February 7. I will need to ask that one or all of you lead the meeting in my absence. I'll leave Alaina with any report I might have if I wind up reporting anything. Thank you, JCW CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: jwelch@co.adams.il.us Sent time: 12/28/2017 02:50:57 PM To: joshjones@co.adams.il.us Subject: FW: Quincy Veterans' Home Subject Matter Hearing FYI -----Original Message----From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Thursday, December 28, 2017 2:50 PM To: Jerrod Welch Subject: Fwd: Quincy Veterans' Home Subject Matter Hearing Jerrod. I apologize I was out sick last week and am now on vacation. I have a response from the director below on hotel rooms. I will answer your other questions immediately upon my return. DS Begin forwarded message: From: "Locker, Becky" <>> Date: December 21, 2017 at 8:30:31 AM CST To: "Santoni, Dillon" <>> Subject: RE: Quincy Veterans' Home Subject Matter Hearing No. Not in this case since they are in IL. It looks like the Amtrak would get them into Chicago around 10:30. Depending on the agenda they might be able to swing that. If we end up with families they would go first, then a gov's office rep/agency which will surely take over 30 minutes. In terms of hotels: The Wit, Allegro, Cambria on Randolph all offer government rates and are within a few blocks from the Bilandic building. The Allegro is right across the street. From: Santoni, Dillon Sent: Thursday, December 21, 2017 6:20 AM To: Locker, Becky Subject: Fwd: Quincy Veterans' Home Subject Matter Hearing We don't provide lodging for people do we? DS Begin forwarded message: From: Jerrod Welch <>> Date: December 20, 2017 at 5:06:09 PM CST To: "Santoni, Dillon" <>> Cc: Josh Jones <>> Subject: RE: Quincy Veterans' Home Subject Matter Hearing We will be happy to do this. I have several questions for you though. We have never done anything of this nature, so we'd like an understanding of what it is, who is in attendance, what we should do to be prepared for the discussion. We are also curious if there is any accommodation for lodging (we are about 5 hours away) or if that is something we will need to attend to. If we do need to make that accommodation, we need to know the best place to lodge that we can access the location of this hearing. Thank you in advance. [cid:image001.png@01D379B4.C0A417D0] From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Tuesday, December 19, 2017 11:34 AM To: Jerrod Welch <>> Subject: Quincy Veterans' Home Subject Matter Hearing Jerrod, My name is Dillon Santoni and I am the Veteran Affairs and Public Health Staffer for the Senate President. With the ongoing issues at the Quincy Veterans' Home, we have scheduled a hearing on the topic to discuss and track progress at the Home. It was recommended that with the participation of the Adams County Health Department, that someone knowledgeable on the subject from your Department attend the hearing. Below you will find the hearing notice sent out to the other agencies: On January 9th at 10am in the Bilandic Hearing Room in Chicago there will be a Joint House and Senate Veterans' Affairs hearing co-chaired by Senator Cullerton and Representative Chapa LaVia. It is requested that IDPH, IDVA, the Adams County Health Department, and the CDC provide testimony on the status of the Quincy Veterans' Home progress in relation to Legionnaires disease. The posting for this hearing will be going out soon. If you or someone from your office could attend it would greatly help resolve the issues at the Home. If have any questions please do not hesitate to email or call. Thanks, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: jwelch@co.adams.il.us Sent time: 01/04/2018 10:00:15 AM To: jcampos@co.adams.il.us Cc: tdede@co.adams.il.us Subject: FW: Quincy Veterans' Home Subject Matter Hearing Jon, Tomorrow morning, you and I need to book out several hours to put this testimony together for the Monday deadline. We will not need to travel to Chicago on Tuesday, but we will need to provide this document in lieu of that as our official testimony. Please come by first thing in the morning and we will get to work. Tony, I think you should be on standby to join us as well. Thank you both, JCW From: Jerrod Welch Sent: Thursday, January 04, 2018 9:42 AM To: Santoni, Dillon Subject: RE: Quincy Veterans' Home Subject Matter Hearing Thank you for the update. I will attempt to get this put together for you by next Monday. I appreciate your assistance in this. JCW From: Santoni, Dillon [dsantoni@senatedem.ilga.gov] Sent: Thursday, January 04, 2018 8:56 AM To: Jerrod Welch Subject: RE: Quincy Veterans' Home Subject Matter Hearing Jerrod, After speaking with the Senator, providing written testimony will be fine. In your written letter if you could outline: What the role of your department was during the response to the outbreak What the role of your department was in developing and implementing a water management program What is the procedure for the reporting of positive tests of Legionella to ACHD Prior to the first cases of LD, were there any concerns of the water treatment at the facility expressed to ACHD It was stated in the CDC report that ACHD interviewed patients with reported LD, how long after determined exposure were these interviews conducted Ultimately this is your testimony, if any of the question above are outside of your scope or irrelevant feel free to state that. This will be provided to all members of the committee to help understand all of the roles everyone had during this process and the timeline of events. If there are other things you feel are relevant to put in the testimony, please include them. Again this is not challenging anything that ACHD did during this event. If you have any questions or need guidance, please don't hesitate to ask. I know this is of short notice but I was hoping to have this around noon on Monday, January 8th. Thanks again, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, December 20, 2017 5:06 PM To: Santoni, Dillon Cc: Josh Jones Subject: RE: Quincy Veterans' Home Subject Matter Hearing We will be happy to do this. I have several questions for you though. We have never done anything of this nature, so we'd like an understanding of what it is, who is in attendance, what we should do to be prepared for the discussion. We are also curious if there is any accommodation for lodging (we are about 5 hours away) or if that is something we will need to attend to. If we do need to make that accommodation, we need to know the best place to lodge that we can access the location of this hearing. Thank you in advance. From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Tuesday, December 19, 2017 11:34 AM To: Jerrod Welch Subject: Quincy Veterans' Home Subject Matter Hearing Jerrod, My name is Dillon Santoni and I am the Veteran Affairs and Public Health Staffer for the Senate President. With the ongoing issues at the Quincy Veterans' Home, we have scheduled a hearing on the topic to discuss and track progress at the Home. It was recommended that with the participation of the Adams County Health Department, that someone knowledgeable on the subject from your Department attend the hearing. Below you will find the hearing notice sent out to the other agencies: On January 9th at 10am in the Bilandic Hearing Room in Chicago there will be a Joint House and Senate Veterans' Affairs hearing co-chaired by Senator Cullerton and Representative Chapa LaVia. It is requested that IDPH, IDVA, the Adams County Health Department, and the CDC provide testimony on the status of the Quincy Veterans' Home progress in relation to Legionnaires disease. The posting for this hearing will be going out soon. If you or someone from your office could attend it would greatly help resolve the issues at the Home. If have any questions please do not hesitate to email or call. Thanks, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: To: Cc: Subject: Date: Kauerauf, Judy Kelley, Lindsey; Linda.Manley@blessinghealthsystem.org Layden, Jennifer E.; Jon Campos FW: specimen type and storage Wednesday, February 14, 2018 1:14:16 PM Linda and Lindsey: CDC has recommended that we obtain NP/OP swabs on all suspect cases and send them to CDC for testing for other pathogens. Please let me know if this is possible, and we can collectively review the line list. You would ship these directly to CDC as detailed below. Also, Linda: Please let me know if you have found any urine specimens on those pending test results. Let me know when is a good time to call you since we seem to be missing each other. From: Smith, Jessica (CDC/OID/NCIRD) [mailto:lyd7@cdc.gov] Sent: Wednesday, February 14, 2018 10:19 AM To: Layden, Jennifer E. ; Kauerauf, Judy Cc: Fay, Katherine (CDC/OID/NCIRD) Subject: [External] FW: specimen type and storage Specimen collection and transport instructions for NP/OP swabs for TAC. From: Kobayashi, Miwako (CDC/OID/NCIRD) Sent: Wednesday, February 14, 2018 9:47 AM To: Smith, Jessica (CDC/OID/NCIRD) Subject: specimen type and storage Types of specimens to collect and timing of collection (from SOP, see specimen collection guidelines for details) 1. Upper respiratory tract specimens (NP/OP swabs) . Specimens should be collected as soon as possible in the course of the illness and before antimicrobic therapy begin. . Specimens should be collected within 72 hours of symptom onset (and no later than 7 days after onset) . Collect both NP and OP swabs. Place both swabs immediately into a sterile vial containing 2ml of viral transport media without antibiotics. . If specimens will be examined within 48 hours after collection, keep specimen at 4?C; otherwise, store frozen at <=-70?C and ship on dry ice. 2. Lower respiratory tract specimens (sputum, tracheal aspirate, bronchoalveolar lavage fluid, pleural fluid) . Can be obtained at any time during the clinical course, but ideally prior to initiation of antimicrobial therapy . Specimens with less chance for upper airway contamination (e.g., BAL, pleural fluid, lung biopsy) are preferred Let me know if you have any questions and/or if you do decide to send samples over for TAC. Good luck! State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: tdede@co.adams.il.us Sent time: 02/01/2018 03:02:29 PM To: jwelch@co.adams.il.us Subject: FW: Water Quality Work Group Meeting Agenda for 1-31-18 @ 3:00 p.m. Attachments: Water Quality Work Group agenda 1-31-18.docx Here is the agenda Tony Dede, LEHP Environmental Health Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 124 Fax (217) 222-8460 tdede@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. 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From: TRAUTVETTER, CARLA [mailto:CARLA.TRAUTVETTER@illinois.gov] Sent: Wednesday, January 31, 2018 1:40 PM To: Bainter, Bill; Jon Campos; CLIFFORD, DAVE; Cook, David; Culbertson, Troy D.; Tony Dede; Detmer, Marty; DeWitt, Justin; Diehl, Gwen; Eddington, Matt P.; Kelley, Lindsey; Kimble, Carl; MacGibbon, Chris; Martin, Aaron; Mattingly, Lisa; McCann, Ken; McMillan, Dave; WHITCOMB, DAWN; Wilson, Mike A; Winnicki, Lenard F.; Wright, Ron Subject: Water Quality Work Group Meeting Agenda for 1-31-18 @ 3:00 p.m. Carla Trautvetter Administration Office Illinois Veterans Home at Quincy 1707 N. 12th Street Quincy, IL 62301 217-222-8641 ext. 203 State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: jcampos@co.adams.il.us Sent time: 02/03/2018 07:43:08 PM To: jwelch@co.adams.il.us Subject: Fwd: [External] CDC Trip Reports Attachments: image001.png image002.jpg image003.jpg Sent via the Samsung Galaxy S(R) 6 edge, an AT&T 4G LTE smartphone -------- Original message -------From: "Kauerauf, Judy" Date: 2/3/18 11:16 AM (GMT-06:00) To: Jon Campos Subject: Re: [External] CDC Trip Reports They are all on the public IDPH website. Look under Legionella. Sent from my iPhone On Feb 2, 2018, at 2:45 PM, Jon Campos wrote: Hi Judy, Can you please send me copies of the 2015, 2016 and if there is a 2017 CDC trip report? Thanks, Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Cc: Subject: Date: Jeffries, Erica L CLIFFORD, DAVE; Winnicki, Lenard F.; Diehl, Gwen; Culbertson, Troy D.; Kelley, Lindsey; WHITCOMB, DAWN; Eddington, Matt P.; DeWitt, Justin; Martin, Aaron; McCann, Ken; McMillan, Dave; Cook, David; MacGibbon, Chris; Wright, Ron; Wilson, Mike A; Mattingly, Lisa; Kimble, Carl; Marty Detmer; Jon Campos; Tony Dede; wkbainter@yahoo.com; Robertson, Lester E.; Whitmer, Sherri L; Simmons, Angela D.; Togarepi, Julia; Miller, Shelly R.; Williams, Laurie A.; McLaughlin, Bill; O"Day, Jaclyn; Martin, Kathryn; Joerger, Marcy; Behnke, Gus; Evans, Amber Shah, Nirav; Romano, Amy; Messina, Alec; Jerrod Welch; Sawyer, Harry; Brown, Renysha Y; Womack, Crystal L; MacDonna, Dave; Murphy, Eric M IVHQ Working Groups Friday, January 26, 2018 10:31:37 AM Team, As you know, the Governor is going to be announcing two Task Forces to address water management and infrastructure investment at the Veterans' Homes (specifically Quincy). Underneath each TF will be a working group - which, of course, is where all the real work will be getting done! The Water Management Working Group will be led by Dave Clifford, Chief Engineer at IVHQ and the Infrastructure Investment team will be led by Len Winnicki, IDVA Senior Homes Administrator. Our task is to begin drafting plans for phased approaches to address the needs of each working group. The Water Management WG will look very much like our current water management team - and it can, in fact, double as this new Working Group. The focus of the Water Management team will be to produce an evolved plan for remediation of water at IVHQ. The remediation plan might include new plumbing, a new water source, new flushing protocols, new technologies for testing - Whatever options are explored that make sense. This plan will be presented to the IL General Assembly with a request for appropriations to implement. The Infrastructure Investment WG will focus on the design, build, and construction requirements for projects at IVHQ - and the other Homes, as needed. This is our opportunity to think broadly and innovatively about what the future of care will look like for our Illinois veterans. The ideas produced for the Quincy Home can and will also be used to create new ideas for our other Homes as well. The plan produced by the Infrastructure Investment WG might include new projects (like roofs or renovations), but could also include an entirely new design for a new building or buildings on the campus. The Infrastructure Investment WG will need to take into account the needs that our veterans will have in the next 5, 10, or 20 years - and beyond. This plan will also be presented to the IL General Assembly with a request for appropriations to implement. Our objective is to have drafts of each plan by March 31st - with the expectation of delivering a final plan to the General Assembly by 1 May. The members of the Water Management team are as follows - if there are others you think should be added, please let me know: Dave Clifford Chief Engineer IVHQ Len Winnicki Senior Homes Administrator Gwen Diehl Homes Coordinator Troy Culbertson Quincy Home Administrator Lindsey Kelley IVHQ Dawn Whitcomb IVHQ Matt Eddington Dpty General Counsel IDVA Justin DeWitt IDPH Aaron Martin IDPH Ken McCann IDPH Dave McMillan IEPA David Cook IEPA Tony Dede Adams County Public Health Jon Campos Adams County Public Health Bill Bainter Certified Water Operator Marty Detmer Phigenics Advisor Chris MacGibbon CDB Ron Wright CDB Mike Wilson CDB Lisa Mattingly CDB Carl Kimble CDB The members of the Infrastructure Investment team are as follows - if there are others you think should be added, please let me know: Len Winnicki Senior Homes Administrator Gwen Diehl IDVA Homes Coordinator Troy Culbertson IVHQ Administrator Lester Robertson IVHM Administrator Sherri Whitmer IVHL Administrator Angela Simmons IVHA Administrator Dave Clifford Chief Engineer IVHQ Julia Togarepi Director of Nursing IVHQ Shelly Miller Director of Nursing IVHA Laurie Williams Asst. DON IVHM Bill McLaughlin Chief Engineer IVHM Justin DeWitt IDPH Aaron Martin IDPH Amy Romano CDB Jackyn O'Day CDB Chris MacGibbon CDB Kathryn Martin CDB Mike Wilson CDB Ron Wright CDB Lisa Mattingly CDB Marcy Joerger CDB Gus Behnke CDB Carl Kimble CDB Amber Evans CDB Again, thank you for taking the time to join the call this morning and my sincere thanks to all of you for your support and assistance over the last 2 1/2 years and now into the future. We appreciate your collaboration, insight, and expertise and look forward to establishing plans that will ensure we are meeting the needs of our veterans and their families for generations to come. Please don't hesitate to reach out with any questions. Erica L. Jeffries Director Illinois Department of Veterans' Affairs (IDVA) 217-785-4114 http://www.illinois.gov/veterans Crystal Womack Executive Assistant 217-785-4114 Crystal.Womack@illinois.gov State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Subject: Date: Arnold, Melaney Jerrod Welch Just some of my thoughts Friday, February 16, 2018 9:30:28 AM In my opinion, I found the following insightful. Not sure if this is helpful, but it's what I was thinking. ftp://www.ilga.gov/jcar/admincode/077/077006900C02000R.html TITLE 77: PUBLIC HEALTH CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER k: COMMUNICABLE DISEASE CONTROL AND IMMUNIZATIONS PART 690 CONTROL OF COMMUNICABLE DISEASES CODE SECTION 690.200 REPORTING Section 690.200 Reporting d) Confidentiality 1) The Department will maintain the confidentiality of information that would identify individual patients. 2) Whenever any medical practitioner or other person is required by statute, regulation, ordinance or resolution to report cases of communicable disease to any government agency or officer, the communicable disease reports shall be confidential. Any medical practitioner or other person who provides a report of communicable disease in good faith shall have immunity from suit for slander or libel for statements made in the report. The identity of any individual contained in a report of communicable disease or foodborne illness or an investigation conducted pursuant to a report of a communicable disease or foodborne illness shall be confidential, and the individual's identity shall not be disclosed publicly in an action of any kind in any court or before any tribunal, board or agency. The individual, his/her legal guardian or his/her estate, with proper consent, may have his/her information released as requested. 3) As outlined in the Privacy Rule (Standards for Privacy of Individually Identifiable Health Information) of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), health information may be disclosed to public health authorities when required by federal, tribal, state, or local laws. This includes the requirements set forth in this Part that provide for reporting disease or conducting public health surveillance, investigation, or intervention. For disclosures not required by law, a public health authority may collect or receive information for the purpose of preventing or controlling disease. 4) To prevent the spread of a contagious or infectious disease, the Department, local boards of health, and local public health authorities may share confidential health information contained in surveillance reports and other individually identifiable health information with each other. In addition, the Department and local public health authorities may share confidential health information contained in surveillance reports and other individually identifiable health information with health care facilities and health care providers, to the extent necessary for treatment, prevention and control of a contagious disease or a dangerously contagious or infectious disease. The Department will share the information in a manner that protects the confidentiality of the protected health information. 5) Subsections (d)(1) through (3) of this Section shall not prevent the Director or authorized personnel of the Department from furnishing what the Department determines to be appropriate information to a physician or institution providing examination or treatment to a person suspected of or affected with a disease or condition, including carrier status, of public health interest, or to any person or institution when necessary for the protection of public health. Only the minimum information necessary for the intended purpose shall be disclosed. A person or institution to whom information is furnished or to whom access to records has been given shall not divulge any part of the information so as to disclose the identity of the person to whom the information or record relates, except as necessary for the treatment of a case or carrier or for the protection of the health of others. 6) To prevent the spread of a contagious disease, or a dangerously contagious or infectious disease, the Department, local boards of health, and local public health authorities shall have emergency access to medical or health information or records or data upon the condition that the Department, local boards of health, and local public health authorities protect the privacy and confidentiality of any medical or health information or records or data obtained pursuant to Section 2 of the Department of Public Health Act, in accordance with federal and State law. Any medical or health information or records or data shall be exempt from inspection and copying under the Freedom of Information Act. Any person, facility, institution, or agency that provides emergency access to health information and data shall have immunity from any civil or criminal liability, or any other type of liability that might result, except in the event of willful and wanton misconduct. The privileged quality of communication between any professional person or any facility shall not constitute grounds for failure to provide emergency access. 