By: Heather Williams

Disneyland Park, located in Anaheim, California is under investigation and has shut down two cooling towers in response to a Legionnaires’ disease outbreak.

At this time, nine people who visited the theme park, located in Southern California in September have developed the disease.  Three others who had been in the city, but did not attend the park also have been sickened bringing the total to twelve cases.  According to Jessica Good, spokesperson for Orange County Health Care Agency, it is indicated that one patient with additional health issues has died, though this person had not visited the park.

Ages of the twelve patients ranged from 52 years old to 94 years old.  Ten of those patients required hospitalization.  Eight of the patients had visited the theme park, and one was an employee.  It has not been disclosed what part of the park this cast member primarily worked. The current health status of those infected has also not been released.

The Agency is still looking for a common exposure source responsible for all of the illnesses.  This is just one investigation currently underway.  This year there have been more than 55 cases of Legionnaire’s’ disease in Orange County.  According to the L.A. Times, this is a higher number than this county has seen in recent years. It is on par with the latest reporting, showing an increase in Legionnaires’ cases nationwide.

Disney Responds to Terrible News

The Orange County Health Care Agency contacted Walt Disney Parks and Resorts on October 27, 2017 to discuss the increase in Legionnaires’ cases in Anaheim.  Dr. Pamela Hymel, chief medical officer for Walt Disney Parks and Resorts issued statements concerning Disney’s actions.  Hymel indicated that after a review, two of the cooling towers tested for elevated levels of Legionella bacteria.  “These towers were treated with chemicals that destroy the bacteria and are currently shut down.  We have proactively shared this information with the County Health Care Agency and given our actions, they have indicated there is no longer any known risk associated with our facilities,” says Hymel.

The park has eighteen cooling towers throughout the park.  The remaining sixteen were not impacted by this situation and remain in service.  Disneyland took the two affected towers (located in the backstage area behind the New Orleans Square train station) out of service on November 1, 2017 and brought them back to service after purported cleaning and disinfection on November 5, 2017.   After an order from Health Officials, those towers were shut down again for a second time.  According to the health department notice, Disney is not to bring the towers back up until they are verified to be free from contamination.  These test results may take up to two weeks to allow these towers to officially come back up.

It seems as though the damage has already been done and no others are currently at risk.  The Health Care Agency indicated that there is “no known ongoing risk with this outbreak” and “to date, no additional Legionella cases have been identified with potential exposure in Anaheim after September.”

What is Legionnaires’ Disease?

Legionnaires’ disease is caused by the Legionella bacteria that is sometimes found in water systems.  It is also known as legionellosis.  The bacteria received its name from a 1976 outbreak where many people attending a convention at the American Legion became sickened with pneumonia.  This bacterium causes a severe form of pneumonia and is very serious for those over the age of 50 or have a compromised immune system.

While individuals of any age can contract Legionnaires’ disease, those who are middle-aged and older and who have chronic lung disease or smoke cigarettes are more susceptible to illness.  Additionally, those who have a compromised immune system such as individuals with cancer, diabetes, kidney failure requiring dialysis, or AIDS along with people who take drugs that can suppress the immune system are of higher risk of acquiring Legionnaires’ disease.

The disease is typically contracted by breathing in contaminated mist from water.  A common source of this contaminated mist is air conditioning units found in large facilities, hot tubs, or even showers.  This disease cannot be passed from person to person.  The bacteria are naturally occurring in fresh water environments such as stream, lakes, and rivers.  When it begins to grow and spread in human-made water systems, it becomes dangerous.  Prevention is key when it comes to Legionella.  It is important to keep this bacterium out of man-made water systems, such as the cooling towers located at Disney.

About 6,000 cases of the disease were reported in the United States in 2015, though most of the time the illness goes undiagnosed, which likely indicates a great underestimation of the true number of infections each year.  About one out of every ten people sickened with this lung disease will die.

Underdiagnoses of Legionnaires’ Disease

This disease is often underdiagnosed because many who are infected do not develop any symptoms.  Additionally, of those who do have symptoms often go undiagnosed, as the sickness presents symptoms similar to other types of pneumonia.  Specialized laboratory tests must be performed to confirm the presence of the bacterium to properly diagnose the illness of legionellosis.  These tests aren’t generally performed on someone presenting pneumonia symptoms unless Legionnaires’ is considered a possibility.  Common diagnostic tools include detecting bacteria found in sputum, finding presence of antigens in urine, or in blood samples by comparing two different samples taken three to six weeks apart.  Once diagnosed, often the antibiotic drug, Erythromycin is prescribed.

Symptoms include fever, chills, and a cough that may or may not produce sputum.  Additional symptoms include diarrhea, abdominal pain, and sometimes confusion.  Some patients may experience headache, muscle ache, loss of appetite, and tiredness.  Symptoms generally appear between two and ten days after exposure.

How Can the Disease be Prevented?

If Legionnaires’ disease is spread through man-made water systems, surely the risk of spreading the disease can be mitigated.  What can facilities do to minimize the risk of contamination and dissemination of this harmful bacteria?

It all starts with improved design and maintenance.  Cooling towers and plumbing systems are key areas that Legionella can grow and thrive and find its way into the air to infect unknowing individuals.  These water systems should be controlled and decontaminated to ensures growth cannot occur.  For those who are undergoing investigation, the CDC often helps setup these safeguards.  Though it would make more sense to include these steps in plans when facilities are being built.

UnsafeFoods will continue to monitor the situation and update as more information becomes available.

Sources:

http://www.cnn.com/2017/11/12/health/disneyland-legionnaires-anaheim/index.html

http://www.ocregister.com/2017/11/10/oc-health-care-agency-is-investigating-source-of-legionnaires-disease-in-anaheim-disneyland-could-be-a-possibility/

https://www.cdc.gov/legionella/fastfacts.html

https://www.bizjournals.com/losangeles/news/2017/11/11/disneyland-guests-contracted-legionnaires-disease.html

http://www.ehso.com/ehshome/diseaselegionaire.htm