Health officials say a hot tub at a New Hampshire resort is the likely source of Legionnaires’ disease that left one Massachusetts woman dead and another person sickened.
Woman Dies, Another Sickened After Using Resort Hot Tub
A hot tub at the Mountain View Grand Resort and Spa in Whitefield, New Hampshire is believed to be the source of Legionella bacteria that caused a deadly case of Legionnaires’ disease, state health officials said Friday.
A woman from Massachusetts died and another person fell ill with pneumonia-like symptoms after using the hot tub in late December, according to the New Hampshire Department of Health and Human Services (DHHS).
The DHHS said the two people tested positive for Legionella bacteria, which can cause a serious type of pneumonia called Legionnaires’ disease when inhaled in contaminated water particles.
“After a thorough investigation, we believe the source of the Legionella bacteria was the hot tub,” said Dr. Benjamin Chan, state epidemiologist. “We have recommended remediation of the hot tub, and the facility is cooperating fully.”
Resort Cooperating, Takes Steps After Outbreak
The Mountain View Grand Resort said it is working closely with health officials in the investigation and has taken steps to remediate the hot tub in question.
“As soon as the outbreak was reported, we immediately closed access to the hot tub and began remediation,” said resort manager Robert Smith. “We have since drained, disinfected and refilled the hot tub following DHHS guidelines.”
Smith said the resort has also disinfected its plumbing system out of an abundance of caution and will be testing water sources over the next few weeks. No other guests have reported illness, he said.
The resort has not seen any cancellations or decrease in bookings since the Legionnaires’ case was publicized this week, according to Smith. “Our guests understand we are taking every precaution necessary and that the risk of illness is very low,” he said.
How Legionnaires’ Disease Spreads in Hot Tubs
Legionnaires’ disease is caused by the Legionella bacteria, which grows well in warm water environments like hot tubs, hot water tanks, plumbing systems and cooling towers.
The bacteria is spread through inhaling contaminated water particles, usually from human-made water sources where Legionella can grow and multiply. Hot tubs with inadequate disinfectant, improper pH or other factors can provide prime conditions for Legionella to thrive.
When people breathe in mist or vapor containing the bacteria, it can lead to Legionnaires’ disease, a severe form of pneumonia that can be fatal in about 10% of cases if left untreated.
Legionnaires’ Outbreaks Linked to Hot Tubs Are Rare
While outbreaks of Legionnaires’ disease have been tied to hot tubs in the past, they remain relatively rare, experts say.
“This latest case underscores the importance of properly maintaining hot tubs to prevent Legionella growth,” said Dr. Andrew Kroger of the U.S. Centers for Disease Control and Prevention (CDC).
CDC recommendations for hot tub maintenance include:
- Maintaining water pH and disinfectant levels within recommended ranges
- Periodically superheating water to kill bacteria
- Cleaning filters frequently
- Promptly addressing water chemistry or maintenance issues
Properly treated hot tubs pose very little risk for Legionella exposure, Kroger emphasized.
The New Hampshire outbreak marks the third hot tub-related Legionnaires’ cluster reported in the U.S. since 2015, according to CDC data. Each sickened no more than three people.
Woman’s Death Highlights Severity of Disease for At-Risk Groups
While Legionnaires’ outbreaks linked to hot tubs may be uncommon, experts note this case demonstrates the potential severity of the disease for those in higher risk groups.
Legionnaires’ tends to most seriously impact older adults, smokers and those with weakened immune systems or chronic diseases.
“For vulnerable populations, Legionnaires’ can be devastating and even fatal, as we sadly saw in this case,” Chan said. “Anyone with underlying medical conditions should take extra care to avoid possible Legionella exposure from hot tubs until the risks can be assessed.”
Chan said the woman who died after using the Mountain View Grand hot tub had undisclosed preexisting medical conditions that likely made her more susceptible to a severe Legionnaires’ infection.
Looking Ahead: Preventing Future Outbreaks
Looking ahead, public health officials say the New Hampshire Legionnaires’ cluster will provide an impetus for enhanced hot tub safety measures statewide.
“We plan to work with the hospitality industry and hot tub vendors on better ensuring maintenance protocols and guest education about safe hot tub use,” Chan said.
The DHHS plans to distribute updated fact sheets to hotels, resorts, inns, rental property managers and others about Legionella risks and prevention in hot tubs. It also intends to ask hot tub manufacturers and retailers to include such information in product manuals and at points of sale.
For its part, the Mountain View Grand Resort does not anticipate updated policies around hot tub use for guests with preexisting medical conditions or other high-risk factors for Legionnaires’ disease.
“We believe current precautions are satisfactory when properly implemented,” manager Smith said. “This was an isolated event, and we remain confident in the safety of our facilities.”
Smith said the resort looks forward to continuing to work hand-in-hand with public health authorities to implement any new advisement around Legionella risk reduction and hot tub maintenance.
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