DAVENPORT, Iowa --- Norovirus is a group of viruses sometimes called Norwalk-like virus.
An Iowa law that allows public health officials to keep secret the name of a business involved in a disease investigation puts business interests before public safety, say citizens who were sickened in March by a suspected norovirus outbreak after visiting an eastern Iowa swim facility.
Johnson County and state health officials won’t release the name of the facility despite dozens being sickened, citing state law that shields businesses that have cleaned up their act after an outbreak. They also believe there is no ongoing public health risk.
“I just wish the name would be out there, so others could know about this happening at a family attraction,” said Courtney Evans of Blue Grass, Iowa. Evans’ two young boys and her husband fell ill from norovirus after a visit to the swim facility.
The Quad-City Times and The Gazette of Cedar Rapids jointly filed a complaint with the Iowa Office of Citizens’ Aide about the health department’s refusal to release the name of the swim facility or provide key details about the investigation, such as dates of when people got sick. The Citizens’ Aide ruled public health officials followed the law.
“The problem is that I have to obey the law,” said State Epidemiologist Patricia Quinlisk. “If people feel that is incorrect, they have to talk with their legislators (about changing the law).”
Some Iowa legislators say the current law might go too far.
“We have a duty to inform the public that this has occurred and that it’s been remedied,” said Rep. Rick Olson, D-Des Moines. “I want to keep my kids healthy.”
Rep. Vicki Lensing, D-Iowa City, said the public needs accurate information from the health department, not speculation. “It would seem like after an investigation is concluded that information could be released,” she said.
Little information about outbreak
Records obtained by the Quad-City Times and the Gazette through an Open Records request with the Johnson County Public Health Department indicate more than 30 people contracted norovirus after visiting the swim facility in March. Johnson County, which handled the facility investigation, inspects pools in Johnson, Iowa, Louisa and Muscatine counties.
“Early this morning, all family members began vomiting and have experienced diarrhea,” states a Johnson County record-of-contact form. The complainant “contacted the family members they traveled with, and all are experiencing the same symptoms.”
“…the complainant believes that illnesses derived from exposure to pool water. The two individuals that did not enter the pool water have not become sick,” the report shows.
According to the records, which include handwritten notes, reports and emails, chemical tests leading up to the outbreak showed the pools had little or no chlorine, which kills pathogens that can cause disease. Pool management told officials a chlorine feeder was plugged.
“It seems plausible, but it (chlorine level) should have been monitored,” Johnson County Public Health Director Doug Beardsley told The Gazette. The facility’s chemistry tests, required every four hours of operation, showed the lack of chlorine, but staff did nothing to rectify the problem, he said.
Health department officials did not force closure of the swimming facility, Beardsley said, because the investigation occurred after the threat of illness had passed and the chemical levels had been restored.
Beardsley and Quinlisk won’t say whether they definitively concluded the norovirus was spread through the water. The corrective action letter, with date whited out by the health department, included remedies related only to the pool area.
Johnson County officials required the pool to raise chlorine levels to 3.5 parts per million — a safe level for swimming — and hold it for 24 hours. Staff members also were ordered to clean and sanitize all surfaces as well as backwash and clean filters.
The facility was required to submit daily operational records to the health department through May 1 and now is sending a weekly summary, Beardsley said.
Businesses shielded by state code
Iowa Code Section 139A.3 states “information contained in the report may be reported in public health records in a manner which prevents the identification of any person or business named in the report.” This means public health officials can tell the public about the outbreak only in a generic way that doesn’t identify the business.
The law does allow Quinlisk or the director of the state health department to release the name of a business or infected person if there is a public health risk associated with keeping that information private.
In 2002, public health officials released the name and a photo of a Cedar Rapids man who died of rabies because they wanted his friends and associates to get vaccinated against the disease.
Before Quinlisk decides to keep investigation details secret she asks herself one question: Would she take her own child to the facility?
In this case, the answer was yes, she said.
Public wants to know
Victims say the information should be public.
Stephanie Weaver, her two young sons and other family members were stricken with diarrhea and vomiting after visiting the swim facility March 24.
“Overall, our family had a great weekend getaway and really enjoyed the facility,” said Weaver, 35, of Grinnell. “Unfortunately, the experience was tarnished with the possibility that our family’s illness may have been caused by the water.”
“The name (of the business) should be public,” Weaver added.
“This did not need to happen,” said Kevin Lake of DeWitt, Iowa. Lake, his wife, and two young daughters were also sickened by norovirus after they left the business. Aftercare included several doctor’s visits and missed days of school and work.
Lake said he’d have been a whole lot happier if the business had chosen to close the pool in the first place. “When you are in customer service, like that business is, just don’t open the pool if it’s not safe,” he said.
Concealing the business name “hurts an individual’s ability to protect himself from a disease,” said Roxanne Conlin, a Des Moines attorney who represented a couple who got norovirus on their 2006 wedding day from contaminated food they had eaten the night before.
Olson, a state representative and an attorney, said it might hurt a business more not to be public because hearsay can be more damaging than an accurate report about the outbreak and cleanup.
“Maybe we need to make a rule change for facilities that are open to the public,” Olson said. “I would support one (a change).”
Other states provide information
Not every state gives businesses the same protection as individuals when it comes to disease reports. Minnesota, for example, only keeps the health records of individuals private, not businesses.
“If we have an outbreak at Joe’s Diner, that’s public,” said Richard Danila, deputy Minnesota epidemiologist.
The Illinois Department of Public Health has a policy to keep confidential the name of a business involved in a disease investigation, but the information can be obtained through open records requests after the investigation is concluded, said Department spokeswoman Melaney Arnold.
Illinois officials named the Belleville city pool where a 2010 cryptosporidium outbreak occurred because they didn’t want people with the disease to swim in other pools. Crypto is resistant to normal levels of chlorine, unlike norovirus, which can’t live in pools with proper chemistry.
“It’s not an exact science, which is maybe why it’s just an internal policy here,” Arnold said about the release of business names.
Quinlisk didn’t write Iowa’s law shielding businesses from exposure after an outbreak — the law was enacted before she came to Iowa in the mid-1990s. But she’s glad it gives her an exception to make names public if there’s an ongoing health risk.
“I’m not here as a business person or an economics person,” she said. “I’m here for the health of Iowans.”