James AE, Kesteloot K, Paul JT, McMullen RL, Louie S, Waters C, Dillaha J, Tumlison J, Haselow DT, Smith JC, Lee S, Ritter T, Lucas C, Kunz J, Miller LA, Said M. Potential Association of Legionnaires' Disease with Hot Spring Water,
Hot Springs National Park and Hot Springs, Arkansas, USA, 2018-2019.
Emerg Infect Dis 2022;
28:44-50. [PMID:
34932451 PMCID:
PMC8714197 DOI:
10.3201/eid2801.211090]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Legionella pneumophila is the cause of Legionnaires' disease, a life-threatening pneumonia that occurs after inhalation of aerosolized water containing the bacteria. Legionella growth occurs in stagnant, warm-to-hot water (77°F-113°F) that is inadequately disinfected. Piped hot spring water in Hot Springs National Park, Arkansas, USA, has naturally high temperatures (>135°F) that prevent Legionella growth, and Legionnaires' disease has not previously been associated with the park or other hot springs in the United States. During 2018-2019, Legionnaires' disease occurred in 5 persons after they visited the park; 3 of these persons were potentially exposed in spa facilities that used untreated hot spring water. Environmental testing revealed Legionella bacteria in piped spring water, including 134°F stagnant pipe water. These findings underscore the importance of water management programs to reduce Legionella growth in plumbing through control activities such as maintaining hot water temperatures, reducing stored water age, and ensuring adequate water flow.
Collapse