7) The Department will provide information pertaining to human or animal cases of zoonotic disease to another State or federal agency only if the disease is reportable to the agency or if another agency is assisting with control of an outbreak. 8) Information contained in I-NEDSS and other Department registries shall be confidential and not subject to inspection by persons other than authorized personnel or agents of the Department, certified local health authorities, and other authorized persons or agencies authorized in this Part. A) In accordance with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule permitting a health care provider to disclose protected health information about an individual, without the individual's authorization, to another health care provider for that provider's health care treatment of the individual (see HIPAA 45 CFR 164.506 and the definition of "treatment" at HIPAA 45 CFR 164.501), the Department may disclose information contained in INEDSS and other Department registries, and the Department may permit access to the information by a licensed health care worker or health care institution that is treating or testing the individual to whom the information relates for the protection of the individual's health or the public's health, including prevention purposes. B) The Department may also disclose what it considers to be appropriate and necessary information from I-NEDSS and other Department registries to a licensed health care provider or health care institution when: i) the licensed health care provider or health care institution has received security approval from the Department to access INEDSS or the other registries and provides identifying information satisfactory to the Department to determine that the person to whom the information relates is currently being treated by or under the care of the licensed health care provider or health care institution; and ii) the disclosure of the I-NEDSS or other registries' information is in the best interests of the person to whom treatment or care is being provided or will contribute to the protection of the public health. C) Disclosure may take place using electronic means compliant with HIPAA security and privacy standards. The Department will prescribe the use of a health information exchange to achieve these purposes when a health information exchange is available. D) A person or institution to whom information is furnished or to whom access to records has been given shall not divulge any part of the records so as to disclose the identity of the person to whom the information or record relates, except as necessary for the treatment of a case or carrier or for the protection of the health of others. Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: jcampos@co.adams.il.us Sent time: 02/12/2018 03:45:08 PM To: abarnes@quincymedgroup.com; bmcdonnell@barry.comm-care.com; jdaniels@siumed.edu; Mary.Barthel@blessinghealthsystem.org; vpastorini@quincymedgroup.com; thiland@quincymedgroup.com; martinje@qps.org; tsjones@quincymedgroup.com; jzwick@siumed.edu; laura.merlo@medexpress.com; Linda.Manley@blessinghealthsystem.org; amushtaq@quincymedgroup.com; rschlepphorst@quincymedgroup.com; robert.gutekunst@blessinghealthsystem.org; merrick@gmail.com; Vickie.Roberts@blessinghealthsystem.org; tmiller1@siumed.edu; awitt@quincymedgroup.com Cc: atippey@co.adams.il.us; aklene@co.adams.il.us; bcoonrod@co.adams.il.us; jdaniels@siumed.edu; dlaird@co.adams.il.us; evonderheide@co.adams.il.us; ejennings@co.adams.il.us; jjimenez@co.adams.il.us; jwelch@co.adams.il.us; leonard@co.adams.il.us; tdede@co.adams.il.us Subject: Legionaires" Disease Surveillance MEMORANDUM TO: Adams County Health Care Providers FROM: Adams County Health Department DATE: 2/12/2018 RE: Legionellosis/Legionnaires' Disease INFORMATION: The Adams County Health Department, is conduct active surveillance among Illinois Veterans Home patients and staff for Legionnaires Disease. Adams County Health Department is asking clinicians to consider Legionella in the differential diagnosis for patients presenting with findings suggestive of Pneumonia who are linked to the Veterans Home. If not readily known, please inquire if the patient is a residents, staff, volunteer, and visitor to IVHQ. Diagnostic testing of patients with community acquired pneumonia, especially severe cases, should include collection of urine for Legionella antigen testing and respiratory specimens for culture. Clinical isolates of Legionella from cultures are valuable for comparison to environmental samples while conducting investigations of Legionnaires' disease. Legionella is reportable, and clinicians and hospitals are asked to promptly report cases to the Adams County Health Department to facilitate the investigation of cases. Legionnaires' disease is a severe form of pneumonia caused by the Legionella bacterium. Symptoms of Legionnaires' disease include: rapid onset of high fever 39?- 40.5?C (102?-105?F), chills, nonproductive progressing to productive cough, anorexia, malaise, headache, and sometimes abdominal pain and diarrhea. A chest x-ray will show evidence of pneumonia. The incubation period is 2-10 days (most often 5-6 days, but may be as long as 14 days). Pontiac fever manifestations are similar but are not associated with pneumonia. Patients with Pontiac fever have a self-limiting illness that will typically resolve in 2-5 days. See CDC Clinician Guidance: http://www.cdc.gov/legionella/clinicians.html Legionella are found naturally in the environment and are present at low levels in many water systems. However, background levels of Legionella are not known to be a significant risk when associated with proper water quality. Maintaining proper water quality suppresses the growth of Legionella bacteria and inhibits development of biofilms which support growth of the bacteria. Furthermore, there are no response guidelines for low levels of Legionella in water supplies, except remediation to non-detect levels. Such responses may be unwarranted and are usually expensive to execute. When proper water quality is not maintained, even for a short period of time, Legionella may flourish and then be present in sufficient concentrations to be a significant health risk. Exposure to Legionella occurs when aerosolized water particles containing large numbers of the bacteria are inhaled. Most people exposed to the bacteria do not become ill. Elderly people, smokers, and people with chronic lung disease or weakened immune systems are more vulnerable to resulting illness. The disease is not contagious and cannot be transmitted from one person to another. Thank you for your assistance in this investigation. Please report any suspect cases to the Adams County Health Department as soon as possible. Please contact our 24/7 with any questions. For reporting during working hours contact Jon Campos RN at: 217-222-8440 x163 After hours please use 24/7 Number: 217-214-4000 Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: jcampos@co.adams.il.us Sent time: 02/06/2018 11:33:06 AM To: cubbygirl_8@yahoo.com Subject: Legionella in Adams County Hi Christina, For prevalence of Legionella in Adams County please see the annual report for 2016. From there you will be able to find additional years. 2017's annual report is being finalized and will be available before March. http://www.co.adams.il.us/health/annualreports/2016AnnualReport.pdf As for State or national levels I would recommend going to the Illinois Department of Public Health website. For national numbers CDC.gov should be an excellent resource. Thank you, Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: Subject: Date: Kauerauf, Judy Jon Campos; Kelley, Lindsey Legionella testing at Blessing Thursday, January 18, 2018 3:02:01 PM Do you know if they've started testing yet? Judy Kauerauf, MPH Communicable Disease Control Section Chief Illinois Department of Public Health 525 West Jefferson Springfield, IL 62761 Phone: 217-785-8375 Cell: 217-622-2886 State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Subject: Date: Attachments: Jeremy Ledford Ellen Vonderheide; Jon Campos Media Log - Legionella Wednesday, January 24, 2018 10:57:06 AM image001.jpg image002.jpg image003.jpg These are the two entries in the media log regarding legionella. Will check on press releases with Emily. tblMediaLog Query Date LastName Program Topic Discussion MediaOutlet ALL MEDIA 04/29/2016 DIETRICH Communicable LEGIONELLA CONFIRMED SINGLE CASE IN Diseases ADAMS COUNTY. PATIENT HAD VISITED IVH CAMPUS. NO DIRECT LINK TO IVH. COVERED BASICS OF LEGIONELLA, PUBLIC HEALTH ROLE IN REPORTING, SURVEILLANCE, AND RESPONSE. tblMediaLog Query Date LastName Program Topic Discussion MediaOutlet ALL MEDIA 06/29/2016 DRUMMOND Environmental LEGIONELLA DISCUSSED THE WATER MANAGEMENT TEAM AT IVH, - Other - WATER TREATMENT LEGIONELLA OUTBREAK AND THE IMPLEMENTATION OF - IVH THE NEW WATER SYSTEM. DISCUSSED COLLABORATION WITH OUR COMMUNITY PARTNERS. jeremy sig Jeremy Ledford, BS Health Educator Public Information Officer Adams County Health Department 330 Vermont Street Quincy, IL 62301 O: (217) 222-8440 Ext 112 C: (573) 639-1278 Fax (217) 222-8460 jledford@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: Subject: Date: cubbygirl_8@yahoo.com Jerrod Welch New Contact Saturday, February 3, 2018 12:44:33 PM From: Christina Kelly Message: Good afternoon, I wanted to know if you can direct me to a link that would provide me with information related to the incidence and prevalence of Legionnaires' disease in Adams County, the state of Illinois, and the United States? I looked at information on your website related to communicable diseases and I didn't find any information about Legionnaires'. Thank you for your time. Christina Email: cubbygirl_8@yahoo.com Phone: From: To: Cc: Subject: Date: Kauerauf, Judy Jon Campos Layden, Jennifer E. New pos Wednesday, February 14, 2018 3:21:22 PM Was it pos from labcorp or Blessing? Sent from my iPhone State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Subject: Date: Attachments: Jon Campos "Kauerauf, Judy" New Positive Friday, February 16, 2018 3:13:00 PM image001.png image002.jpg image003.jpg A 4th positive was just brought to my attention. Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: Subject: Date: Attachments: Arnold, Melaney Jerrod Welch News release Tuesday, February 13, 2018 7:56:26 AM 02.12.18 Legionnaires" Quincy.pdf Jerrod ~ I apologize for not getting this to you last night. Melaney Arnold Illinois Department of Public Health Public Information Officer (217) 558-0500 melaney.arnold@illinois.gov Facebook: www.facebook.com/IDPH.Illinois Twitter: www.twitter.com/IDPH State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: jwelch@co.adams.il.us Sent time: 01/25/2018 12:51:58 PM To: evonderheide@co.adams.il.us; dlaird@co.adams.il.us; leonard@co.adams.il.us; atippey@co.adams.il.us Subject: Next Staff Meeting All, I will be in Springfield providing testimony to the General Assembly on our Legionella response on February 7. I will need to ask that one or all of you lead the meeting in my absence. I'll leave Alaina with any report I might have if I wind up reporting anything. Thank you, JCW CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: jcampos@co.adams.il.us Sent time: 02/09/2018 09:36:14 AM To: dixie@stvincentshome.com Cc: jjimenez@co.adams.il.us Subject: Norovirus reporting Attachments: norovirus-guidelines.pdf Hi Dixie, Thank you for your call yesterday. For additional information I have included definitions for Norovirus and recommendations for reporting. Also attached is the CDC guidelines for controlling norovirus outbreaks in a healthcare facility. Thank you and have a wonderful weekend. Outbreak Definitions: Acute gastroenteritis (AGE) in a LTCF: An Outbreak is defined as two or more A.G.E. cases occurring in a unit with initial dates of onset within 48 hours of each other. Use the following definitions to determine if an A.G.E. outbreak is occurring: Diarrhea: three or more loose stools in a 24-hour period when the occurrence is not readily explained by other known pre-disposing medical factors. Vomiting: two or more episodes of vomiting in a 24-hour period when the occurrence is not readily explained by other known pre-disposing medical factors. Fever: Is currently subjective in outbreak situation. Notify the local health department whenever any of the following criteria is met: Percentage of A.G.E. cases exceeds 25% of the LTCF average daily census Ongoing occurrence of new A.G.E. cases during the outbreak for more than 14 days after the index or (first) case onset Two or more A.G.E. cases are hospitalized Death of an A.G.E. case Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: "Arnold, Melaney" To: "Jerrod Welch" CC: Date: 12/19/2017 10:21:30 AM Subject: numbers Does this help? We also have the one home staff - which was in March. From: Austin, Connie Sent: Tuesday, December 19, 2017 9:58 AM To: Arnold, Melaney Subject: I'm missing his email, but here are the 5 residents linked to the 2017 IVH situation, I used in my report outbreak ID=IL2017-496 https://prodbi.illinois.gov/BOE/BI State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney w ork product privilege, or any other exemption from disclosure. From: jcampos@co.adams.il.us Sent time: 02/02/2018 03:03:44 PM To: jwelch@co.adams.il.us Subject: pneaumonia Attachments: pneumonia3year.docx Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: jcampos@co.adams.il.us Sent time: 02/12/2018 11:11:56 AM To: tsjones@quincymedgroup.com; abarnes@quincymedgroup.com; thiland@quincymedgroup.com Subject: Pneumonia records Hi Tasha and Tena, Hope all is well. Things have been very busy for us regarding Legionella. Hopefully everything is coming to an end. Legionella is the reason I am reaching out to you today. Illinois Congress has asked us to gather additional data related to pneumonia. We are looking to see what the standard pneumonia rates have been in our area over the last 3 years (2015, 2016, and 2017). This would be all forms of pneumonia seen at QMG. Could you please guide me to who might be able to help me gather this information. We have not been asked to do any additional surveillance going forward. Thank you for any help Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: jcampos@co.adams.il.us Sent time: 02/15/2018 10:51:56 AM To: LINDSEY.KELLEY@illinois.gov Subject: Question Sheet Hey Lindsey, Can you send me a blank questionnaire sheet you use for Legionella? Thanks, Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: Subject: Date: Dave McKinney Jerrod Welch Quick question.... Wednesday, February 14, 2018 4:33:17 PM Jerrod, I left a voice mail with an assistant about a half hour ago. Not sure if you're around, but can you please identify what building or buildings in which the latest two Legionnaires' cases at the veterans home resided? Thanks, Dave McKinney State political reporter WBEZ 848 E. Grand Ave., Navy Pier Chicago, IL 60611 Landline: (312) 948-4643 Twitter: @davemckinney From: To: Subject: Date: Attachments: Kauerauf, Judy Jon Campos Re: [External] CDC Trip Reports Saturday, February 3, 2018 11:16:43 AM image001.png image002.jpg image003.jpg They are all on the public IDPH website. Look under Legionella. Sent from my iPhone On Feb 2, 2018, at 2:45 PM, Jon Campos wrote: Hi Judy, Can you please send me copies of the 2015, 2016 and if there is a 2017 CDC trip report? Thanks, Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Subject: Date: Attachments: Jeffries, Erica L Jerrod Welch Re: [External] Water Management Task Force Friday, February 9, 2018 12:25:02 PM image001.png Fantastic, Jerrod! Thank you! Erica L. Jeffries Director Illinois Department of Veterans' Affairs 217-785-4114 http://www.illinois.gov/veterans On Feb 9, 2018, at 10:23, Jerrod Welch wrote: Dear Director, I am in receipt of your letter dated February 2, 2018 containing invitation to serve on the Water Management Task Force. This email is confirming acceptance of invitation to this Task Force. Kindest Regards, CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Cc: Subject: Date: Attachments: Mcelhoe, Sandy Jerrod Welch Kahn, Maureen RE: ACT - Correspondence from Maureen Kahn, President/CEO - The Blessing Health System RE - Legionella Hearings on 2-7-18 Tuesday, February 6, 2018 5:37:45 PM AR-M455N_20180206_180117.pdf Mr. Welch - The attached letter was sent to Senator Jil Tracy as well as Rep. Randy Frese regarding the Legionella hearings tomorrow. Maureen Kahn wanted you to have this information for your knowledge. Thanks. Sandy McElhoe Executive Assistant The Blessing Health System PO Box 7005 Quincy, IL 62305-7005 Ph: 217-223-8400, ext. 6813 Fax: 217-223-6891 The information contained in this e-mail message is PRIVILEGED AND CONFIDENTIAL and is intended for the use of the addressee and no one else. If you are not the intended recipient, please do not read, distribute, reproduce or use this e-mail message (or the attachments). Please delete the original and notify the sender of the mistaken transmission. Thank you. From: jwelch@co.adams.il.us Sent time: 01/29/2018 09:31:46 AM To: Elliot.Kuida@blessinghealthsystem.org Cc: Maureen.Kahn@blessinghealthsystem.org Subject: RE: BH Statement Legionella Testing_20180124 Elliot, Thank you for the attachment. To address any concerns you guys have, I will just state I don't plan to address this issue at all. If it comes up, I just want to have that understanding of what you are stating. I appreciate your assistance and the conversation on the topic. Best Regards, JCW From: Kuida, Elliot [Elliot.Kuida@blessinghealthsystem.org] Sent: Friday, January 26, 2018 1:17 PM To: Jerrod Welch Cc: Kahn, Maureen Subject: BH Statement Legionella Testing_20180124 As follow-up to our discussion on Wednesday, here is the text from a recent story we ran in our internal publication on Legionella testing. Also, as I mentioned, the in-house Legionella urine test is coming online soon - I would say within the next few days, we will have the test available. Right now, the lab team is conducting all of the correlation and quality assurance testing necessary for a initiating a new test. As we discussed, I appreciate you wanting to be prepared for your testimony, but it is also very difficult for you to be the spokesperson for the Blessing Health System. If you have any questions or if we need to discuss further, please let me know. Have a great weekend! Elliot Elliot H. Kuida | Executive Vice President, Chief Operating Officer Blessing Hospital | 1005 Broadway, PO Box 7005 | Quincy, IL 62305-7005 elliot.kuida@blessinghealthsystem.org P | 217-223-8400 | ext. 6806 Betsey Powell | Executive Assistant betsey.powell@blessinghealthsystem.org P | 217-223-8400 | ext. 6802 The information contained in this e-mail message is PRIVILEGED AND CONFIDENTIAL and is intended for the use of the addressee and no one else. If you are not the intended recipient, please do not read, distribute, reproduce or use this e-mail message (or the attachments). Please delete the original and notify the sender of the mistaken transmission. Thank you. From: To: Subject: Date: Attachments: Layden, Jennifer E. Jon Campos Re: CXR Monday, February 12, 2018 4:15:03 PM image001.png image002.jpg image003.jpg thanks jon. From: Jon Campos Sent: Monday, February 12, 2018 3:54 PM To: Layden, Jennifer E. Subject: [External] CXR CXR Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: jwelch@co.adams.il.us Sent time: 12/20/2017 03:14:23 PM To: dmckinney@wbez.org Cc: tarnold@wbez.org; akeefe@wbez.org; joshjones@co.adams.il.us Subject: RE: FOIA request from Dave McKinney at WBEZ.... Hello Mr. McKinney. Would it be possible to narrow your broad request specified below. We have run search criteria and we are coming up with 8000 emails, many of which have 1-4 attachments, and most of which are not responsive to what I believe to be the intent of your request based on our discussion. For example, we use a time off management system for our employees to track their time. When they make an overtime request with a key word in it, that is captured in our search criteria. There are hundreds of these. Other examples are several duplicate versions of the same email. I would like to provide you with any information that you seek, but I come to realize that the request that I suggested to you is broader in scope than the other requests I was replying to in such a manner that I do not know how we are going to be able to fulfill it. If you would wish to discuss this or if you would be willing to narrow the request, I believe we will be much more responsive to your needs. Please advise. