FLINT, MI - A legionella outbreak may have played a role in more than the 12 deaths the state originally reported, an infectious disease specialist testified in court today.
Dr. Marcus Zervos - the head of Henry Ford Hospital's Infectious Diseases division and co-principal investigator of Wayne State University's study of Flint's water contamination crisis -- took the witness stand during the first day of testimony in the preliminary exam of Michigan Department of Health and Human Services Director Nick Lyon on Thursday, Sept. 21.
Before Genesee District Judge David J. Goggins' packed courtroom, Zervos explained that according to the state's public health criteria, Legionnaires' must only be listed as a cause of death of a person if they die from contracting the bacteria during hospitalization or 30 days after being discharged.
For example, Zervos said, if a patient contracted legionella bacteria while in a hospital, but died six months later after the bacteria weakened their heart, their cause of death - by public health definition - would be "heart failure," but could be considered by disease specialists to be precipitated by legionella.
Legionnaires' disease is a potentially fatal type of pneumonia or lung infection, according to the Centers for Disease Control and Prevention. About one in every 10 cases of the disease proves to be fatal, but the mortality rate can rise to over 50 percent in patients with compromised immune systems, Zervos said.
"That's why I say it's likely more than 12 actually died from the outbreak," Zervos said.
Zervos' testimony may provide insight into why prosecutors have charged Lyon and four others with the involuntary manslaughter of 85-year-old Robert Skidmore, a Genesee Township man whose death certificate says he died of congestive heart failure.
Neither Legionnaires' disease nor legionella is listed on the county's record of Skidmore's death.
A spike in legionella bacteria in Flint's water was seen as early as June 2014, prosecutors showed on charts in court, two months after Flint switched its water source from Detroit water to the more-corrosive Flint River water.
Zervos said that in his professional opinion and in "common sense," he believes the water switch was linked to the legionella outbreak.
He noted that warm weather and low chlorine levels can allow the bacteria to flourish in the water, testifying that at the time of the outbreak, the chlorine level of Flint's water was zero.
Zervos said that he previously brought his study showing an outbreak of legionella bacteria to a meeting with Lyon and other MDHHS officials.
"I said, 'If we didn't get started soon, people would lose their lives,'" Zervos testified.
"And what did Mr. Lyon say?" asked Special Prosecutor Todd Flood.
"He said that, 'People were going to die of something,'" Zervos testified, saying the director's response upset him.
The infectious disease specialist testified that the MDHHS "could have done something," such as alerting the public and cautioning against water usage, as soon as legionella data from the first two weeks of June 2014 was made available.
"If there is a single hospital-related (legionella) case, the health department's got to be all over it," Zervos said.
Instead, he said that some of the measures to save lives were taken, and some were not.
Just last month, a new study by professors and students at Virginia Tech University concluded that the use of the river for drinking water was "a likely trigger contributing to the increase in Legionnaires' disease incidence" here.
In addition to involuntary manslaughter, Lyon is also accused of misconduct in office, which prosecutors will work to prove during the case's preliminary exam.
Lyon is the highest-ranking state employee to face criminal charges for his role in the water crisis and represents the first time a Snyder cabinet member has been charged.
Two former emergency managers, current and former employees of the state Department of Environmental Quality and DHHS, and city employees are among 15 individuals charged in Attorney General Bill Schuette's investigation of the water crisis to date.
Testimony - beginning with the cross-examination of Zervos by Lyon's defense - in the case is scheduled to continue at 9:30 a.m. on Friday, Sept. 22.