What is the risk of spa hot tubs?: Legionnaires’ disease


Officials from California's Contra Costa County Health Department closed the spa on Friday after a second death was reported

Two patrons of a spa in Northern California died of Legionnaires’ disease that health officials said was lurking in a spa.

The legionella bacteria is believed to have contaminated a Jacuzzi that the Zen Day Spa in Richmond was not supposed to have in the first place.

County health officials launched an investigation last Thursday afternoon and Friday morning into the deaths linked to the bacteria that causes Legionnaires’ disease, a serious lung infection, which thrives in moist freshwater environments and can become airborne.

Contra Costa County officials also learned that a third person had fallen ill with the bacterial infection after visiting the Bay Area spa, which has closed, though that person is said to have recovered.

Legionnaires’ disease isn’t always fatal — it’s estimated that about 10 percent of patients die — but older people and those in poor health are particularly susceptible, especially if they don’t start a course of antibiotics early.

Officials from California’s Contra Costa County Health Department closed the spa on Friday after a second death was reported

County officials await the results of lab-tested samples of jacuzzi water to confirm it was contaminated with Legionella

County officials await the results of lab-tested samples of jacuzzi water to confirm it was contaminated with Legionella

A warm pool in a humid day spa is an excellent environment for legionella bacteria to multiply and become aerosolized, meaning droplets have the opportunity to spread through the air where they can be inhaled by unsuspecting swimmers.

County health officials closed down the spa, which did not appear to have any form of permit allowing it to have a pool or Jacuzzi.

According to Contra Costa officials, “CCH’s (Contra Costa Health’s) environmental and health inspectors conducted an assessment of the facility and found no existing records indicating that the company has ever been licensed for a spa or swimming pool.”

The two people who died last week would have visited the spa just days earlier, which would follow with the Legionnaires’ disease progression. The incubation period — or the time between when a person is exposed to a disease-causing pathogen and when they begin to notice symptoms.

It is not clear whether the two people were in good health. Smokers are particularly susceptible to lung infections, including Legionnaires’ disease, as are those with weakened immune systems and older adults over 50.

The incubation period for Legionnaires’ disease ranges from two days to two weeks, meaning the bacteria can live in a person’s body for at least a day or two before they begin to feel unwell. The symptoms can vary in severity, but are very similar to a classic case of pneumonia.

Within the first 10 days of exposure, a person may experience a high fever, chills, muscle aches, fatigue, and headache, as well as symptoms more suggestive of lung infections such as cough, shortness of breath, and chest pain.

Early detection of illness and prompt antibiotic prescription is crucial to avoid the worst possible consequences: being put on a ventilator due to respiratory failure or death from pneumonia.

A warm pool in a day spa is an excellent environment for legionella bacteria to multiply and become aerosolized, where they can be inhaled by unsuspecting swimmers

A warm pool in a day spa is an excellent environment for legionella bacteria to multiply and become aerosolized, where they can be inhaled by unsuspecting swimmers

Legionella can not only lead to lung failure, but can also lead to acute renal and multi-organ failure, as well as neurological damage and sepsis.

Legionnaires’ disease can’t be passed from person to person in the same way as flu and Covid, but once droplets of bacteria disintegrate into airborne mist, anyone who breathes is vulnerable to infection.

Contra Costa’s health department took samples from the incriminating jacuzzi to confirm conclusively in lab tests that the water was loaded with disease-causing bacteria. If officials’ suspicions are correct, that would mean hundreds, if not more, patrons could be exposed.

They said: ‘CCH encourages anyone who has recently visited Zen Day Spa to watch for Legionnaires’ disease symptoms. If they experience symptoms such as shortness of breath, fever, chills and cough, they should seek immediate medical attention.”

Officials are also urging healthcare providers in the area to test their sick patients for legionella if they have been to the spa in the last two weeks after their illness.