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Monday, December 18, 2017 1:53 PM To: Jerrod Welch Cc: Tony Arnold ; Alex Keefe Subject: RE: FOIA request from Dave McKinney at WBEZ.... Thanks for your and your department's work on this matter, Jerrod. The Dec. 31 extension on the portion of the request you cited is acceptable by us. Dave McKinney From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Monday, December 18, 2017 1:35 PM To: Dave McKinney Cc: Alex Keefe ; Tony Arnold Subject: RE: FOIA request from Dave McKinney at WBEZ.... Hello Mr. McKinney, I have received your request. Department staff is currently working on it. We should be able to forward to you the specified CDC line list before close of business on Wednesday, December 20 as requested. As discussed, the larger request including all emails, reports and spreadsheets is being worked on for several requestors, and we may be requiring an extension on this information. Currently, we intend to respond to your request for "any documents sent by or to the Adams County Health Department..." by no later than December 31, 2017. I hope this is sufficient for your needs and I believe it to be consistent with our discussion earlier today. Best Regards, From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Monday, December 18, 2017 1:26 PM To: Jerrod Welch Cc: Alex Keefe ; Tony Arnold Subject: FOIA request from Dave McKinney at WBEZ.... Jerrod, Nice chatting this morning and, again, thanks for all of your time in helping me understand the timeline at the veterans' home. Per our conversation, under the Illinois Freedom of Information Act, I'd like to request a copy of the CDC line list that was generated to track cases of Legionnaires' disease at the Illinois Veterans' Home in Quincy. Also, I'd like any documents sent by or to the Adams County Health Department, including but not limited to emails, reports and spreadsheets, that have mentioned the terms, Legionnaires' disease, Legionella or legionellosis. Please waive any fees associated with my request because any responsive documents could be used for the production of a news story or stories for WBEZ, which is Chicago's National Public Radio affiliate. If you have any questions, please contact me at my number below. Thanks, Dave McKinney State political reporter WBEZ 848 E. Grand Ave., Navy Pier Chicago, IL 60611 Landline: (312) 948-4643 Twitter: @davemckinney From: jwelch@co.adams.il.us Sent time: 12/18/2017 01:35:24 PM To: dmckinney@wbez.org Cc: akeefe@wbez.org; tarnold@wbez.org Subject: RE: FOIA request from Dave McKinney at WBEZ.... Hello Mr. McKinney, I have received your request. Department staff is currently working on it. We should be able to forward to you the specified CDC line list before close of business on Wednesday, December 20 as requested. As discussed, the larger request including all emails, reports and spreadsheets is being worked on for several requestors, and we may be requiring an extension on this information. Currently, we intend to respond to your request for "any documents sent by or to the Adams County Health Department..." by no later than December 31, 2017. I hope this is sufficient for your needs and I believe it to be consistent with our discussion earlier today. Best Regards, From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Monday, December 18, 2017 1:26 PM To: Jerrod Welch Cc: Alex Keefe ; Tony Arnold Subject: FOIA request from Dave McKinney at WBEZ.... Jerrod, Nice chatting this morning and, again, thanks for all of your time in helping me understand the timeline at the veterans' home. Per our conversation, under the Illinois Freedom of Information Act, I'd like to request a copy of the CDC line list that was generated to track cases of Legionnaires' disease at the Illinois Veterans' Home in Quincy. Also, I'd like any documents sent by or to the Adams County Health Department, including but not limited to emails, reports and spreadsheets, that have mentioned the terms, Legionnaires' disease, Legionella or legionellosis. Please waive any fees associated with my request because any responsive documents could be used for the production of a news story or stories for WBEZ, which is Chicago's National Public Radio affiliate. If you have any questions, please contact me at my number below. Thanks, Dave McKinney State political reporter WBEZ 848 E. Grand Ave., Navy Pier Chicago, IL 60611 Landline: (312) 948-4643 Twitter: @davemckinney From: jwelch@co.adams.il.us Sent time: 12/22/2017 11:40:33 AM To: dmckinney@wbez.org Cc: tarnold@wbez.org; akeefe@wbez.org; joshjones@co.adams.il.us Subject: RE: FOIA request from Dave McKinney at WBEZ.... Hello again Mr. McKinney, I am very hopeful to hear from you on this. We are looking at several hundred thousand individual pages of documentation that we will need to review for PHI and/or irrelevance. Would you please refine a request for us that will allow it to be appropriately fulfilled. There is no way that we will be able to comply with this massive of a request and I believe that if we attempt to, it will take several months and will give us great risk of releasing HIPAA protected health information. Merry Christmas and I hope to hear from you soon. From: Jerrod Welch Sent: Wednesday, December 20, 2017 3:14 PM To: 'Dave McKinney' Cc: Tony Arnold ; Alex Keefe ; Josh Jones Subject: RE: FOIA request from Dave McKinney at WBEZ.... Hello Mr. McKinney. Would it be possible to narrow your broad request specified below. We have run search criteria and we are coming up with 8000 emails, many of which have 1-4 attachments, and most of which are not responsive to what I believe to be the intent of your request based on our discussion. For example, we use a time off management system for our employees to track their time. When they make an overtime request with a key word in it, that is captured in our search criteria. There are hundreds of these. Other examples are several duplicate versions of the same email. I would like to provide you with any information that you seek, but I come to realize that the request that I suggested to you is broader in scope than the other requests I was replying to in such a manner that I do not know how we are going to be able to fulfill it. If you would wish to discuss this or if you would be willing to narrow the request, I believe we will be much more responsive to your needs. Please advise. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Monday, December 18, 2017 1:53 PM To: Jerrod Welch Cc: Tony Arnold ; Alex Keefe Subject: RE: FOIA request from Dave McKinney at WBEZ.... Thanks for your and your department's work on this matter, Jerrod. The Dec. 31 extension on the portion of the request you cited is acceptable by us. Dave McKinney From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Monday, December 18, 2017 1:35 PM To: Dave McKinney Cc: Alex Keefe ; Tony Arnold Subject: RE: FOIA request from Dave McKinney at WBEZ.... Hello Mr. McKinney, I have received your request. Department staff is currently working on it. We should be able to forward to you the specified CDC line list before close of business on Wednesday, December 20 as requested. As discussed, the larger request including all emails, reports and spreadsheets is being worked on for several requestors, and we may be requiring an extension on this information. Currently, we intend to respond to your request for "any documents sent by or to the Adams County Health Department..." by no later than December 31, 2017. I hope this is sufficient for your needs and I believe it to be consistent with our discussion earlier today. Best Regards, From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Monday, December 18, 2017 1:26 PM To: Jerrod Welch Cc: Alex Keefe ; Tony Arnold Subject: FOIA request from Dave McKinney at WBEZ.... Jerrod, Nice chatting this morning and, again, thanks for all of your time in helping me understand the timeline at the veterans' home. Per our conversation, under the Illinois Freedom of Information Act, I'd like to request a copy of the CDC line list that was generated to track cases of Legionnaires' disease at the Illinois Veterans' Home in Quincy. Also, I'd like any documents sent by or to the Adams County Health Department, including but not limited to emails, reports and spreadsheets, that have mentioned the terms, Legionnaires' disease, Legionella or legionellosis. Please waive any fees associated with my request because any responsive documents could be used for the production of a news story or stories for WBEZ, which is Chicago's National Public Radio affiliate. If you have any questions, please contact me at my number below. Thanks, Dave McKinney State political reporter WBEZ 848 E. Grand Ave., Navy Pier Chicago, IL 60611 Landline: (312) 948-4643 Twitter: @davemckinney From: jwelch@co.adams.il.us Sent time: 12/26/2017 02:43:30 PM To: dmckinney@wbez.org Cc: tarnold@wbez.org; akeefe@wbez.org; joshjones@co.adams.il.us Subject: RE: FOIA request from Dave McKinney at WBEZ.... Hello Mr McKinney, I am leaving the office today, but will be able to forward any query that we can build for you to our IT Department. I would truly appreciate it if you could get me some definition to this request. Thank you in advance. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Friday, December 22, 2017 12:39 PM To: Jerrod Welch Cc: Tony Arnold ; Alex Keefe ; Josh Jones Subject: Re: FOIA request from Dave McKinney at WBEZ.... I'd like to pick your brain on how to narrow this. I'm around this afternoon. Do you have a few moments to talk? Then, I can put something in writing. On Dec 22, 2017, at 11:56 AM, Jerrod Welch wrote: Hello again Mr. McKinney, I am very hopeful to hear from you on this. We are looking at several hundred thousand individual pages of documentation that we will need to review for PHI and/or irrelevance. Would you please refine a request for us that will allow it to be appropriately fulfilled. There is no way that we will be able to comply with this massive of a request and I believe that if we attempt to, it will take several months and will give us great risk of releasing HIPAA protected health information. Merry Christmas and I hope to hear from you soon. From: Jerrod Welch Sent: Wednesday, December 20, 2017 3:14 PM To: 'Dave McKinney' Cc: Tony Arnold ; Alex Keefe ; Josh Jones Subject: RE: FOIA request from Dave McKinney at WBEZ.... Hello Mr. McKinney. Would it be possible to narrow your broad request specified below. We have run search criteria and we are coming up with 8000 emails, many of which have 1-4 attachments, and most of which are not responsive to what I believe to be the intent of your request based on our discussion. For example, we use a time off management system for our employees to track their time. When they make an overtime request with a key word in it, that is captured in our search criteria. There are hundreds of these. Other examples are several duplicate versions of the same email. I would like to provide you with any information that you seek, but I come to realize that the request that I suggested to you is broader in scope than the other requests I was replying to in such a manner that I do not know how we are going to be able to fulfill it. If you would wish to discuss this or if you would be willing to narrow the request, I believe we will be much more responsive to your needs. Please advise. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Monday, December 18, 2017 1:53 PM To: Jerrod Welch Cc: Tony Arnold ; Alex Keefe Subject: RE: FOIA request from Dave McKinney at WBEZ.... Thanks for your and your department's work on this matter, Jerrod. The Dec. 31 extension on the portion of the request you cited is acceptable by us. Dave McKinney From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Monday, December 18, 2017 1:35 PM To: Dave McKinney Cc: Alex Keefe ; Tony Arnold Subject: RE: FOIA request from Dave McKinney at WBEZ.... Hello Mr. McKinney, I have received your request. Department staff is currently working on it. We should be able to forward to you the specified CDC line list before close of business on Wednesday, December 20 as requested. As discussed, the larger request including all emails, reports and spreadsheets is being worked on for several requestors, and we may be requiring an extension on this information. Currently, we intend to respond to your request for "any documents sent by or to the Adams County Health Department..." by no later than December 31, 2017. I hope this is sufficient for your needs and I believe it to be consistent with our discussion earlier today. Best Regards, From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Monday, December 18, 2017 1:26 PM To: Jerrod Welch Cc: Alex Keefe ; Tony Arnold Subject: FOIA request from Dave McKinney at WBEZ.... Jerrod, Nice chatting this morning and, again, thanks for all of your time in helping me understand the timeline at the veterans' home. Per our conversation, under the Illinois Freedom of Information Act, I'd like to request a copy of the CDC line list that was generated to track cases of Legionnaires' disease at the Illinois Veterans' Home in Quincy. Also, I'd like any documents sent by or to the Adams County Health Department, including but not limited to emails, reports and spreadsheets, that have mentioned the terms, Legionnaires' disease, Legionella or legionellosis. Please waive any fees associated with my request because any responsive documents could be used for the production of a news story or stories for WBEZ, which is Chicago's National Public Radio affiliate. If you have any questions, please contact me at my number below. Thanks, Dave McKinney State political reporter WBEZ 848 E. Grand Ave., Navy Pier Chicago, IL 60611 Landline: (312) 948-4643 Twitter: @davemckinney From: jwelch@co.adams.il.us Sent time: 12/26/2017 03:08:43 PM To: dmckinney@wbez.org Cc: tarnold@wbez.org; akeefe@wbez.org; joshjones@co.adams.il.us Subject: RE: FOIA request from Dave McKinney at WBEZ.... Thank you for the reply. One more question, would you give me a date range for this. I am not aware of such a request at this point. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Tuesday, December 26, 2017 3:02 PM To: Jerrod Welch Cc: Tony Arnold ; Alex Keefe ; Josh Jones Subject: Re: FOIA request from Dave McKinney at WBEZ.... Jerrod, as we talked about, please narrow our request to searches for the terms "Legionnaires'," "veterans," and "outbreak." Please filter out specific news clippings unless people are reacting to those reports. We also are interested particularly in emails with "Illinois.gov" in the address. Can't remember if I have asked, but can you also verify that you have not received a FOIA request from a James Williams" with "Red Group Analytics"? Thanks, Dave McKinney On Dec 26, 2017, at 2:57 PM, Jerrod Welch wrote: Hello Mr McKinney, I am leaving the office today, but will be able to forward any query that we can build for you to our IT Department. I would truly appreciate it if you could get me some definition to this request. Thank you in advance. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Friday, December 22, 2017 12:39 PM To: Jerrod Welch Cc: Tony Arnold ; Alex Keefe ; Josh Jones Subject: Re: FOIA request from Dave McKinney at WBEZ.... I'd like to pick your brain on how to narrow this. I'm around this afternoon. Do you have a few moments to talk? Then, I can put something in writing. On Dec 22, 2017, at 11:56 AM, Jerrod Welch wrote: Hello again Mr. McKinney, I am very hopeful to hear from you on this. We are looking at several hundred thousand individual pages of documentation that we will need to review for PHI and/or irrelevance. Would you please refine a request for us that will allow it to be appropriately fulfilled. There is no way that we will be able to comply with this massive of a request and I believe that if we attempt to, it will take several months and will give us great risk of releasing HIPAA protected health information. Merry Christmas and I hope to hear from you soon. From: Jerrod Welch Sent: Wednesday, December 20, 2017 3:14 PM To: 'Dave McKinney' Cc: Tony Arnold ; Alex Keefe ; Josh Jones Subject: RE: FOIA request from Dave McKinney at WBEZ.... Hello Mr. McKinney. Would it be possible to narrow your broad request specified below. We have run search criteria and we are coming up with 8000 emails, many of which have 1-4 attachments, and most of which are not responsive to what I believe to be the intent of your request based on our discussion. For example, we use a time off management system for our employees to track their time. When they make an overtime request with a key word in it, that is captured in our search criteria. There are hundreds of these. Other examples are several duplicate versions of the same email. I would like to provide you with any information that you seek, but I come to realize that the request that I suggested to you is broader in scope than the other requests I was replying to in such a manner that I do not know how we are going to be able to fulfill it. If you would wish to discuss this or if you would be willing to narrow the request, I believe we will be much more responsive to your needs. Please advise. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Monday, December 18, 2017 1:53 PM To: Jerrod Welch Cc: Tony Arnold ; Alex Keefe Subject: RE: FOIA request from Dave McKinney at WBEZ.... Thanks for your and your department's work on this matter, Jerrod. The Dec. 31 extension on the portion of the request you cited is acceptable by us. Dave McKinney From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Monday, December 18, 2017 1:35 PM To: Dave McKinney Cc: Alex Keefe ; Tony Arnold Subject: RE: FOIA request from Dave McKinney at WBEZ.... Hello Mr. McKinney, I have received your request. Department staff is currently working on it. We should be able to forward to you the specified CDC line list before close of business on Wednesday, December 20 as requested. As discussed, the larger request including all emails, reports and spreadsheets is being worked on for several requestors, and we may be requiring an extension on this information. Currently, we intend to respond to your request for "any documents sent by or to the Adams County Health Department..." by no later than December 31, 2017. I hope this is sufficient for your needs and I believe it to be consistent with our discussion earlier today. Best Regards, From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Monday, December 18, 2017 1:26 PM To: Jerrod Welch Cc: Alex Keefe ; Tony Arnold Subject: FOIA request from Dave McKinney at WBEZ.... Jerrod, Nice chatting this morning and, again, thanks for all of your time in helping me understand the timeline at the veterans' home. Per our conversation, under the Illinois Freedom of Information Act, I'd like to request a copy of the CDC line list that was generated to track cases of Legionnaires' disease at the Illinois Veterans' Home in Quincy. Also, I'd like any documents sent by or to the Adams County Health Department, including but not limited to emails, reports and spreadsheets, that have mentioned the terms, Legionnaires' disease, Legionella or legionellosis. Please waive any fees associated with my request because any responsive documents could be used for the production of a news story or stories for WBEZ, which is Chicago's National Public Radio affiliate. If you have any questions, please contact me at my number below. Thanks, Dave McKinney State political reporter WBEZ 848 E. Grand Ave., Navy Pier Chicago, IL 60611 Landline: (312) 948-4643 Twitter: @davemckinney From: jwelch@co.adams.il.us Sent time: 12/26/2017 03:35:41 PM To: dmckinney@wbez.org Cc: tarnold@wbez.org; akeefe@wbez.org; joshjones@co.adams.il.us Subject: RE: FOIA request from Dave McKinney at WBEZ.... What date for ending? Thx From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Tuesday, December 26, 2017 3:33 PM To: Jerrod Welch Cc: Tony Arnold ; Alex Keefe ; Josh Jones Subject: Re: FOIA request from Dave McKinney at WBEZ.... Let's begin July 1, 2015. On Dec 26, 2017, at 3:08 PM, Jerrod Welch wrote: Thank you for the reply. One more question, would you give me a date range for this. I am not aware of such a request at this point. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Tuesday, December 26, 2017 3:02 PM To: Jerrod Welch Cc: Tony Arnold ; Alex Keefe ; Josh Jones Subject: Re: FOIA request from Dave McKinney at WBEZ.... Jerrod, as we talked about, please narrow our request to searches for the terms "Legionnaires'," "veterans," and "outbreak." Please filter out specific news clippings unless people are reacting to those reports. We also are interested particularly in emails with "Illinois.gov" in the address. Can't remember if I have asked, but can you also verify that you have not received a FOIA request from a James Williams" with "Red Group Analytics"? Thanks, Dave McKinney On Dec 26, 2017, at 2:57 PM, Jerrod Welch wrote: Hello Mr McKinney, I am leaving the office today, but will be able to forward any query that we can build for you to our IT Department. I would truly appreciate it if you could get me some definition to this request. Thank you in advance. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Friday, December 22, 2017 12:39 PM To: Jerrod Welch Cc: Tony Arnold ; Alex Keefe ; Josh Jones Subject: Re: FOIA request from Dave McKinney at WBEZ.... I'd like to pick your brain on how to narrow this. I'm around this afternoon. Do you have a few moments to talk? Then, I can put something in writing. On Dec 22, 2017, at 11:56 AM, Jerrod Welch wrote: Hello again Mr. McKinney, I am very hopeful to hear from you on this. We are looking at several hundred thousand individual pages of documentation that we will need to review for PHI and/or irrelevance. Would you please refine a request for us that will allow it to be appropriately fulfilled. There is no way that we will be able to comply with this massive of a request and I believe that if we attempt to, it will take several months and will give us great risk of releasing HIPAA protected health information. Merry Christmas and I hope to hear from you soon. From: Jerrod Welch Sent: Wednesday, December 20, 2017 3:14 PM To: 'Dave McKinney' Cc: Tony Arnold ; Alex Keefe ; Josh Jones Subject: RE: FOIA request from Dave McKinney at WBEZ.... Hello Mr. McKinney. Would it be possible to narrow your broad request specified below. We have run search criteria and we are coming up with 8000 emails, many of which have 1-4 attachments, and most of which are not responsive to what I believe to be the intent of your request based on our discussion. For example, we use a time off management system for our employees to track their time. When they make an overtime request with a key word in it, that is captured in our search criteria. There are hundreds of these. Other examples are several duplicate versions of the same email. I would like to provide you with any information that you seek, but I come to realize that the request that I suggested to you is broader in scope than the other requests I was replying to in such a manner that I do not know how we are going to be able to fulfill it. If you would wish to discuss this or if you would be willing to narrow the request, I believe we will be much more responsive to your needs. Please advise. