Hot Springs Legionnaires outbreaks at bathhouse, senior apartment

There are two unrelated Legionnaires’ disease outbreaks in Hot Springs, Arkansas: one at a senior apartment complex, and the other at a historic bathhouse.

The Arkansas Department of Health (ADH) informed tenants of Garland Towers & Garden Apartments that two residents were sickened with Legionnaires’ disease, the Hot Springs Sentinel-Record reported. Health department protocols call for public notification after two or more LD cases are reported at the same address within a three-month period.

Meanwhile, building owners on Bathhouse Row in Hot Springs National Park were advised to forbid the use of showers connected to thermal water sources after Legionella were detected in October at Quapaw Baths & Spa. The decision was made after three LD illnesses were confirmed in out-of-town visitors, one of whom died.

Legionnaires’ disease is a serious respiratory illness that is contracted by inhaling microscopic, aerosolized water droplets (vapor or mist) contaminated with Legionella bacteria.

Hot Springs Legionnaires outbreaks: Legionella present

Dr. Jennifer Dillaha, the ADH’s medical director for immunizations, said the apartment complex cases were reported to the ADH by health-care professionals who treated the tenants.

The Garland Towers & Garden Apartments (126 Oriole Street) is a low-income housing apartment for seniors that is subsidized by the U.S. Department of Housing and Urban Development (HUD).

A public records request by the Sentinel-Record uncovered preliminary test results from the apartment complex that showed the presence of Legionella. Dillaha said further testing is needed to confirm if the bacteria are viable – that is, capable of being the cause of the illnesses.

“It doesn’t tell us if those bacteria are dead or alive,” she told the Sentinel-Record, explaining that Legionella is commonly found in water and mostly harmless if deprived of the proper living conditions. “We don’t know if it’s viable or not. We’re interested to see if it’s live bacteria. That takes time. They have to be cultured on a special medium with a petri dish with special food for them to grow.”

Hot Springs Legionnaires outbreaks have been confirmed by the Arkansas Department of Health at a senior apartment complex and a historic bathhouse.

Hot Springs Legionnaires outbreaks: showers banned

At Quapaw Baths & Spa, the National Park Service Office of Public Health recommendation to disallow the use of showers was made in conjunction with the ADH and the Centers for Disease Control and Prevention (CDC).

The bathhouse shuttered its shower area and initiated chlorination of its baths after Legionella was found in early October. A previous test in August also was positive, but follow-up testing proved that result false.

Hot Springs, which is also known as Spa City, is a resort city at the eastern edge of the Ouachita Mountains set among several natural hot springs. The national park includes 47 hot springs and eight historic bathhouses along Central Avenue, including Quapaw at 413 Central Avenue on the southwestern slope of Hot Springs Mountain. The bathhouse is less than 1.5 miles from Garland Towers & Garden Apartments.

Hot Springs Legionnaires outbreaks: water temps

Dillaha said the contaminated water at Quapaw came from a hot spring that was cooled before going to the showers and baths. Water that comes directly from a hot spring is too hot for bacteria to survive, she said.

“The water supplies that are at risk … are largely thermal waters that have been cooled, or altered in some way,” ADH chief medical officer Dr. Gary Wheeler said. “If the temperature falls low enough, there’s a risk that the Legionella bacteria can survive, so that can be picked up in a number of ways.”

Said Dillaha: “Any building that has a complex water system – like a hotel or a hospital or a cruise ship – is vulnerable to having this organism grow because the waters are warm enough for it to grow but not hot enough to kill it.”

Hot Springs Legionnaires outbreaks: symptoms

Officials said the park’s facilities and businesses remain open and continue to offer guest services, but anyone who tests positive for legionellosis should inform the ADH as soon as possible at 501-537-8969. (Legionellosis is the collective term for the two diseases caused by Legionella: Legionnaires’ disease, which is also known as Legionella pneumonia, and Pontiac fever, a less-severe illness that does not affect the lungs.)

If you live at or have visited the Garland Towers & Garden Apartments or you visited the Quapaw Baths & Spa within the past two months and you are feeling flu- or pneumonia-like symptoms, you should seek care from your health-care provider.

Symptoms, which usually occur two to 10 days after exposure to Legionella, generally include:

• severe headaches
• muscle aches
• fever, which can be 104 degrees Fahrenheit or higher, and chills.

By the second or third day, symptoms can worsen to include:

• coughing, which can bring up mucus or blood
• shortness of breath (dyspnea)
• chest pains (pleurisy or pleuritis)
• gastrointestinal symptoms (diarrhea, nausea, vomiting)
• confusion and other mental changes.

Hot Springs Legionnaires outbreaks: little oversight

Hospitals and nursing homes are required to provide thorough oversight of water systems and medical equipment that could expose patients to Legionella. There is, however, little regulatory oversight of non-medical buildings like apartments and hotels.

“There’s not a lot of people checking up on a hotel, a condominium or a large building,” said attorney Elliot Olsen, who has filed Legionnaires lawsuits on behalf of clients for more than 20 years. “I am not aware of any oversight really at any level.”