Potential Association of Legionnaires’ Disease with Hot Spring Water,Hot Springs National Park and Hot Springs,Arkansas, USA, 2018–2019 |
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| Authors: | Allison E. James Kurt Kesteloot J. Terry Paul Richard L. McMullen Shirley Louie Catherine Waters Jennifer Dillaha Joel Tumlison Dirk T. Haselow Jessica C. Smith Sooji Lee Troy Ritter Claressa Lucas Jasen Kunz Laura A. Miller Maria Said |
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| Affiliation: | Centers for Disease Control and Prevention, Atlanta, Georgia, USA (A.E. James, J.C. Smith, S. Lee, T. Ritter, C. Lucas, J. Kunz);US Public Health Service, Rockville, Maryland, USA (K. Kesteloot, T. Ritter, M. Said);US National Park Service, Washington, DC, USA (K. Kesteloot, L.A. Miller, M. Said);Arkansas Department of Health, Little Rock, Arkansas, USA (J.T. Paul, R.L. McMullen, S. Louie, C. Waters, J. Dillaha, J. Tumlison, D.T. Haselow) |
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| 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. |
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| Keywords: | Legionnaires’ disease, Legionella, environmental health, Legionellosis, hot springs, Hot Springs National Park, Arkansas, United States, bacteria |
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