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Monday, December 18, 2017 1:53 PM To: Jerrod Welch Cc: Tony Arnold ; Alex Keefe Subject: RE: FOIA request from Dave McKinney at WBEZ.... Thanks for your and your department's work on this matter, Jerrod. The Dec. 31 extension on the portion of the request you cited is acceptable by us. Dave McKinney From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Monday, December 18, 2017 1:35 PM To: Dave McKinney Cc: Alex Keefe ; Tony Arnold Subject: RE: FOIA request from Dave McKinney at WBEZ.... Hello Mr. McKinney, I have received your request. Department staff is currently working on it. We should be able to forward to you the specified CDC line list before close of business on Wednesday, December 20 as requested. As discussed, the larger request including all emails, reports and spreadsheets is being worked on for several requestors, and we may be requiring an extension on this information. Currently, we intend to respond to your request for "any documents sent by or to the Adams County Health Department..." by no later than December 31, 2017. I hope this is sufficient for your needs and I believe it to be consistent with our discussion earlier today. Best Regards, From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Monday, December 18, 2017 1:26 PM To: Jerrod Welch Cc: Alex Keefe ; Tony Arnold Subject: FOIA request from Dave McKinney at WBEZ.... Jerrod, Nice chatting this morning and, again, thanks for all of your time in helping me understand the timeline at the veterans' home. Per our conversation, under the Illinois Freedom of Information Act, I'd like to request a copy of the CDC line list that was generated to track cases of Legionnaires' disease at the Illinois Veterans' Home in Quincy. Also, I'd like any documents sent by or to the Adams County Health Department, including but not limited to emails, reports and spreadsheets, that have mentioned the terms, Legionnaires' disease, Legionella or legionellosis. Please waive any fees associated with my request because any responsive documents could be used for the production of a news story or stories for WBEZ, which is Chicago's National Public Radio affiliate. If you have any questions, please contact me at my number below. Thanks, Dave McKinney State political reporter WBEZ 848 E. Grand Ave., Navy Pier Chicago, IL 60611 Landline: (312) 948-4643 Twitter: @davemckinney From: To: Cc: Subject: Date: Kauerauf, Judy Layden, Jennifer E.; Vickie.Roberts@blessinghealthsystem.org; Linda.Manley@blessinghealthsystem.org; amushtaq@quincymedgroup.com Jon Campos RE: Follow-up Thursday, January 18, 2018 3:08:53 PM Good afternoon, Blessing Team. I was wondering if you had an update on legionella testing at Blessing. From: Layden, Jennifer E. Sent: Monday, December 11, 2017 4:48 PM To: Vickie.Roberts@blessinghealthsystem.org; Linda.Manley@blessinghealthsystem.org; amushtaq@quincymedgroup.com Cc: Kauerauf, Judy ; Jon Campos Subject: Follow-up Hello Infection Prevention team and Dr Mushtaq, It was a pleasure to meet you all last week during our visit(s) to Blessing, and I appreciate your willingness to review cases with Judy and I later that afternoon. That process was very helpful for us to begin understanding the many aspects involved in the transfer and care of patients coming from IVH to Blessing. As we all identified during that meeting, there were several instances where it seemed that a UAT may have been warranted for a patient admitted to Blessing from IVH. While it is not possible for us to look back retrospectively and completely understand these cases and the specific details, I do think there is value to learn from the prior cases, and identifying potential ways to enhance the ability to rapidly identify cases that warrant UAT testing. We would welcome the opportunity to continue discussions around this topic. One thought we discussed was incorporating an order set, or bundle, into the ED setting for patients being admitted with PNA, that would identify those who meet criteria, per clinical guidelines, for UAT testing. Does this seem a reasonable idea to pursue? Have you had other thoughts since our meetings? If best to arrange a time to talk, I would be happy to arrange a time to talk. Again, we really appreciate all your efforts and dedication to improving the identification, diagnosis, and care of patients with Legionella! best, jen Jennifer E Layden, MD, PhD Chief Medical Officer and State Epidemiologist IDPH State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Cc: Subject: Date: Attachments: Layden, Jennifer E. Barthel, Mary Jon Campos; Kauerauf, Judy; Whitaker, Chontel; Manley, Linda; Roberts, Vickie; Mushtaq, Adnan; Kelley, Lindsey Re: Follow-up Thursday, January 25, 2018 4:25:32 PM image003.png HI MaryThanks for the follow up. How did the validation testing go? Is testing up and running? When we met with the team while onsite, we had also discussed the idea of developing an EHR based prompt to encourage clinicians to appropriately test. Do you know if further thought has gone into that? Happy to assist, or review anything, if the intent is to still pursue that. Thanks to you and your team- jen From: Barthel, Mary Sent: Friday, January 19, 2018 11:51 AM To: Layden, Jennifer E. Cc: jcampos@co.adams.il.us; Kauerauf, Judy; Whitaker, Chontel; Manley, Linda; Roberts, Vickie; Mushtaq, Adnan; Kelley, Lindsey Subject: [External] FW: Follow-up Dr. Layden: I have learned from our lab director that we expect to begin testing for Legionella Urine Antigen within the next week. The 40 sample validation testing will be completed by end of today. IT system build is complete and in final testing. The Equivalency Quality Control is underway. The final validation results must be signed by Pathologist. We expect to begin patient testing by Monday or Tuesday, well in advance of our projected start date of Jan 29 or Jan 30. Judy Kauerauf has requested a contact person at Blessing for Lindsey Kelley regarding testing, orders, and results. I suggest the following list of individuals in case one or more of us is absent. All emails are attached. Linda Manley, RN Vickie Roberts, RN Chontel Whitaker, RN Adnan Mushtaq, MD Mary Frances Barthel, MD Please let me know if you have any other questions. Thank you, Mary Frances Barthel, MD, FACP, SFHM Chief Quality and Safety Officer Medical Director Infection Control and Prevenion Medical Director Utilization Management Blessing Health System 1005 Broadway Quincy, IL 62301 Office: (217)223-1200 ext 6676 or ext 7217 Cell: (217)577-4566 Mary.barthel@blessinghealthsystem.org Hello Infection Prevention team and Dr Mushtaq, It was a pleasure to meet you all last week during our visit(s) to Blessing, and I appreciate your willingness to review cases with Judy and I later that afternoon. That process was very helpful for us to begin understanding the many aspects involved in the transfer and care of patients coming from IVH to Blessing. As we all identified during that meeting, there were several instances where it seemed that a UAT may have been warranted for a patient admitted to Blessing from IVH. While it is not possible for us to look back retrospectively and completely understand these cases and the specific details, I do think there is value to learn from the prior cases, and identifying potential ways to enhance the ability to rapidly identify cases that warrant UAT testing. We would welcome the opportunity to continue discussions around this topic. One thought we discussed was incorporating an order set, or bundle, into the ED setting for patients being admitted with PNA, that would identify those who meet criteria, per clinical guidelines, for UAT testing. Does this seem a reasonable idea to pursue? Have you had other thoughts since our meetings? If best to arrange a time to talk, I would be happy to arrange a time to talk. Again, we really appreciate all your efforts and dedication to improving the identification, diagnosis, and care of patients with Legionella! best, jen Jennifer E Layden, MD, PhD Chief Medical Officer and State Epidemiologist IDPH State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. The information contained in this e-mail message is PRIVILEGED AND CONFIDENTIAL and is intended for the use of the addressee and no one else. If you are not the intended recipient, please do not read, distribute, reproduce or use this e-mail message (or the attachments). Please delete the original and notify the sender of the mistaken transmission. Thank you. From: jwelch@co.adams.il.us Sent time: 12/19/2017 01:05:12 PM To: dmckinney@wbez.org Cc: joshjones@co.adams.il.us; tarnold@wbez.org; akeefe@wbez.org; Melaney.Arnold@Illinois.gov Subject: RE: Hey, Jerrod.... We were notified via INEDSS, so these were likely by the hospital. As far as how they were classified by the state, we defer to them to determine their context in the outbreak. As I said before, determination of the cases as part of the outbreak is a function of the state agencies. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Tuesday, December 19, 2017 12:32 PM To: Jerrod Welch Cc: Josh Jones ; Tony Arnold ; Alex Keefe Subject: RE: Hey, Jerrod.... So, to be clear, Jerrod: The state did notify your department of all six Legionnaires' cases at the facility this year? From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Tuesday, December 19, 2017 12:24 PM To: Dave McKinney Cc: Arnold, Melaney (Melaney.Arnold@Illinois.gov) ; Josh Jones ; Tony Arnold ; Alex Keefe Subject: RE: Hey, Jerrod.... Dave, I would like to clarify with you. We did receive these reports of the illnesses through INEDSS. I am referring to the fact that we were not aware of whether these were to be considered as part of the outbreak until it was clarified through today's discussion. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Tuesday, December 19, 2017 12:13 PM To: Jerrod Welch Cc: Arnold, Melaney (Melaney.Arnold@Illinois.gov) ; Josh Jones ; Tony Arnold ; Alex Keefe Subject: RE: Hey, Jerrod.... Thanks, Jerrod. Melaney, since you're on this email thread, I want to pose to you the question of whether the state - and particularly Veterans Affairs, if they were doing the testing at the veterans' home this year - was at fault for not reporting ALL of the 2017 cases to the Adams County Health Department. Section 690.100 of the Illinois Administrative Code, as you're aware, deals with infectious disease reporting requirements. Legionellosis is among the diseases listed. To quote the rule: "Each suspected or diagnosed case shall be reported to the local health authority, which shall subsequently report each case to the department." There is no stipulation that I can find within the rule that specifies only "suspected or diagnosed" cases associated with an outbreak be reported to the local health authority. Why did the agency not adhere to the rule and inform Adams County about all six cases this year? Dave McKinney From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Tuesday, December 19, 2017 10:37 AM To: Dave McKinney Cc: Arnold, Melaney (Melaney.Arnold@Illinois.gov) ; Josh Jones Subject: RE: Hey, Jerrod.... Hello Dave, I have looked back through what cases we have reviewed and reported to IDPH. Here is a summary and more information that should help answer your questions. I spoke with IDPH this morning about which cases were reported. IDPH has confirmed to us that only the October cluster was reported previously, and that individual cases were not reported as part of the outbreak. ACHD received an report of an individual on March 13 of a suspected case. We do not have this as part of our case count, but have confirmed with IDPH that they have that case. We also began initial case work in May on a suspected individual. Up until now, we were not sure if that was considered part of the outbreak, but again, we've received confirmation that it is. We also have a suspected case reported to us on September 16. There was again, a lab confirmation of that case, and it does appear as part of INEDSS. IDPH is now confirming it as well. The cases that were previously confirmed by IDHP as part of the outbreak were those on 10/13, 10/16 and then 11/25. We also find one community case in 2017 that shows up on INEDSS. All cases that we receive reports on are simultaneously received by IDHP, and they make a determination on whether that investigation yields a confirmed case and whether it is attributed to the outbreak. So I would defer to them for accurate case counts. We will always report what they are reporting, as they ultimately determine the status of an individual case, both as to its confirmation and to whether to attribute it to the IVH. I have copied their PIO on this response so she may follow up with you on any clarification. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Tuesday, December 19, 2017 9:18 AM To: Jerrod Welch Subject: Hey, Jerrod.... I left a voicemail for you in the office, as well. The state Public Health Department is confirming this morning that a total of SIX cases of confirmed Legionnaires' have occurred this calendar year at the veterans' home. This is double what they have publicly disclosed. Five were residents, and one was staff. Has the home reported these cases to your department? Dave McKinney State political reporter WBEZ 848 E. Grand Ave., Navy Pier Chicago, IL 60611 Landline: (312) 948-4643 Twitter: @davemckinney From: jwelch@co.adams.il.us Sent time: 12/19/2017 12:24:03 PM To: dmckinney@wbez.org Cc: Melaney.Arnold@Illinois.gov; joshjones@co.adams.il.us; tarnold@wbez.org; akeefe@wbez.org Subject: RE: Hey, Jerrod.... Dave, I would like to clarify with you. We did receive these reports of the illnesses through INEDSS. I am referring to the fact that we were not aware of whether these were to be considered as part of the outbreak until it was clarified through today's discussion. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Tuesday, December 19, 2017 12:13 PM To: Jerrod Welch Cc: Arnold, Melaney (Melaney.Arnold@Illinois.gov) ; Josh Jones ; Tony Arnold ; Alex Keefe Subject: RE: Hey, Jerrod.... Thanks, Jerrod. Melaney, since you're on this email thread, I want to pose to you the question of whether the state - and particularly Veterans Affairs, if they were doing the testing at the veterans' home this year - was at fault for not reporting ALL of the 2017 cases to the Adams County Health Department. Section 690.100 of the Illinois Administrative Code, as you're aware, deals with infectious disease reporting requirements. Legionellosis is among the diseases listed. To quote the rule: "Each suspected or diagnosed case shall be reported to the local health authority, which shall subsequently report each case to the department." There is no stipulation that I can find within the rule that specifies only "suspected or diagnosed" cases associated with an outbreak be reported to the local health authority. Why did the agency not adhere to the rule and inform Adams County about all six cases this year? Dave McKinney From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Tuesday, December 19, 2017 10:37 AM To: Dave McKinney Cc: Arnold, Melaney (Melaney.Arnold@Illinois.gov) ; Josh Jones Subject: RE: Hey, Jerrod.... Hello Dave, I have looked back through what cases we have reviewed and reported to IDPH. Here is a summary and more information that should help answer your questions. I spoke with IDPH this morning about which cases were reported. IDPH has confirmed to us that only the October cluster was reported previously, and that individual cases were not reported as part of the outbreak. ACHD received an report of an individual on March 13 of a suspected case. We do not have this as part of our case count, but have confirmed with IDPH that they have that case. We also began initial case work in May on a suspected individual. Up until now, we were not sure if that was considered part of the outbreak, but again, we've received confirmation that it is. We also have a suspected case reported to us on September 16. There was again, a lab confirmation of that case, and it does appear as part of INEDSS. IDPH is now confirming it as well. The cases that were previously confirmed by IDHP as part of the outbreak were those on 10/13, 10/16 and then 11/25. We also find one community case in 2017 that shows up on INEDSS. All cases that we receive reports on are simultaneously received by IDHP, and they make a determination on whether that investigation yields a confirmed case and whether it is attributed to the outbreak. So I would defer to them for accurate case counts. We will always report what they are reporting, as they ultimately determine the status of an individual case, both as to its confirmation and to whether to attribute it to the IVH. I have copied their PIO on this response so she may follow up with you on any clarification. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Tuesday, December 19, 2017 9:18 AM To: Jerrod Welch Subject: Hey, Jerrod.... I left a voicemail for you in the office, as well. The state Public Health Department is confirming this morning that a total of SIX cases of confirmed Legionnaires' have occurred this calendar year at the veterans' home. This is double what they have publicly disclosed. Five were residents, and one was staff. Has the home reported these cases to your department? Dave McKinney State political reporter WBEZ 848 E. Grand Ave., Navy Pier Chicago, IL 60611 Landline: (312) 948-4643 Twitter: @davemckinney From: jwelch@co.adams.il.us Sent time: 12/19/2017 10:37:06 AM To: dmckinney@wbez.org Cc: Melaney.Arnold@Illinois.gov; joshjones@co.adams.il.us Subject: RE: Hey, Jerrod.... Hello Dave, I have looked back through what cases we have reviewed and reported to IDPH. Here is a summary and more information that should help answer your questions. I spoke with IDPH this morning about which cases were reported. IDPH has confirmed to us that only the October cluster was reported previously, and that individual cases were not reported as part of the outbreak. ACHD received an report of an individual on March 13 of a suspected case. We do not have this as part of our case count, but have confirmed with IDPH that they have that case. We also began initial case work in May on a suspected individual. Up until now, we were not sure if that was considered part of the outbreak, but again, we've received confirmation that it is. We also have a suspected case reported to us on September 16. There was again, a lab confirmation of that case, and it does appear as part of INEDSS. IDPH is now confirming it as well. The cases that were previously confirmed by IDHP as part of the outbreak were those on 10/13, 10/16 and then 11/25. We also find one community case in 2017 that shows up on INEDSS. All cases that we receive reports on are simultaneously received by IDHP, and they make a determination on whether that investigation yields a confirmed case and whether it is attributed to the outbreak. So I would defer to them for accurate case counts. We will always report what they are reporting, as they ultimately determine the status of an individual case, both as to its confirmation and to whether to attribute it to the IVH. I have copied their PIO on this response so she may follow up with you on any clarification. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Tuesday, December 19, 2017 9:18 AM To: Jerrod Welch Subject: Hey, Jerrod.... I left a voicemail for you in the office, as well. The state Public Health Department is confirming this morning that a total of SIX cases of confirmed Legionnaires' have occurred this calendar year at the veterans' home. This is double what they have publicly disclosed. Five were residents, and one was staff. Has the home reported these cases to your department? Dave McKinney State political reporter WBEZ 848 E. Grand Ave., Navy Pier Chicago, IL 60611 Landline: (312) 948-4643 Twitter: @davemckinney From: jwelch@co.adams.il.us Sent time: 01/23/2018 05:41:00 PM To: dmckinney@wbez.org Cc: tarnold@wbez.org; joshjones@co.adams.il.us Subject: RE: Hey, Jerrod.... Hello, Thank you for the feedback on the redactions Dave. As far as the attachments go, if you could identify the file name of the specific ones you are looking at, I will see if we could retrieve them or figure out why you can't open them. The Quincy Herald Whig requested the emails that you requested. Regarding upcoming testimony, I guess I'll just be trying to answer any questions they have. Thanks, Jerrod Welch From: Dave McKinney [dmckinney@wbez.org] Sent: Tuesday, January 23, 2018 5:07 PM To: Jerrod Welch Cc: Tony Arnold Subject: Hey, Jerrod.... I have finally gone through all of the emails you sent to us through our FOIA request and want to thank you again for your help. This was a significant ask on our part, and your adherence to Illinois' open-records laws is much appreciated. I wanted to let you know that I did not see any un-redacted names in what you sent so that should set aside any worries on that front. Second, many of the emails contain attachments that cannot be opened. Do you know whether we can get access to them? I can think of really only a couple that would be of interest. Finally, what other news organizations have requested and been given the same set of emails that you provided us, and what do you expect your testimony to be at the upcoming joint House-Senate veterans' affairs hearing? Again, Jerrod, thank you for your help. If it's easier, give me a call tomorrow on my landline (below) or my cell, which is (217) 891-4344. Dave McKinney State political reporter WBEZ 848 E. Grand Ave., Navy Pier Chicago, IL 60611 Landline: (312) 948-4643 Twitter: @davemckinney From: jwelch@co.adams.il.us Sent time: 01/24/2018 12:54:37 PM To: dmckinney@wbez.org Subject: RE: Hey, Jerrod.... Dave, If you open the PDF file in Acrobat Pro or Acrobat Reader, you should see a menu bar on the left side of the window. It should have a paperclip icon. That Icon will open up an attachment housed in the PDF document. That should be the case for any pdf file I believe. From: Dave McKinney [mailto:dmckinney@wbez.org] Sent: Wednesday, January 24, 2018 10:15 AM To: Jerrod Welch Subject: RE: Hey, Jerrod.... Jerrod, here's one example near the beginning of the batch. I'm wondering if because these are saved and sent as PDF files, that is why attachments won't open. Do you have access to this particular attachment? Thanks, Dave From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Tuesday, January 23, 2018 5:41 PM To: Dave McKinney Cc: Tony Arnold ; Josh Jones Subject: RE: Hey, Jerrod.... Hello, Thank you for the feedback on the redactions Dave. As far as the attachments go, if you could identify the file name of the specific ones you are looking at, I will see if we could retrieve them or figure out why you can't open them. The Quincy Herald Whig requested the emails that you requested. Regarding upcoming testimony, I guess I'll just be trying to answer any questions they have. Thanks, Jerrod Welch From: Dave McKinney [dmckinney@wbez.org] Sent: Tuesday, January 23, 2018 5:07 PM To: Jerrod Welch Cc: Tony Arnold Subject: Hey, Jerrod.... I have finally gone through all of the emails you sent to us through our FOIA request and want to thank you again for your help. This was a significant ask on our part, and your adherence to Illinois' open-records laws is much appreciated. I wanted to let you know that I did not see any un-redacted names in what you sent so that should set aside any worries on that front. Second, many of the emails contain attachments that cannot be opened. Do you know whether we can get access to them? I can think of really only a couple that would be of interest. Finally, what other news organizations have requested and been given the same set of emails that you provided us, and what do you expect your testimony to be at the upcoming joint House-Senate veterans' affairs hearing? Again, Jerrod, thank you for your help. If it's easier, give me a call tomorrow on my landline (below) or my cell, which is (217) 891-4344. Dave McKinney State political reporter WBEZ 848 E. Grand Ave., Navy Pier Chicago, IL 60611 Landline: (312) 948-4643 Twitter: @davemckinney From: jcampos@co.adams.il.us Sent time: 02/16/2018 02:25:15 PM To: Heather.Reid@Illinois.gov Subject: RE: IVH influenza outbreak Hi Heather, IVH has two positive influenza, but the two clients are on different units. IVH is already implementing influenza prevention strategies. From: Reid, Heather [mailto:Heather.Reid@Illinois.gov] Sent: Friday, February 16, 2018 12:28 PM To: Jon Campos Subject: RE: IVH influenza outbreak Can you update me before you leave for the day so I can relay the status of this to others here? Thanks, Heather From: Reid, Heather Sent: Friday, February 16, 2018 8:19 AM To: 'jcampos@co.adams.il.us' Cc: Sinner, Mallory ; Morgan, Jodi Subject: IVH influenza outbreak Hi Jon, I spoke with Judy today and it sounds like the veterans home may have illness that meet criteria for an influenza outbreak. I spoke with Lindsay last Friday to see what measures they had been doing to prevent influenza in their facility since we have many ltcf outbreak with flu being so widespread this season, but at that point they didn't have an outbreak. She said they have our flu outbreak guidance (attached) and were implementing it even when flu wasn't identified to be the cause. Can you f/u with her about this and put the outbreak into ORS today if they meet the outbreak definition? (2 cases of ILI within 72 hours with at least 1 influenza positive). Judy said specimens were being sent to CDC for testing which includes influenza testing. Keep me posted. Thanks, Heather Heather Reid VPD Surveillance Manager Illinois Department of Public Health PH: 217-782-2016 FAX: 217-524-0962 www.dph.illinois.gov State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: jcampos@co.adams.il.us Sent time: 02/16/2018 02:30:08 PM To: Heather.Reid@Illinois.gov Subject: RE: IVH influenza outbreak The units are under one roof, but the clients can't enter the other unit. From: Reid, Heather [mailto:Heather.Reid@Illinois.gov] Sent: Friday, February 16, 2018 2:27 PM To: Jon Campos Subject: RE: IVH influenza outbreak Are the two units in two different buildings? From: Jon Campos [mailto:jcampos@co.adams.il.us] Sent: Friday, February 16, 2018 2:25 PM To: Reid, Heather Subject: [External] RE: IVH influenza outbreak Hi Heather, IVH has two positive influenza, but the two clients are on different units. IVH is already implementing influenza prevention strategies. From: Reid, Heather [mailto:Heather.Reid@Illinois.gov] Sent: Friday, February 16, 2018 12:28 PM To: Jon Campos Subject: RE: IVH influenza outbreak Can you update me before you leave for the day so I can relay the status of this to others here? Thanks, Heather From: Reid, Heather Sent: Friday, February 16, 2018 8:19 AM To: 'jcampos@co.adams.il.us' Cc: Sinner, Mallory ; Morgan, Jodi Subject: IVH influenza outbreak Hi Jon, I spoke with Judy today and it sounds like the veterans home may have illness that meet criteria for an influenza outbreak. I spoke with Lindsay last Friday to see what measures they had been doing to prevent influenza in their facility since we have many ltcf outbreak with flu being so widespread this season, but at that point they didn't have an outbreak. She said they have our flu outbreak guidance (attached) and were implementing it even when flu wasn't identified to be the cause. Can you f/u with her about this and put the outbreak into ORS today if they meet the outbreak definition? (2 cases of ILI within 72 hours with at least 1 influenza positive). Judy said specimens were being sent to CDC for testing which includes influenza testing. Keep me posted. Thanks, Heather Heather Reid VPD Surveillance Manager Illinois Department of Public Health PH: 217-782-2016 FAX: 217-524-0962 www.dph.illinois.gov State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: jcampos@co.adams.il.us Sent time: 02/16/2018 02:32:20 PM To: Heather.Reid@Illinois.gov Subject: RE: IVH influenza outbreak Yes. So I guess we will call it an outbreak From: Reid, Heather [mailto:Heather.Reid@Illinois.gov] Sent: Friday, February 16, 2018 2:31 PM To: Jon Campos Subject: RE: IVH influenza outbreak Do they share staff at all? Will it be considered an outbreak yet? From: Jon Campos [mailto:jcampos@co.adams.il.us] Sent: Friday, February 16, 2018 2:30 PM To: Reid, Heather Subject: [External] RE: IVH influenza outbreak The units are under one roof, but the clients can't enter the other unit. From: Reid, Heather [mailto:Heather.Reid@Illinois.gov] Sent: Friday, February 16, 2018 2:27 PM To: Jon Campos Subject: RE: IVH influenza outbreak Are the two units in two different buildings? From: Jon Campos [mailto:jcampos@co.adams.il.us] Sent: Friday, February 16, 2018 2:25 PM To: Reid, Heather Subject: [External] RE: IVH influenza outbreak Hi Heather, IVH has two positive influenza, but the two clients are on different units. IVH is already implementing influenza prevention strategies. From: Reid, Heather [mailto:Heather.Reid@Illinois.gov] Sent: Friday, February 16, 2018 12:28 PM To: Jon Campos Subject: RE: IVH influenza outbreak Can you update me before you leave for the day so I can relay the status of this to others here? Thanks, Heather From: Reid, Heather Sent: Friday, February 16, 2018 8:19 AM To: 'jcampos@co.adams.il.us' Cc: Sinner, Mallory ; Morgan, Jodi Subject: IVH influenza outbreak Hi Jon, I spoke with Judy today and it sounds like the veterans home may have illness that meet criteria for an influenza outbreak. I spoke with Lindsay last Friday to see what measures they had been doing to prevent influenza in their facility since we have many ltcf outbreak with flu being so widespread this season, but at that point they didn't have an outbreak. She said they have our flu outbreak guidance (attached) and were implementing it even when flu wasn't identified to be the cause. Can you f/u with her about this and put the outbreak into ORS today if they meet the outbreak definition? (2 cases of ILI within 72 hours with at least 1 influenza positive). Judy said specimens were being sent to CDC for testing which includes influenza testing. Keep me posted. Thanks, Heather Heather Reid VPD Surveillance Manager Illinois Department of Public Health PH: 217-782-2016 FAX: 217-524-0962 www.dph.illinois.gov State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Cc: Subject: Date: CLIFFORD, DAVE Jeffries, Erica L; Winnicki, Lenard F.; Diehl, Gwen; Culbertson, Troy D.; Kelley, Lindsey; WHITCOMB, DAWN; Eddington, Matt P.; DeWitt, Justin; Martin, Aaron; McCann, Ken; McMillan, Dave; Cook, David; MacGibbon, Chris; Wright, Ron; Wilson, Mike A; Mattingly, Lisa; Kimble, Carl; Marty Detmer; Jon Campos; Tony Dede; wkbainter@yahoo.com; Robertson, Lester E.; Whitmer, Sherri L; Simmons, Angela D.; Togarepi, Julia; Miller, Shelly R.; Williams, Laurie A.; McLaughlin, Bill; O"Day, Jaclyn; Martin, Kathryn; Joerger, Marcy; Behnke, Gus; Evans, Amber Shah, Nirav; Romano, Amy; Messina, Alec; Jerrod Welch; Sawyer, Harry; Brown, Renysha Y; Womack, Crystal L; MacDonna, Dave; Murphy, Eric M RE: IVHQ Working Groups Friday, January 26, 2018 4:40:12 PM Thank you Erica for your confidence in my abilities to lead the water management team and being a part of the infrastructure investment as well. Looking forward to enhancing an already great program along with working with what I call the best staff and professionals in the industry. Go Illinois!!! From: Jeffries, Erica L Sent: Friday, January 26, 2018 10:31 AM To: CLIFFORD, DAVE ; Winnicki, Lenard F. ; Diehl, Gwen ; Culbertson, Troy D. ; Kelley, Lindsey ; WHITCOMB, DAWN ; Eddington, Matt P. ; DeWitt, Justin ; Martin, Aaron ; McCann, Ken ; McMillan, Dave ; Cook, David ; MacGibbon, Chris ; Wright, Ron ; Wilson, Mike A ; Mattingly, Lisa ; Kimble, Carl ; Marty Detmer ; jcampos@co.adams.il.us; tdede@co.adams.il.us; wkbainter@yahoo.com; Robertson, Lester E. ; Whitmer, Sherri L ; Simmons, Angela D. ; Togarepi, Julia ; Miller, Shelly R. ; Williams, Laurie A. ; McLaughlin, Bill ; O'Day, Jaclyn ; Martin, Kathryn ; Joerger, Marcy ; Behnke, Gus ; Evans, Amber Cc: Shah, Nirav ; Romano, Amy ; Messina, Alec ; jwelch@co.adams.il.us; Sawyer, Harry ; Brown, Renysha Y ; Womack, Crystal L ; MacDonna, Dave ; Murphy, Eric M Subject: IVHQ Working Groups Team, As you know, the Governor is going to be announcing two Task Forces to address water management and infrastructure investment at the Veterans' Homes (specifically Quincy). Underneath each TF will be a working group - which, of course, is where all the real work will be getting done! The Water Management Working Group will be led by Dave Clifford, Chief Engineer at IVHQ and the Infrastructure Investment team will be led by Len Winnicki, IDVA Senior Homes Administrator. Our task is to begin drafting plans for phased approaches to address the needs of each working group. The Water Management WG will look very much like our current water management team - and it can, in fact, double as this new Working Group. The focus of the Water Management team will be to produce an evolved plan for remediation of water at IVHQ. The remediation plan might include new plumbing, a new water source, new flushing protocols, new technologies for testing - Whatever options are explored that make sense. This plan will be presented to the IL General Assembly with a request for appropriations to implement. The Infrastructure Investment WG will focus on the design, build, and construction requirements for projects at IVHQ - and the other Homes, as needed. This is our opportunity to think broadly and innovatively about what the future of care will look like for our Illinois veterans. The ideas produced for the Quincy Home can and will also be used to create new ideas for our other Homes as well. The plan produced by the Infrastructure Investment WG might include new projects (like roofs or renovations), but could also include an entirely new design for a new building or buildings on the campus. The Infrastructure Investment WG will need to take into account the needs that our veterans will have in the next 5, 10, or 20 years - and beyond. This plan will also be presented to the IL General Assembly with a request for appropriations to implement. Our objective is to have drafts of each plan by March 31st - with the expectation of delivering a final plan to the General Assembly by 1 May. The members of the Water Management team are as follows - if there are others you think should be added, please let me know: Dave Clifford Chief Engineer IVHQ Len Winnicki Senior Homes Administrator Gwen Diehl Homes Coordinator Troy Culbertson Quincy Home Administrator Lindsey Kelley IVHQ Dawn Whitcomb IVHQ Matt Eddington Dpty General Counsel IDVA Justin DeWitt IDPH Aaron Martin IDPH Ken McCann IDPH Dave McMillan IEPA David Cook IEPA Tony Dede Adams County Public Health Jon Campos Adams County Public Health Bill Bainter Certified Water Operator Marty Detmer Phigenics Advisor Chris MacGibbon CDB Ron Wright CDB Mike Wilson CDB Lisa Mattingly CDB Carl Kimble CDB The members of the Infrastructure Investment team are as follows - if there are others you think should be added, please let me know: Len Winnicki Senior Homes Administrator Gwen Diehl IDVA Homes Coordinator Troy Culbertson IVHQ Administrator Lester Robertson IVHM Administrator Sherri Whitmer IVHL Administrator Angela Simmons IVHA Administrator Dave Clifford Chief Engineer IVHQ Julia Togarepi Director of Nursing IVHQ Shelly Miller Director of Nursing IVHA Laurie Williams Asst. DON IVHM Bill McLaughlin Chief Engineer IVHM Justin DeWitt IDPH Aaron Martin IDPH Amy Romano CDB Jackyn O'Day CDB Chris MacGibbon CDB Kathryn Martin CDB Mike Wilson CDB Ron Wright CDB Lisa Mattingly CDB Marcy Joerger CDB Gus Behnke CDB Carl Kimble CDB Amber Evans CDB Again, thank you for taking the time to join the call this morning and my sincere thanks to all of you for your support and assistance over the last 2 1/2 years and now into the future. We appreciate your collaboration, insight, and expertise and look forward to establishing plans that will ensure we are meeting the needs of our veterans and their families for generations to come. Please don't hesitate to reach out with any questions. Erica L. Jeffries Director Illinois Department of Veterans' Affairs (IDVA) 217-785-4114 http://www.illinois.gov/veterans Crystal Womack Executive Assistant 217-785-4114 Crystal.Womack@illinois.gov State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Subject: Date: Attachments: cubbygirl_8@yahoo.com Jon Campos Re: Legionella in Adams County Tuesday, February 6, 2018 11:40:42 AM image001.png image002.jpg image003.jpg Jon, Thank you very much for the information! Christina Kelly On Tue, Feb 6, 2018 at 11:33 AM -0600, "Jon Campos" wrote: Hi Christina, For prevalence of Legionella in Adams County please see the annual report for 2016. From there you will be able to find additional years. 2017's annual report is being finalized and will be available before March. http://www.co.adams.il.us/health/annualreports/2016AnnualReport.pdf As for State or national levels I would recommend going to the Illinois Department of Public Health website. For national numbers CDC.gov should be an excellent resource. Thank you, Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: jcampos@co.adams.il.us Sent time: 01/18/2018 03:02:46 PM To: Judy.Kauerauf@Illinois.gov Subject: RE: Legionella testing at Blessing Only from the news. I haven't spoken with them directly about it. From: Kauerauf, Judy [mailto:Judy.Kauerauf@Illinois.gov] Sent: Thursday, January 18, 2018 3:02 PM To: Jon Campos; Kelley, Lindsey Subject: Legionella testing at Blessing Do you know if they've started testing yet? Judy Kauerauf, MPH Communicable Disease Control Section Chief Illinois Department of Public Health 525 West Jefferson Springfield, IL 62761 Phone: 217-785-8375 Cell: 217-622-2886 State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: jwelch@co.adams.il.us Sent time: 01/04/2018 09:41:39 AM To: ryanniekamp@gmail.com Subject: RE: Legionnaires Hello Ryan, If you want to, we can sit down and discuss. I am very wrapped up for the next few weeks, so I would need to set something late in January or early in February. Let me know a few dates you'd be interested in discussing. Thanks, JCW From: Ryan Niekamp [ryanniekamp@gmail.com] Sent: Thursday, January 04, 2018 9:22 AM To: Jerrod Welch Subject: Legionnaires Jerrod, I read a recent article published my NBC, I think it was, which read that as a nation there has been an increase of Legionella Pneumophila bacteria being discovered throughout our Country. This makes me ponder the question, has there been more out breaks in Adams County than just the Illinois Veteran's Home? Have any of the other long-term care facilities found Legionnaires on their campuses? Once a case is found, is the institution and/or Doctor requires to report the case to the ACHD? Any insight you can provide that would make me better understand the County's role is appreciated. Thank you, RN Ryan A. Niekamp Adams County Board, Illinois District Two Sent from my iPhone From: To: Subject: Date: Jerrod Welch Ryan Niekamp RE: Legionnaires Thursday, January 4, 2018 9:41:41 AM Hello Ryan, If you want to, we can sit down and discuss. I am very wrapped up for the next few weeks, so I would need to set something late in January or early in February. Let me know a few dates you'd be interested in discussing. Thanks, JCW From: Ryan Niekamp [ryanniekamp@gmail.com] Sent: Thursday, January 04, 2018 9:22 AM To: Jerrod Welch Subject: Legionnaires Jerrod, I read a recent article published my NBC, I think it was, which read that as a nation there has been an increase of Legionella Pneumophila bacteria being discovered throughout our Country. This makes me ponder the question, has there been more out breaks in Adams County than just the Illinois Veteran's Home? Have any of the other long-term care facilities found Legionnaires on their campuses? Once a case is found, is the institution and/or Doctor requires to report the case to the ACHD? Any insight you can provide that would make me better understand the County's role is appreciated. Thank you, RN Ryan A. Niekamp Adams County Board, Illinois District Two Sent from my iPhone From: jcampos@co.adams.il.us Sent time: 01/24/2018 10:59:13 AM To: jledford@co.adams.il.us Subject: RE: Media Log - Legionella Thanks Jeremy, There were several others that may have only been sent by fax. I don't know if copies of those releases are available. It would be helpful to capture these in any way possible. Thanks, From: Jeremy Ledford Sent: Wednesday, January 24, 2018 10:57 AM To: Ellen Vonderheide; Jon Campos Subject: Media Log - Legionella These are the two entries in the media log regarding legionella. Will check on press releases with Emily. tblMediaLog Query Date LastName Program Topic Discussion 04/29/2016 DIETRICH Communicable LEGIONELLA CONFIRMED SINGLE CASE IN ADAMS COUNTY. PATIENT HAD Diseases VISITED IVH CAMPUS. NO DIRECT LINK TO IVH. COVERED BASICS OF LEGIONELLA, PUBLIC HEALTH ROLE IN REPORTING, SURVEILLANCE, AND RESPONSE. MediaOutlet ALL MEDIA tblMediaLog Query Date LastName Program Topic 06/29/2016 DRUMMOND Environmental LEGIONELLA - Other - WATER TREATMENT - IVH Discussion MediaOutlet DISCUSSED THE WATER MANAGEMENT TEAM AT IVH, ALL MEDIA LEGIONELLA OUTBREAK AND THE IMPLEMENTATION OF THE NEW WATER SYSTEM. DISCUSSED COLLABORATION WITH OUR COMMUNITY PARTNERS. Jeremy Ledford, BS Health Educator Public Information Officer Adams County Health Department 330 Vermont Street Quincy, IL 62301 O: (217) 222-8440 Ext 112 C: (573) 639-1278 Fax (217) 222-8460 jledford@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: Subject: Date: Layden, Jennifer E. Kauerauf, Judy; Jon Campos Re: New pos Wednesday, February 14, 2018 3:28:44 PM JonThanks for the quick update. If you could send us the lab result, that would be great. Want to clarify if labcorp or the Blessing rapid test. Also, what other testing may have been done (flu test, CXR). Thanks for looking into all the exposures. thanksjen From: Kauerauf, Judy Sent: Wednesday, February 14, 2018 3:21 PM To: jcampos@co.adams.il.us Cc: Layden, Jennifer E. Subject: New pos Was it pos from labcorp or Blessing? Sent from my iPhone State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Subject: Date: Attachments: Kauerauf, Judy Jon Campos RE: New Positive Friday, February 16, 2018 3:14:31 PM image001.png image002.jpg image003.jpg Who is it From: Jon Campos [mailto:jcampos@co.adams.il.us] Sent: Friday, February 16, 2018 3:14 PM To: Kauerauf, Judy Subject: [External] New Positive A 4th positive was just brought to my attention. Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Subject: Date: Attachments: Kauerauf, Judy Jon Campos RE: New Positive Friday, February 16, 2018 3:22:04 PM image001.png image002.jpg image003.jpg Got it. From: Jon Campos [mailto:jcampos@co.adams.il.us] Sent: Friday, February 16, 2018 3:15 PM To: Kauerauf, Judy Subject: [External] RE: New Positive From: Kauerauf, Judy [mailto:Judy.Kauerauf@Illinois.gov] Sent: Friday, February 16, 2018 3:14 PM To: Jon Campos Subject: RE: New Positive Who is it From: Jon Campos [mailto:jcampos@co.adams.il.us] Sent: Friday, February 16, 2018 3:14 PM To: Kauerauf, Judy Subject: [External] New Positive A 4th positive was just brought to my attention. Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain con?dential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is con?dential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attomey-client privilege, attorney work product privilege, or any other exemption from disclosure. From: jwelch@co.adams.il.us Sent time: 12/20/2017 05:06:09 PM To: dsantoni@senatedem.ilga.gov Cc: joshjones@co.adams.il.us Subject: RE: Quincy Veterans' Home Subject Matter Hearing We will be happy to do this. I have several questions for you though. We have never done anything of this nature, so we'd like an understanding of what it is, who is in attendance, what we should do to be prepared for the discussion. We are also curious if there is any accommodation for lodging (we are about 5 hours away) or if that is something we will need to attend to. If we do need to make that accommodation, we need to know the best place to lodge that we can access the location of this hearing. Thank you in advance. From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Tuesday, December 19, 2017 11:34 AM To: Jerrod Welch Subject: Quincy Veterans' Home Subject Matter Hearing Jerrod, My name is Dillon Santoni and I am the Veteran Affairs and Public Health Staffer for the Senate President. With the ongoing issues at the Quincy Veterans' Home, we have scheduled a hearing on the topic to discuss and track progress at the Home. It was recommended that with the participation of the Adams County Health Department, that someone knowledgeable on the subject from your Department attend the hearing. Below you will find the hearing notice sent out to the other agencies: On January 9th at 10am in the Bilandic Hearing Room in Chicago there will be a Joint House and Senate Veterans' Affairs hearing co-chaired by Senator Cullerton and Representative Chapa LaVia. It is requested that IDPH, IDVA, the Adams County Health Department, and the CDC provide testimony on the status of the Quincy Veterans' Home progress in relation to Legionnaires disease. The posting for this hearing will be going out soon. If you or someone from your office could attend it would greatly help resolve the issues at the Home. If have any questions please do not hesitate to email or call. Thanks, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: jwelch@co.adams.il.us Sent time: 12/28/2017 02:44:50 PM To: dsantoni@senatedem.ilga.gov Cc: joshjones@co.adams.il.us Subject: RE: Quincy Veterans' Home Subject Matter Hearing Hello again Dillon, I am still looking for a reply on this. Do you have any additional detail about this matter. Thank you, From: Jerrod Welch Sent: Wednesday, December 20, 2017 5:06 PM To: 'Santoni, Dillon' Cc: Josh Jones Subject: RE: Quincy Veterans' Home Subject Matter Hearing We will be happy to do this. I have several questions for you though. We have never done anything of this nature, so we'd like an understanding of what it is, who is in attendance, what we should do to be prepared for the discussion. We are also curious if there is any accommodation for lodging (we are about 5 hours away) or if that is something we will need to attend to. If we do need to make that accommodation, we need to know the best place to lodge that we can access the location of this hearing. Thank you in advance. From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Tuesday, December 19, 2017 11:34 AM To: Jerrod Welch Subject: Quincy Veterans' Home Subject Matter Hearing Jerrod, My name is Dillon Santoni and I am the Veteran Affairs and Public Health Staffer for the Senate President. With the ongoing issues at the Quincy Veterans' Home, we have scheduled a hearing on the topic to discuss and track progress at the Home. It was recommended that with the participation of the Adams County Health Department, that someone knowledgeable on the subject from your Department attend the hearing. Below you will find the hearing notice sent out to the other agencies: On January 9th at 10am in the Bilandic Hearing Room in Chicago there will be a Joint House and Senate Veterans' Affairs hearing co-chaired by Senator Cullerton and Representative Chapa LaVia. It is requested that IDPH, IDVA, the Adams County Health Department, and the CDC provide testimony on the status of the Quincy Veterans' Home progress in relation to Legionnaires disease. The posting for this hearing will be going out soon. If you or someone from your office could attend it would greatly help resolve the issues at the Home. If have any questions please do not hesitate to email or call. Thanks, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: jwelch@co.adams.il.us Sent time: 12/28/2017 02:52:06 PM To: dsantoni@senatedem.ilga.gov Cc: joshjones@co.adams.il.us Subject: RE: Quincy Veterans' Home Subject Matter Hearing Thank you. I'll look forward to hearing from you next week. -----Original Message----From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Thursday, December 28, 2017 2:50 PM To: Jerrod Welch Subject: Fwd: Quincy Veterans' Home Subject Matter Hearing Jerrod. I apologize I was out sick last week and am now on vacation. I have a response from the director below on hotel rooms. I will answer your other questions immediately upon my return. DS Begin forwarded message: From: "Locker, Becky" <>> Date: December 21, 2017 at 8:30:31 AM CST To: "Santoni, Dillon" <>> Subject: RE: Quincy Veterans' Home Subject Matter Hearing No. Not in this case since they are in IL. It looks like the Amtrak would get them into Chicago around 10:30. Depending on the agenda they might be able to swing that. If we end up with families they would go first, then a gov's office rep/agency which will surely take over 30 minutes. In terms of hotels: The Wit, Allegro, Cambria on Randolph all offer government rates and are within a few blocks from the Bilandic building. The Allegro is right across the street. From: Santoni, Dillon Sent: Thursday, December 21, 2017 6:20 AM To: Locker, Becky Subject: Fwd: Quincy Veterans' Home Subject Matter Hearing We don't provide lodging for people do we? DS Begin forwarded message: From: Jerrod Welch <>> Date: December 20, 2017 at 5:06:09 PM CST To: "Santoni, Dillon" <>> Cc: Josh Jones <>> Subject: RE: Quincy Veterans' Home Subject Matter Hearing We will be happy to do this. I have several questions for you though. We have never done anything of this nature, so we'd like an understanding of what it is, who is in attendance, what we should do to be prepared for the discussion. We are also curious if there is any accommodation for lodging (we are about 5 hours away) or if that is something we will need to attend to. If we do need to make that accommodation, we need to know the best place to lodge that we can access the location of this hearing. Thank you in advance. [cid:image001.png@01D379B4.C0A417D0] From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Tuesday, December 19, 2017 11:34 AM To: Jerrod Welch <>> Subject: Quincy Veterans' Home Subject Matter Hearing Jerrod, My name is Dillon Santoni and I am the Veteran Affairs and Public Health Staffer for the Senate President. With the ongoing issues at the Quincy Veterans' Home, we have scheduled a hearing on the topic to discuss and track progress at the Home. It was recommended that with the participation of the Adams County Health Department, that someone knowledgeable on the subject from your Department attend the hearing. Below you will find the hearing notice sent out to the other agencies: On January 9th at 10am in the Bilandic Hearing Room in Chicago there will be a Joint House and Senate Veterans' Affairs hearing co-chaired by Senator Cullerton and Representative Chapa LaVia. It is requested that IDPH, IDVA, the Adams County Health Department, and the CDC provide testimony on the status of the Quincy Veterans' Home progress in relation to Legionnaires disease. The posting for this hearing will be going out soon. If you or someone from your office could attend it would greatly help resolve the issues at the Home. If have any questions please do not hesitate to email or call. Thanks, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: jwelch@co.adams.il.us Sent time: 01/04/2018 09:42:30 AM To: dsantoni@senatedem.ilga.gov Subject: RE: Quincy Veterans' Home Subject Matter Hearing Thank you for the update. I will attempt to get this put together for you by next Monday. I appreciate your assistance in this. JCW From: Santoni, Dillon [dsantoni@senatedem.ilga.gov] Sent: Thursday, January 04, 2018 8:56 AM To: Jerrod Welch Subject: RE: Quincy Veterans' Home Subject Matter Hearing Jerrod, After speaking with the Senator, providing written testimony will be fine. In your written letter if you could outline: What the role of your department was during the response to the outbreak What the role of your department was in developing and implementing a water management program What is the procedure for the reporting of positive tests of Legionella to ACHD Prior to the first cases of LD, were there any concerns of the water treatment at the facility expressed to ACHD It was stated in the CDC report that ACHD interviewed patients with reported LD, how long after determined exposure were these interviews conducted Ultimately this is your testimony, if any of the question above are outside of your scope or irrelevant feel free to state that. This will be provided to all members of the committee to help understand all of the roles everyone had during this process and the timeline of events. If there are other things you feel are relevant to put in the testimony, please include them. Again this is not challenging anything that ACHD did during this event. If you have any questions or need guidance, please don't hesitate to ask. I know this is of short notice but I was hoping to have this around noon on Monday, January 8th. Thanks again, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, December 20, 2017 5:06 PM To: Santoni, Dillon Cc: Josh Jones Subject: RE: Quincy Veterans' Home Subject Matter Hearing We will be happy to do this. I have several questions for you though. We have never done anything of this nature, so we'd like an understanding of what it is, who is in attendance, what we should do to be prepared for the discussion. We are also curious if there is any accommodation for lodging (we are about 5 hours away) or if that is something we will need to attend to. If we do need to make that accommodation, we need to know the best place to lodge that we can access the location of this hearing. Thank you in advance. From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Tuesday, December 19, 2017 11:34 AM To: Jerrod Welch Subject: Quincy Veterans' Home Subject Matter Hearing Jerrod, My name is Dillon Santoni and I am the Veteran Affairs and Public Health Staffer for the Senate President. With the ongoing issues at the Quincy Veterans' Home, we have scheduled a hearing on the topic to discuss and track progress at the Home. It was recommended that with the participation of the Adams County Health Department, that someone knowledgeable on the subject from your Department attend the hearing. Below you will find the hearing notice sent out to the other agencies: On January 9th at 10am in the Bilandic Hearing Room in Chicago there will be a Joint House and Senate Veterans' Affairs hearing co-chaired by Senator Cullerton and Representative Chapa LaVia. It is requested that IDPH, IDVA, the Adams County Health Department, and the CDC provide testimony on the status of the Quincy Veterans' Home progress in relation to Legionnaires disease. The posting for this hearing will be going out soon. If you or someone from your office could attend it would greatly help resolve the issues at the Home. If have any questions please do not hesitate to email or call. Thanks, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: jcampos@co.adams.il.us Sent time: 01/04/2018 10:07:14 AM To: jwelch@co.adams.il.us Cc: tdede@co.adams.il.us Subject: RE: Quincy Veterans' Home Subject Matter Hearing Ok, that's great. I will see you in the morning. Jon Campos, RN Communicable Disease Coordinator Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: Jerrod Welch Sent: Thursday, January 04, 2018 10:00 AM To: Jon Campos Cc: Tony Dede Subject: FW: Quincy Veterans' Home Subject Matter Hearing Jon, Tomorrow morning, you and I need to book out several hours to put this testimony together for the Monday deadline. We will not need to travel to Chicago on Tuesday, but we will need to provide this document in lieu of that as our official testimony. Please come by first thing in the morning and we will get to work. Tony, I think you should be on standby to join us as well. Thank you both, JCW From: Jerrod Welch Sent: Thursday, January 04, 2018 9:42 AM To: Santoni, Dillon Subject: RE: Quincy Veterans' Home Subject Matter Hearing Thank you for the update. I will attempt to get this put together for you by next Monday. I appreciate your assistance in this. JCW From: Santoni, Dillon [dsantoni@senatedem.ilga.gov] Sent: Thursday, January 04, 2018 8:56 AM To: Jerrod Welch Subject: RE: Quincy Veterans' Home Subject Matter Hearing Jerrod, After speaking with the Senator, providing written testimony will be fine. In your written letter if you could outline: What the role of your department was during the response to the outbreak What the role of your department was in developing and implementing a water management program What is the procedure for the reporting of positive tests of Legionella to ACHD Prior to the first cases of LD, were there any concerns of the water treatment at the facility expressed to ACHD It was stated in the CDC report that ACHD interviewed patients with reported LD, how long after determined exposure were these interviews conducted Ultimately this is your testimony, if any of the question above are outside of your scope or irrelevant feel free to state that. This will be provided to all members of the committee to help understand all of the roles everyone had during this process and the timeline of events. If there are other things you feel are relevant to put in the testimony, please include them. Again this is not challenging anything that ACHD did during this event. If you have any questions or need guidance, please don't hesitate to ask. I know this is of short notice but I was hoping to have this around noon on Monday, January 8th. Thanks again, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, December 20, 2017 5:06 PM To: Santoni, Dillon Cc: Josh Jones Subject: RE: Quincy Veterans' Home Subject Matter Hearing We will be happy to do this. I have several questions for you though. We have never done anything of this nature, so we'd like an understanding of what it is, who is in attendance, what we should do to be prepared for the discussion. We are also curious if there is any accommodation for lodging (we are about 5 hours away) or if that is something we will need to attend to. If we do need to make that accommodation, we need to know the best place to lodge that we can access the location of this hearing. Thank you in advance. From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Tuesday, December 19, 2017 11:34 AM To: Jerrod Welch Subject: Quincy Veterans' Home Subject Matter Hearing Jerrod, My name is Dillon Santoni and I am the Veteran Affairs and Public Health Staffer for the Senate President. With the ongoing issues at the Quincy Veterans' Home, we have scheduled a hearing on the topic to discuss and track progress at the Home. It was recommended that with the participation of the Adams County Health Department, that someone knowledgeable on the subject from your Department attend the hearing. Below you will find the hearing notice sent out to the other agencies: On January 9th at 10am in the Bilandic Hearing Room in Chicago there will be a Joint House and Senate Veterans' Affairs hearing co-chaired by Senator Cullerton and Representative Chapa LaVia. It is requested that IDPH, IDVA, the Adams County Health Department, and the CDC provide testimony on the status of the Quincy Veterans' Home progress in relation to Legionnaires disease. The posting for this hearing will be going out soon. If you or someone from your office could attend it would greatly help resolve the issues at the Home. If have any questions please do not hesitate to email or call. Thanks, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: jwelch@co.adams.il.us Sent time: 01/08/2018 08:32:04 AM To: dsantoni@senatedem.ilga.gov Subject: RE: Quincy Veterans' Home Subject Matter Hearing Attachments: 01092018 Testimony.docx Hello Dillon, Here are answers to the questions posed in your email below. Thank you for coordinating this. Please let me know that you have received it. Thanks, JCW From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Thursday, January 4, 2018 8:57 AM To: Jerrod Welch Subject: RE: Quincy Veterans' Home Subject Matter Hearing Jerrod, After speaking with the Senator, providing written testimony will be fine. In your written letter if you could outline: What the role of your department was during the response to the outbreak What the role of your department was in developing and implementing a water management program What is the procedure for the reporting of positive tests of Legionella to ACHD Prior to the first cases of LD, were there any concerns of the water treatment at the facility expressed to ACHD It was stated in the CDC report that ACHD interviewed patients with reported LD, how long after determined exposure were these interviews conducted Ultimately this is your testimony, if any of the question above are outside of your scope or irrelevant feel free to state that. This will be provided to all members of the committee to help understand all of the roles everyone had during this process and the timeline of events. If there are other things you feel are relevant to put in the testimony, please include them. Again this is not challenging anything that ACHD did during this event. If you have any questions or need guidance, please don't hesitate to ask. I know this is of short notice but I was hoping to have this around noon on Monday, January 8th. Thanks again, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, December 20, 2017 5:06 PM To: Santoni, Dillon Cc: Josh Jones Subject: RE: Quincy Veterans' Home Subject Matter Hearing We will be happy to do this. I have several questions for you though. We have never done anything of this nature, so we'd like an understanding of what it is, who is in attendance, what we should do to be prepared for the discussion. We are also curious if there is any accommodation for lodging (we are about 5 hours away) or if that is something we will need to attend to. If we do need to make that accommodation, we need to know the best place to lodge that we can access the location of this hearing. Thank you in advance. From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Tuesday, December 19, 2017 11:34 AM To: Jerrod Welch Subject: Quincy Veterans' Home Subject Matter Hearing Jerrod, My name is Dillon Santoni and I am the Veteran Affairs and Public Health Staffer for the Senate President. With the ongoing issues at the Quincy Veterans' Home, we have scheduled a hearing on the topic to discuss and track progress at the Home. It was recommended that with the participation of the Adams County Health Department, that someone knowledgeable on the subject from your Department attend the hearing. Below you will find the hearing notice sent out to the other agencies: On January 9th at 10am in the Bilandic Hearing Room in Chicago there will be a Joint House and Senate Veterans' Affairs hearing co-chaired by Senator Cullerton and Representative Chapa LaVia. It is requested that IDPH, IDVA, the Adams County Health Department, and the CDC provide testimony on the status of the Quincy Veterans' Home progress in relation to Legionnaires disease. The posting for this hearing will be going out soon. If you or someone from your office could attend it would greatly help resolve the issues at the Home. If have any questions please do not hesitate to email or call. Thanks, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: jwelch@co.adams.il.us Sent time: 01/25/2018 12:46:06 PM To: dsantoni@senatedem.ilga.gov Cc: PHostert@hds.ilga.gov; rsurlina@senatedem.ilga.gov Subject: RE: Quincy Veterans' Home Subject Matter Hearing OK, I will plan to attend this hearing. I would like to know what I should do to be prepared. I am not overly comfortable in this venue, and would like to be as prepared and helpful as possible to the committee, so any details would be very appreciated. Thank you, From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Thursday, January 25, 2018 10:52 AM To: Jerrod Welch Cc: 'Hostert, Patrick' ; Surlina, Robert Subject: RE: Quincy Veterans' Home Subject Matter Hearing Jerrod, This hearing has officially been set for February 7th at 9am in Room 212 of the State house in Springfield. If you have any questions please don't hesitate to reach out. Thanks, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: Santoni, Dillon Sent: Thursday, January 18, 2018 9:03 AM To: 'Jerrod Welch' Cc: 'Hostert, Patrick'; Surlina, Robert Subject: RE: Quincy Veterans' Home Subject Matter Hearing Jerrod, There has been a change in the date for this hearing. We are going to schedule the hearing for either the 6th or 7th instead of the 1s t. I will let you know as soon as I do in regards to the exact time and location. If you have any questions, please do not hesitate to ask. Thanks DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: Santoni, Dillon Sent: Wednesday, January 17, 2018 11:17 AM To: 'Jerrod Welch' Cc: 'Hostert, Patrick'; Surlina, Robert Subject: RE: Quincy Veterans' Home Subject Matter Hearing Jerrod, Senator Cullerton and Representative Chapa LaVia have requested a joint hearing on February 1, 2018 at 9am in Springfield for follow up questions related to the Quincy Veterans Home. The chairs are requesting Adam's County to send a representative. They all received your previously written testimony and are hoping to ask follow up questions to everyone mostly on updates made since the last hearing. Can ACHD attend? DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Monday, January 08, 2018 8:32 AM To: Santoni, Dillon Subject: RE: Quincy Veterans' Home Subject Matter Hearing Hello Dillon, Here are answers to the questions posed in your email below. Thank you for coordinating this. Please let me know that you have received it. Thanks, JCW From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Thursday, January 4, 2018 8:57 AM To: Jerrod Welch Subject: RE: Quincy Veterans' Home Subject Matter Hearing Jerrod, After speaking with the Senator, providing written testimony will be fine. In your written letter if you could outline: What the role of your department was during the response to the outbreak What the role of your department was in developing and implementing a water management program What is the procedure for the reporting of positive tests of Legionella to ACHD Prior to the first cases of LD, were there any concerns of the water treatment at the facility expressed to ACHD It was stated in the CDC report that ACHD interviewed patients with reported LD, how long after determined exposure were these interviews conducted Ultimately this is your testimony, if any of the question above are outside of your scope or irrelevant feel free to state that. This will be provided to all members of the committee to help understand all of the roles everyone had during this process and the timeline of events. If there are other things you feel are relevant to put in the testimony, please include them. Again this is not challenging anything that ACHD did during this event. If you have any questions or need guidance, please don't hesitate to ask. I know this is of short notice but I was hoping to have this around noon on Monday, January 8th. Thanks again, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, December 20, 2017 5:06 PM To: Santoni, Dillon Cc: Josh Jones Subject: RE: Quincy Veterans' Home Subject Matter Hearing We will be happy to do this. I have several questions for you though. We have never done anything of this nature, so we'd like an understanding of what it is, who is in attendance, what we should do to be prepared for the discussion. We are also curious if there is any accommodation for lodging (we are about 5 hours away) or if that is something we will need to attend to. If we do need to make that accommodation, we need to know the best place to lodge that we can access the location of this hearing. Thank you in advance. From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Tuesday, December 19, 2017 11:34 AM To: Jerrod Welch Subject: Quincy Veterans' Home Subject Matter Hearing Jerrod, My name is Dillon Santoni and I am the Veteran Affairs and Public Health Staffer for the Senate President. With the ongoing issues at the Quincy Veterans' Home, we have scheduled a hearing on the topic to discuss and track progress at the Home. It was recommended that with the participation of the Adams County Health Department, that someone knowledgeable on the subject from your Department attend the hearing. Below you will find the hearing notice sent out to the other agencies: On January 9th at 10am in the Bilandic Hearing Room in Chicago there will be a Joint House and Senate Veterans' Affairs hearing co-chaired by Senator Cullerton and Representative Chapa LaVia. It is requested that IDPH, IDVA, the Adams County Health Department, and the CDC provide testimony on the status of the Quincy Veterans' Home progress in relation to Legionnaires disease. The posting for this hearing will be going out soon. If you or someone from your office could attend it would greatly help resolve the issues at the Home. If have any questions please do not hesitate to email or call. Thanks, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 21 7.558.2805 From: jwelch@co.adams.il.us Sent time: 02/01/2018 09:09:56 AM To: dsantoni@senatedem.ilga.gov Subject: RE: Quincy Veterans' Home Subject Matter Hearing Thank you Dillon, I appreciate this information and it will help me be prepared to assist the committee. Regards, JCW From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Thursday, February 1, 2018 9:02 AM To: Jerrod Welch Subject: RE: Quincy Veterans' Home Subject Matter Hearing Jerrod, Sorry for the delayed response I wanted to gather some information for you. Primarily these things tend to rehash over details already covered. So this would mean you will most likely receive questions about a local health departments roll in these matters. Additionally, there will be questions about the timeline and where ACHD began to support the efforts to manage the legionella. Finally I anticipate questions about Blessing Hospital and the testing they provided for the samples from IVHQ. These won't be technical questions, but rather questions of timing. If you don't know the answer to any question or feel as though it is not your purview, then feel free to defer to one of the Directors or just let the committee know that it's not the area you cover. You will be flanked by the DPH Director and the DVA Director with other parties providing testimony. Mainly these questions will be to the CDC, DPH, and DVA. There shouldn't be too many questions outside of the Quincy Home Legionella management. The link to the hearing time date and place is here: http://ilga.gov/senate/committees/hearing.asp?CommitteeID=2155 Again, if you have any more questions please do not hesitate to ask. Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Thursday, January 25, 2018 12:46 PM To: Santoni, Dillon Cc: 'Hostert, Patrick'; Surlina, Robert Subject: RE: Quincy Veterans' Home Subject Matter Hearing OK, I will plan to attend this hearing. I would like to know what I should do to be prepared. I am not overly comfortable in this venue, and would like to be as prepared and helpful as possible to the committee, so any details would be very appreciated. Thank you, From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Thursday, January 25, 2018 10:52 AM To: Jerrod Welch Cc: 'Hostert, Patrick' ; Surlina, Robert Subject: RE: Quincy Veterans' Home Subject Matter Hearing Jerrod, This hearing has officially been set for February 7th at 9am in Room 212 of the State house in Springfield. If you have any questions please don't hesitate to reach out. Thanks, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: Santoni, Dillon Sent: Thursday, January 18, 2018 9:03 AM To: 'Jerrod Welch' Cc: 'Hostert, Patrick'; Surlina, Robert Subject: RE: Quincy Veterans' Home Subject Matter Hearing Jerrod, There has been a change in the date for this hearing. We are going to schedule the hearing for either the 6th or 7th instead of the 1s t. I will let you know as soon as I do in regards to the exact time and location. If you have any questions, please do not hesitate to ask. Thanks DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: Santoni, Dillon Sent: Wednesday, January 17, 2018 11:17 AM To: 'Jerrod Welch' Cc: 'Hostert, Patrick'; Surlina, Robert Subject: RE: Quincy Veterans' Home Subject Matter Hearing Jerrod, Senator Cullerton and Representative Chapa LaVia have requested a joint hearing on February 1, 2018 at 9am in Springfield for follow up questions related to the Quincy Veterans Home. The chairs are requesting Adam's County to send a representative. They all received your previously written testimony and are hoping to ask follow up questions to everyone mostly on updates made since the last hearing. Can ACHD attend? DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Monday, January 08, 2018 8:32 AM To: Santoni, Dillon Subject: RE: Quincy Veterans' Home Subject Matter Hearing Hello Dillon, Here are answers to the questions posed in your email below. Thank you for coordinating this. Please let me know that you have received it. Thanks, JCW From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Thursday, January 4, 2018 8:57 AM To: Jerrod Welch Subject: RE: Quincy Veterans' Home Subject Matter Hearing Jerrod, After speaking with the Senator, providing written testimony will be fine. In your written letter if you could outline: What the role of your department was during the response to the outbreak What the role of your department was in developing and implementing a water management program What is the procedure for the reporting of positive tests of Legionella to ACHD Prior to the first cases of LD, were there any concerns of the water treatment at the facility expressed to ACHD It was stated in the CDC report that ACHD interviewed patients with reported LD, how long after determined exposure were these interviews conducted Ultimately this is your testimony, if any of the question above are outside of your scope or irrelevant feel free to state that. This will be provided to all members of the committee to help understand all of the roles everyone had during this process and the timeline of events. If there are other things you feel are relevant to put in the testimony, please include them. Again this is not challenging anything that ACHD did during this event. If you have any questions or need guidance, please don't hesitate to ask. I know this is of short notice but I was hoping to have this around noon on Monday, January 8th. Thanks again, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, December 20, 2017 5:06 PM To: Santoni, Dillon Cc: Josh Jones Subject: RE: Quincy Veterans' Home Subject Matter Hearing We will be happy to do this. I have several questions for you though. We have never done anything of this nature, so we'd like an understanding of what it is, who is in attendance, what we should do to be prepared for the discussion. We are also curious if there is any accommodation for lodging (we are about 5 hours away) or if that is something we will need to attend to. If we do need to make that accommodation, we need to know the best place to lodge that we can access the location of this hearing. Thank you in advance. From: Santoni, Dillon [mailto:dsantoni@senatedem.ilga.gov] Sent: Tuesday, December 19, 2017 11:34 AM To: Jerrod Welch Subject: Quincy Veterans' Home Subject Matter Hearing Jerrod, My name is Dillon Santoni and I am the Veteran Affairs and Public Health Staffer for the Senate President. With the ongoing issues at the Quincy Veterans' Home, we have scheduled a hearing on the topic to discuss and track progress at the Home. It was recommended that with the participation of the Adams County Health Department, that someone knowledgeable on the subject from your Department attend the hearing. Below you will find the hearing notice sent out to the other agencies: On January 9th at 10am in the Bilandic Hearing Room in Chicago there will be a Joint House and Senate Veterans' Affairs hearing co-chaired by Senator Cullerton and Representative Chapa LaVia. It is requested that IDPH, IDVA, the Adams County Health Department, and the CDC provide testimony on the status of the Quincy Veterans' Home progress in relation to Legionnaires disease. The posting for this hearing will be going out soon. If you or someone from your office could attend it would greatly help resolve the issues at the Home. If have any questions please do not hesitate to email or call. Thanks, DS Dillon Santoni Office of the Senate President Policy and Budget Staff 217.558.2805 From: jwelch@co.adams.il.us Sent time: 12/19/2017 11:26:42 AM To: joshjones@co.adams.il.us Subject: Re: Release Ok Sent from my U.S.Cellular(C) Smartphone ------ Original message-----From: Josh Jones Date: Tue, Dec 19, 2017 11:26 AM To: Jerrod Welch; Subject:Re: Release We should not refer to the FOIA request....it will lead to lots of people making FOIAs about this. JJ Sent from my iPhone On Dec 19, 2017, at 11:24 AM, Jerrod Welch wrote: In the past 48 hours we have received several inquiries with regard to recent reports from the State-run Illinois Veterans Home. The Illinois Department of Public Health and Illinois Veterans Affairs are responsible for the investigation and response to this event. When requested by these State of Illinois agencies, the Adams County Health Department has and will continue to provide assistance. However, we are reliant on and limited to the information from those agencies. Requests for information on this event should properly be referred to those agencies. Should we reference that we are currently in the process of preparing foia requests related to all public records we have compiled? JCW CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: jwelch@co.adams.il.us Sent time: 12/19/2017 11:29:03 AM To: joshjones@co.adams.il.us Subject: RE: Release As opposed to a release, could we post this on our website and facebook? From: Josh Jones Sent: Tuesday, December 19, 2017 11:26 AM To: Jerrod Welch Subject: Re: Release We should not refer to the FOIA request....it will lead to lots of people making FOIAs about this. JJ Sent from my iPhone On Dec 19, 2017, at 11:24 AM, Jerrod Welch wrote: In the past 48 hours we have received several inquiries with regard to recent reports from the State-run Illinois Veterans Home. The Illinois Department of Public Health and Illinois Veterans Affairs are responsible for the investigation and response to this event. When requested by these State of Illinois agencies, the Adams County Health Department has and will continue to provide assistance. However, we are reliant on and limited to the information from those agencies. Requests for information on this event should properly be referred to those agencies. Should we reference that we are currently in the process of preparing foia requests related to all public records we have compiled? JCW CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: Cc: Subject: Date: Attachments: Kelley, Lindsey Kauerauf, Judy; Linda.Manley@blessinghealthsystem.org Layden, Jennifer E.; Jon Campos RE: specimen type and storage Wednesday, February 14, 2018 2:37:32 PM image001.png image002.png image003.png image004.png image005.png image006.png image007.png Below is the submission form for CDC specimens. Specimen Submission Form Submitting Specimens to CDC Recommend on Facebook Tweet Twitter Facebook LinkedIn Email Digg Add this to your site Submitters sending specimens to CDC for laboratory testing should supply all pertinent information associated with the specimen(s). This information will allow the laboratory to effectively review the test order and perform the appropriate test(s). The information supplied will be included in the laboratory report. Specimens submitted for testing must be accompanied by CDC Form 50.34[PDF - 2 pages](https://www.cdc.gov/laboratory/specimen-submission/pdf/form-50-34.pdf).* Features of the form: . Pick-lists to select the correct form, order valid tests, enter accurate information . Interactive Test Directory . Easier data entry and printing using your computer . Accurate data transfer using barcodes . Download and save the form with your data . To view the latest changes to the 50.34 Form, view the major list of changes here.[PDF - 3 pages](https://www.cdc.gov/laboratory/specimen-submission/pdf/summary-CDC-50-34-formchanges.pdf) If you have any questions about the form or the submission process, check the "Help and FAQs(https://www.cdc.gov/laboratory/specimen-submission/help-faqs.html)" section or the "Training(https://www.cdc.gov/laboratory/specimen-submission/training.html)" Section to view a training webinar on the new submission form and view form specific training manuals. Troubleshooting the 50.34 Specimen Submission Form Right-click the link, select save target as... Form 50.34? Try one of these options: . Trouble downloading the CDC Right click on the "CDC Form 50.34" PDF link. From the menu, select "Save Target As..." (NOTE: Depending on your browser, the wording may be different to save the file/link). Save the file as an Adobe document . Try opening and downloading the form using another browser, such as Internet Explorer 11 . Make sure you have the latest version of Adobe Reader * Persons with disabilities experiencing problems accessing this document should contact CDCINFO by either completing the form at www.cdc.gov/cdc-info/requestform.html and use subject "508 Accommodation PR#31", or by calling 800-232-4636 (TTY number: 888-232-6348) and ask for 508 Accommodation PR#31. Get Email Updates To receive email updates about this page, enter your email address: What's this?Submit What's this? Related Links . Division of Scientific Resources (DSR)(https://www.cdc.gov/ncezid/dsr/index.html) File Formats Help: How do I view different file formats (PDF, DOC, PPT, MPEG) on this site? Adobe PDF file Lindsey King-Kelley RN PSA Illinois Veterans Home 1707 N. 12th St. Quincy, Il 62301 217-222-8641 Ext. 471 From: Kauerauf, Judy Sent: Wednesday, February 14, 2018 1:14 PM To: Kelley, Lindsey ; Linda.Manley@blessinghealthsystem.org Cc: Layden, Jennifer E. ; 'jcampos@co.adams.il.us' Subject: FW: specimen type and storage Linda and Lindsey: CDC has recommended that we obtain NP/OP swabs on all suspect cases and send them to CDC for testing for other pathogens. Please let me know if this is possible, and we can collectively review the line list. You would ship these directly to CDC as detailed below. Also, Linda: Please let me know if you have found any urine specimens on those pending test results. Let me know when is a good time to call you since we seem to be missing each other. From: Smith, Jessica (CDC/OID/NCIRD) [mailto:lyd7@cdc.gov] Sent: Wednesday, February 14, 2018 10:19 AM To: Layden, Jennifer E. ; Kauerauf, Judy Cc: Fay, Katherine (CDC/OID/NCIRD) Subject: [External] FW: specimen type and storage Specimen collection and transport instructions for NP/OP swabs for TAC. From: Kobayashi, Miwako (CDC/OID/NCIRD) Sent: Wednesday, February 14, 2018 9:47 AM To: Smith, Jessica (CDC/OID/NCIRD) Subject: specimen type and storage Types of specimens to collect and timing of collection (from SOP, see specimen collection guidelines for details) 1. Upper respiratory tract specimens (NP/OP swabs) . Specimens should be collected as soon as possible in the course of the illness and before . . . antimicrobic therapy begin. Specimens should be collected within 72 hours of symptom onset (and no later than 7 days after onset) Collect both NP and OP swabs. Place both swabs immediately into a sterile vial containing 2ml of viral transport media without antibiotics. If specimens will be examined within 48 hours after collection, keep specimen at 4?C; otherwise, store frozen at <=-70?C and ship on dry ice. 2. Lower respiratory tract specimens (sputum, tracheal aspirate, bronchoalveolar lavage fluid, pleural fluid) . Can be obtained at any time during the clinical course, but ideally prior to initiation of antimicrobial therapy . Specimens with less chance for upper airway contamination (e.g., BAL, pleural fluid, lung biopsy) are preferred Let me know if you have any questions and/or if you do decide to send samples over for TAC. Good luck! State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: jwelch@co.adams.il.us Sent time: 01/05/2018 03:21:59 PM To: avtvman14@hotmail.com Subject: RE: Testing for Legionnaires Disease Hello John, No. The majority of individuals who pass away in Adams County would not be tested. Reasons for testing while alive but ill would be per the CDC recommendations for certain individuals with pneumonia-like illness. Once someone passes, unless there is a known link to an outbreak, it would be highly unlikely that they would be tested. That said, I'd refer you to the coroner for more detail on how those determinations would be made after death. From: J Gebhardt [mailto:avtvman14@hotmail.com] Sent: Friday, January 5, 2018 11:38 AM To: Jerrod Welch Subject: Testing for Legionnaires Disease Importance: High Jerod, do all the elderly folks in Adams County folks who die, get tested to see if they died from Legionnaires Disease? John Gebhardt, Lt Col USAF Reserve Retired and Member of IL Veterans Home Advisory Council From: jwelch@co.adams.il.us Sent time: 02/02/2018 11:35:48 AM To: jfrank@co.adams.il.us Subject: RE: time stamps I would agree with that assessment right now as it seems to be more sensible in the timeframe. I think that you have pursued it enough with this information. Thank you. JCW From: John Frankenhoff Sent: Friday, February 2, 2018 11:35 AM To: Jerrod Welch Subject: RE: time stamps This text below is the source code from the email that I just now retrieved from the Barracuda Email Archiver. Right now my opinion is that the message actually arrived at 3:59 PM. I'm still reviewing, but this text is clear. Received: from emailfilter.co.adams.il.us (10.104.10.19) by Exchange10.co.adams.il.us (10.101.15.5) with Microsoft SMTP Server id 14.3.248.2; Fri, 21 Aug 2015 15:59:08 -0500 X-ASG-Debug-ID: 1440190747-092215535ed8790001-nKmEUQ Received: from smtp01.illinois.gov (smtp01.illinois.gov [163.191.142.163]) by emailfilter.co.adams.il.us with ESMTP id imFZBIGDngXm83aw for ; Fri, 21 Aug 2015 15:59:07 -0500 (CDT) X-Barracuda-Envelope-From: Whitney.Clegg@illinois.gov X-ASG-Whitelist: Sender X-Barracuda-Apparent-Source-IP: 163.191.142.163 X-ASG-Whitelist: Client Received: from IL084EX13-01.illinois.gov (unknown [10.155.72.254]) by smtp01.illinois.gov with smtp (TLS: TLSv1/SSLv3,256bits,AES256-SHA) id 39c4_2faf_3726b5a6_8a72_41c8_88e7_69125be5008d; Fri, 21 Aug 2015 15:59:00 -0500 Received: from IL084EX13-04.Illinois.gov (10.155.112.195) by IL084EX13-01.illinois.gov (10.155.112.192) with Microsoft SMTP Server (TLS) id 15.0.1076.9; Fri, 21 Aug 2015 15:58:58 -0500 Received: from IL084EX13-04.Illinois.gov ([fe80::11f:a956:ef0e:9866]) by IL084EX13-04.illinois.gov ([fe80::11f:a956:ef0e:9866%18]) with mapi id 15.00.1076.000; Fri, 21 Aug 2015 15:58:58 -0500 From: "Clegg, Whitney" To: "'jcampos@co.adams.il.us'" Subject: legionella at LTCF follow up Thread-Topic: legionella at LTCF follow up X-ASG-Orig-Subj: legionella at LTCF follow up Thread-Index: AdDcVDLkhTM9r+s1R5GJB8uq7Oa6Ig== Date: Fri, 21 Aug 2015 20:58:57 +0000 Message-ID: <3b39406172834c898038716f02d94d37@IL084EX13-04.illinois.gov> Accept-Language: en-US Content-Language: en-US X-MS-Has-Attach: X-MS-TNEF-Correlator: x-ms-exchange-transport-fromentityheader: Hosted x-originating-ip: [10.155.112.10] Content-Type: multipart/alternative; boundary="_4e755afb-615f-4a2e-833d-8a0cec663e7a_" MIME-Version: 1.0 X-Barracuda-Connect: smtp01.illinois.gov[163.191.142.163] X-Barracuda-Start-Time: 1440190747 X-Barracuda-URL: https://emailfilter.co.adams.il.us:443/cgi-mod/mark.cgi X-Virus-Scanned: by bsmtpd at co.adams.il.us X-Barracuda-BRTS-Status: 1 Return-Path: Whitney.Clegg@illinois.gov X-MS-Exchange-Organization-OriginalArrivalTime: 21 Aug 2015 20:59:08.5981 (UTC) X-MS-Exchange-Forest-ArrivalHubServer: EXCHANGE10.co.adams.il.us X-MS-Exchange-Organization-OriginalClientIPAddress: 10.104.10.19 X-MS-Exchange-Organization-OriginalServerIPAddress: 10.101.15.5 X-MS-Exchange-Organization-AuthSource: Exchange10.co.adams.il.us X-MS-Exchange-Organization-AuthAs: Anonymous X-MS-Exchange-Organization-MessageDirectionality: Incoming X-MS-Exchange-Organization-Cross-Premises-Headers-Processed: Exchange10.co.adams.il.us X-MS-Exchange-Organization-OriginalSize: 15429 X-MS-Exchange-Forest-MessageScope: 00000000-0000-0000-0000-000000000000 X-MS-Exchange-Organization-MessageScope: 00000000-0000-0000-0000-000000000000 X-MS-Exchange-Organization-HygienePolicy: Standard X-MS-Exchange-Organization-Recipient-Limit-Verified: True X-MS-Exchange-Forest-RulesExecuted: Exchange10 X-MS-Exchange-Organization-Rules-Execution-History: Allowed ACSO Copier recipients --_4e755afb-615f-4a2e-833d-8a0cec663e7a_ Content-Type: text/plain; charset="us-ascii" Content-Transfer-Encoding: quoted-printable Hi Jon, Here are some questions to review with the facility if you are able to cont= act them. Regarding facility: From: Jerrod Welch Sent: Friday, February 02, 2018 11:06 AM To: John Frankenhoff Subject: time stamps So here are the two exact emails. The one with the long name is the one that was pulled in the barracuda search when we were responding to foia requests. The other, named "time is off", is the one that Jon Campos recovered from one of the folders in his email system. They appear off by an hour, so my working theory is that we are currently in daylight savings time and thus his system is time stamping incorrectly. Other theories are that one of the two user's computers was off during the time of the email exchange. Either way, it is utterly imperitive that we are accurate on which of the two of these times is correct. Please let me know your thoughts asap. CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: jcampos@co.adams.il.us Sent time: 01/15/2018 11:29:42 AM To: tsjones@quincymedgroup.com; abarnes@quincymedgroup.com; Elizabeth.Anderson@health.mo.gov Cc: jjimenez@co.adams.il.us Subject: RE: Upcoming meeting Attachments: Meeting Agenda Qmg LAB.PDF OK Great! Here is a meeting agenda we created. Thank you for this meeting From: Jones, Tena (Lab Director) [mailto:tsjones@quincymedgroup.com] Sent: Monday, January 15, 2018 10:33 AM To: Jon Campos; Barnes, Angela; Anderson, Elizabeth Cc: Jeanne Jimenez Subject: RE: Upcoming meeting Good morning, We are scheduled in the Board Room by Administration on the 2n d floor of the Support Services building. Thanks for accommodating our request. See you tomorrow. Thanks, From: Jon Campos [mailto:jcampos@co.adams.il.us] Sent: Monday, January 15, 2018 10:06 AM To: Jones, Tena (Lab Director); Barnes, Angela; Anderson, Elizabeth Cc: Jeanne Jimenez Subject: RE: Upcoming meeting Ok Great will 3pm work? Where would you like to meet? From: Jones, Tena (Lab Director) [mailto:tsjones@quincymedgroup.com] Sent: Monday, January 15, 2018 10:05 AM To: Jon Campos; Barnes, Angela; Anderson, Elizabeth Cc: Jeanne Jimenez Subject: RE: Upcoming meeting Sure. If it would work for you, we would appreciate you coming to QMG? Thanks, From: Jon Campos [mailto:jcampos@co.adams.il.us] Sent: Monday, January 15, 2018 9:26 AM To: Jones, Tena (Lab Director); Barnes, Angela; Anderson, Elizabeth Cc: Jeanne Jimenez Subject: Upcoming meeting Would 1/16 @ 3pm at the Health Department work for everyone? Please let me know. We would gladly come to QMG if needed. Thanks, Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. Our Mission: "We believe by serving patients and community we improve lives, creating a healthier tomorrow." PRIVACY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain business confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If this e-mail was not intended for you, please notify the sender by reply e-mail that you received this in error. Destroy all copies of the original message and attachments. From: To: Subject: Date: Powell, Betsey Jerrod Welch RE: Visit with Blessing-2017 Thursday, February 8, 2018 6:59:45 AM I found it late last night. J July 27, 2016 Thank you. Betsey From: Jerrod Welch [mailto:jwelch@co.adams.il.us] Sent: Wednesday, February 7, 2018 8:59 PM To: Powell, Betsey Subject: RE: Visit with Blessing-2017 sorry to get back with you so late. I believe that meeting was in July or August 2016, but I don't know that for sure. I'd say this info is late in coming anyway, but I thought i'd try to look and get back with you anyway. From: Powell, Betsey [Betsey.Powell@blessinghealthsystem.org] Sent: Tuesday, February 06, 2018 2:04 PM To: Jerrod Welch Subject: Visit with Blessing-2017 Hi Jerrod, I am working on a timeframe for Maureen and Elliot and I am trying to track down the specific date that Dr. Shah and Erica Jeffries visited with Maureen and Elliot in early 2017 by chance that Dr. Shah has referenced? Betsey Powell | Executive Assistant Blessing Hospital 1005 Broadway Street | PO Box 7005 Quincy, IL | 62305-7005 P | 217-223-8400, ext. 6802 F | 217-223-6891 Betsey.Powell@blessinghealthsystem.org Assistant to: Maureen A. Kahn | President/CEO Elliot H. Kuida | Executive Vice President/COO Timothy A. Moore | VP of Finance Services/CAO The information contained in this e-mail message is PRIVILEGED AND CONFIDENTIAL and is intended for the use of the addressee and no one else. If you are not the intended recipient, please do not read, distribute, reproduce or use this e-mail message (or the attachments). Please delete the original and notify the sender of the mistaken transmission. Thank you. The information contained in this e-mail message is PRIVILEGED AND CONFIDENTIAL and is intended for the use of the addressee and no one else. If you are not the intended recipient, please do not read, distribute, reproduce or use this e-mail message (or the attachments). Please delete the original and notify the sender of the mistaken transmission. Thank you. From: To: Subject: Date: Jerrod Welch Powell, Betsey RE: Visit with Blessing-2017 Wednesday, February 7, 2018 8:59:04 PM sorry to get back with you so late. I believe that meeting was in July or August 2016, but I don't know that for sure. I'd say this info is late in coming anyway, but I thought i'd try to look and get back with you anyway. From: Powell, Betsey [Betsey.Powell@blessinghealthsystem.org] Sent: Tuesday, February 06, 2018 2:04 PM To: Jerrod Welch Subject: Visit with Blessing-2017 Hi Jerrod, I am working on a timeframe for Maureen and Elliot and I am trying to track down the specific date that Dr. Shah and Erica Jeffries visited with Maureen and Elliot in early 2017 by chance that Dr. Shah has referenced? Betsey Powell | Executive Assistant Blessing Hospital 1005 Broadway Street | PO Box 7005 Quincy, IL | 62305-7005 P | 217-223-8400, ext. 6802 F | 217-223-6891 Betsey.Powell@blessinghealthsystem.org Assistant to: Maureen A. Kahn | President/CEO Elliot H. Kuida | Executive Vice President/COO Timothy A. Moore | VP of Finance Services/CAO The information contained in this e-mail message is PRIVILEGED AND CONFIDENTIAL and is intended for the use of the addressee and no one else. If you are not the intended recipient, please do not read, distribute, reproduce or use this e-mail message (or the attachments). Please delete the original and notify the sender of the mistaken transmission. Thank you. From: To: Subject: Date: CLIFFORD, DAVE Cook, David; Mattingly, Lisa; TRAUTVETTER, CARLA; Bainter, Bill; Jon Campos; Culbertson, Troy D.; Tony Dede; Detmer, Marty; DeWitt, Justin; Diehl, Gwen; Eddington, Matt P.; Kelley, Lindsey; Kimble, Carl; MacGibbon, Chris; Martin, Aaron; McCann, Ken; McMillan, Dave; Perrine, Holly; WHITCOMB, DAWN; Wilson, Mike A; Winnicki, Lenard F.; Wright, Ron RE: Water Quality Working Group Meeting Friday, February 9, 2018 1:07:55 PM Thank you David! _____________________________________________ From: Cook, David Sent: Friday, February 9, 2018 7:57 AM To: Mattingly, Lisa ; TRAUTVETTER, CARLA ; Bainter, Bill ; Campos, Jon ; CLIFFORD, DAVE ; Culbertson, Troy D. ; Dede, Tony ; Detmer, Marty ; DeWitt, Justin ; Diehl, Gwen ; Eddington, Matt P. ; Kelley, Lindsey ; Kimble, Carl ; MacGibbon, Chris ; Martin, Aaron ; McCann, Ken ; McMillan, Dave ; Perrine, Holly ; WHITCOMB, DAWN ; Wilson, Mike A ; Winnicki, Lenard F. ; Wright, Ron Subject: RE: Water Quality Working Group Meeting Attached are two articles on copper-silver ionization. << File: Copper Silver water research.pdf >> << File: Negative Effects of High pH Legionella.pdf >> David Cook, P.E. Acting Manager, Permit Section Division of Public Water Supplies 217/782-0078 David.Cook@Illinois.gov << OLE Object: Picture (Device Independent Bitmap) >> << OLE Object: Picture (Device Independent Bitmap) >> << OLE Object: Picture (Device Independent Bitmap) >> << OLE Object: Picture (Device Independent Bitmap) >> State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: jwelch@co.adams.il.us Sent time: 12/19/2017 11:23:58 AM To: joshjones@co.adams.il.us Subject: Release In the past 48 hours we have received several inquiries with regard to recent reports from the State-run Illinois Veterans Home. The Illinois Department of Public Health and Illinois Veterans Affairs are responsible for the investigation and response to this event. When requested by these State of Illinois agencies, the Adams County Health Department has and will continue to provide assistance. However, we are reliant on and limited to the information from those agencies. Requests for information on this event should properly be referred to those agencies. Should we reference that we are currently in the process of preparing foia requests related to all public records we have compiled? JCW CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: Cc: Subject: Date: Kelley, Lindsey Kauerauf, Judy; Layden, Jennifer E.; Jon Campos Trusewych, Zorian; Culbertson, Troy D. Sputum Friday, February 16, 2018 10:14:34 PM I have been informed that staff was able to get a sputum specimen while giving the member a nebulizer treatment. We have it in the freezer. Thanks, Lindsey From: Kauerauf, Judy Sent: Friday, February 16, 2018 5:38 PM To: Kelley, Lindsey Subject: RE: Copy of Legionella Tracking-2-18-1.xlsx Please freeze it if you can, and let me know. I may drive to pick it up myself. 217-415-8280 From: Kauerauf, Judy Sent: Friday, February 16, 2018 5:36 PM To: Kelley, Lindsey Subject: RE: Copy of Legionella Tracking-2-18-1.xlsx No, we need a lower respiratory sputum. It is critical to confirming the diagnosis and linking it to the environmental testing. If possible to get it today, that would be great. From: Kelley, Lindsey Sent: Friday, February 16, 2018 4:07 PM To: Kauerauf, Judy Subject: RE: Copy of Legionella Tracking-2-18-1.xlsx Dr. Trusewcyh got a NP/OP on him...can it be run for a PCR or do we need something else. Lindsey King-Kelley RN PSA Illinois Veterans Home 1707 N. 12th St. Quincy, Il 62301 217-222-8641 Ext. 471 From: Kauerauf, Judy Sent: Friday, February 16, 2018 4:03 PM To: Kelley, Lindsey Subject: RE: Copy of Legionella Tracking-2-18-1.xlsx We really need a sputum on him; can you work with your respiratory therapist for this? From: Kelley, Lindsey Sent: Friday, February 16, 2018 3:12 PM To: Kauerauf, Judy Subject: RE: Copy of Legionella Tracking-2-18-1.xlsx Yes. We have another positive UAT. Lindsey King-Kelley RN PSA Illinois Veterans Home 1707 N. 12th St. Quincy, Il 62301 217-222-8641 Ext. 471 From: Kauerauf, Judy Sent: Friday, February 16, 2018 3:10 PM To: Kelley, Lindsey Subject: RE: Copy of Legionella Tracking-2-18-1.xlsx Are you doing rapid flu testing? From: Kelley, Lindsey Sent: Friday, February 16, 2018 3:09 PM To: Kauerauf, Judy Subject: Copy of Legionella Tracking-2-18-1.xlsx Refer to the spreadsheet for Np/op swabs sent. State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: jwelch@co.adams.il.us Sent time: 12/19/2017 04:09:06 PM To: joshjones@co.adams.il.us Subject: statement on PHI for redaction Please review and approve The 5 attached pdf documents are the requested line lists. In summary, they are the 2015 CDC Line List, the 2015 IVH Line List, the 2016 IVH Line List, the October 2017 IVH Line List, and the November 2017 IVH Line List. As you will see, these were detailed documents tracking individual case data. We have attempted to thoroughly review the documents for any Protected Health Information, and we have redacted names, personal addresses, individual identifier numbers, and individual room numbers. We believe that all Protected Health Information and personal identifiers have been redacted. However, if we have made an error on this effort, we respectfully request that you do not release any personal identifiers and notify us immediately, permanently delete the files containing such data and request a redacted version. We consider these 5 documents to fulfill the first portion of your FOIA Request for "CDC Line List". We are diligently working to fulfill a broader request as specified in your email below. CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: Subject: Date: Importance: J Gebhardt Jerrod Welch Testing for Legionnaires Disease Friday, January 5, 2018 11:37:39 AM High Jerod, do all the elderly folks in Adams County folks who die, get tested to see if they died from Legionnaires Disease? John Gebhardt, Lt Col USAF Reserve Retired and Member of IL Veterans Home Advisory Council From: jwelch@co.adams.il.us Sent time: 02/02/2018 11:05:36 AM To: jfrank@co.adams.il.us Subject: time stamps Attachments: 2015_8_21_Clegg, Whitney_Whitney.Clegg@illinois.gov__legionella at LTCF....pdf time is off.pdf So here are the two exact emails. The one with the long name is the one that was pulled in the barracuda search when we were responding to foia requests. The other, named "time is off", is the one that Jon Campos recovered from one of the folders in his email system. They appear off by an hour, so my working theory is that we are currently in daylight savings time and thus his system is time stamping incorrectly. Other theories are that one of the two user's computers was off during the time of the email exchange. Either way, it is utterly imperitive that we are accurate on which of the two of these times is correct. Please let me know your thoughts asap. CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: Subject: Date: Attachments: Jon Campos "Kauerauf, Judy" Update Thursday, February 15, 2018 11:21:00 AM image001.png image002.jpg image003.jpg I have an update on case #3. Give me a call anytime today. Also let me know if I can assist on campus. Thanks, Jon Campos, RN Infectious Disease Supervisor Adams County Health Department 330 Vermont Street Quincy, IL 62301 Phone (217) 222-8440 Ext 163 Fax (217) 222-8460 jcampos@co.adams.il.us CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: Subject: Date: Powell, Betsey Jerrod Welch Visit with Blessing-2017 Tuesday, February 6, 2018 2:04:26 PM Hi Jerrod, I am working on a timeframe for Maureen and Elliot and I am trying to track down the specific date that Dr. Shah and Erica Jeffries visited with Maureen and Elliot in early 2017 by chance that Dr. Shah has referenced? Betsey Powell | Executive Assistant Blessing Hospital 1005 Broadway Street | PO Box 7005 Quincy, IL | 62305-7005 P | 217-223-8400, ext. 6802 F | 217-223-6891 Betsey.Powell@blessinghealthsystem.org Assistant to: Maureen A. Kahn | President/CEO Elliot H. Kuida | Executive Vice President/COO Timothy A. Moore | VP of Finance Services/CAO The information contained in this e-mail message is PRIVILEGED AND CONFIDENTIAL and is intended for the use of the addressee and no one else. If you are not the intended recipient, please do not read, distribute, reproduce or use this e-mail message (or the attachments). Please delete the original and notify the sender of the mistaken transmission. Thank you. From: To: Subject: Date: Attachments: Jerrod Welch "erica.l.jeffries@illinois.gov" Water Management Task Force Friday, February 9, 2018 10:23:00 AM image001.png Dear Director, I am in receipt of your letter dated February 2, 2018 containing invitation to serve on the Water Management Task Force. This email is confirming acceptance of invitation to this Task Force. Kindest Regards, CONFIDENTIALITY STATEMENT: The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipients named above. The documents accompanying this transmission may contain confidential health information that is legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulations and is required to destroy the information after its stated need has been fulfilled. If the reader of this message is not the intended recipient, you are hereby notified that you have received this document in error and that any review, dissemination, distribution or copying of this message is strictly prohibited. If you have received this e-mail in error, please notify us and delete the original message. Thank you. From: To: Subject: CARLA.TRAUTVETTER@illinois.gov on behalf of Culbertson, Troy D. Winnicki, Lenard F.; Diehl, Gwen; Kelley, Lindsey; WHITCOMB, DAWN; Eddington, Matt P.; DeWitt, Justin; Martin, Aaron; McCann, Ken; McMillan, Dave; Cook, David; MacGibbon, Chris; Wright, Ron; Wilson, Mike A; Mattingly, Lisa; Kimble, Carl; Jon Campos; Tony Dede; wkbainter@yahoo.com; mdetmer@phigenics.com Water Management Working Group Initial Meeting Water quality work group members: Thank you for your willingness to participate in these water quality work groups created by the Director. This is an opportunity to explore all possibilities for the improvement and enhancement of the water quality initiatives on the Veterans Home campus in Quincy. We appreciate the opportunity to work with fellow administrators and agency experts. Recognizing that this is a very large group, we want to be responsive to your schedules and prior work commitments. We would like to hold our initial meeting at 3 pm tomorrow, January 31, 2018. We will briefly discuss optimal meeting schedules at tomorrow's meeting or you may send an email to Carla if unable to attend. My contact information is below if you have any questions, or refer to Carla as she will be the communication liaison for this task force going forward. Again, we thank you for your willingness to serve and the opportunity to consider best practices as we work to continue our improvements in water quality management. Regards, Dave Clifford Chief Engineer Illinois Veterans Home at Quincy 1707 N. 12th Street Quincy, IL 62301 217-222-8641 ext. 201 dave.clifford@illinois.gov Carla Trautvetter Administration Office Illinois Veterans Home at Quincy 1707 N. 12th Street Quincy, IL 62301 217-222-8641 ext. 203 carla.trautvetter@illinois.gov State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Subject: Date: Attachments: TRAUTVETTER, CARLA Bainter, Bill; Jon Campos; CLIFFORD, DAVE; Cook, David; Culbertson, Troy D.; Tony Dede; Detmer, Marty; DeWitt, Justin; Diehl, Gwen; Eddington, Matt P.; Kelley, Lindsey; Kimble, Carl; MacGibbon, Chris; Martin, Aaron; Mattingly, Lisa; McCann, Ken; McMillan, Dave; WHITCOMB, DAWN; Wilson, Mike A; Winnicki, Lenard F.; Wright, Ron Water Quality Work Group Meeting Agenda for 1-31-18 @ 3:00 p.m. Wednesday, January 31, 2018 1:39:52 PM Water Quality Work Group agenda 1-31-18.docx Carla Trautvetter Administration Office Illinois Veterans Home at Quincy 1707 N. 12th Street Quincy, IL 62301 217-222-8641 ext. 203 State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure. From: To: Subject: Crystal.Womack@illinois.gov on behalf of Jeffries, Erica L Winnicki, Lenard F.; Diehl, Gwen; Culbertson, Troy D.; CLIFFORD, DAVE; Robertson, Lester E.; Whitmer, Sherri L; Simmons, Angela D.; WHITCOMB, DAWN; Eddington, Matt P.; Marty Detmer; Kelley, Lindsey; DeWitt, Justin; Martin, Aaron; McCann, Ken; McMillan, Dave; Cook, David; Togarepi, Julia; Miller, Shelly R.; Williams, Laurie A.; McLaughlin, Bill; Sawyer, Harry; Brown, Renysha Y; Murphy, Eric M; Womack, Crystal L; wkbainter@yahoo.com; Jon Campos; Tony Dede Working Group Meeting (Water Management / Infrastructure Investment) State of Illinois - CONFIDENTIALITY NOTICE: The information contained in this communication is confidential, may be attorney-client privileged or attorney work product, may constitute inside information or internal deliberative staff communication, and is intended only for the use of the addressee. Unauthorized use, disclosure or copying of this communication or any part thereof is strictly prohibited and may be unlawful. If you have received this communication in error, please notify the sender immediately by return e-mail and destroy this communication and all copies thereof, including all attachments. Receipt by an unintended recipient does not waive attorney-client privilege, attorney work product privilege, or any other exemption from disclosure.