Los Angeles Times

Still no source for 4 cases of Legionnair­es’

Of the 15 people sickened, 11 had visited Disneyland. The others pose a mystery for health officials.

- By Soumya Karlamangl­a

After several people in Orange County fell sick with Legionnair­es’ disease in recent weeks, officials said two cooling towers at Disneyland had been linked to the outbreak.

Those towers were shut down, and officials say they no longer pose a risk to park visitors.

But a crucial question remained unanswered Wednesday: How did four people who had not visited Disneyland become infected?

The outbreak has sickened a total of 15 people, two of whom have died. Eleven of those people visited Disneyland in September, said Orange County health agency spokeswoma­n Jessica Good.

The other four lived in or had visited Anaheim, suggesting there could be sources of infection not yet discovered.

“It’s too early to point fingers at Disneyland for those four people,” said Sanjay Mohanty, a UCLA environmen­tal engineerin­g professor who studies water systems.

Cases of Legionnair­es’ disease, a severe lung infection, have been increasing nationwide and in California in recent years, and officials often struggle to identify where the infections originate.

Legionella is a bacterium that grows naturally in lakes and streams. Most healthy people who are exposed to it don’t get sick.

But when high concentrat­ions of Legionella grow in man- made water systems, such as hot tubs and plumbing, some people develop pneumonia after breathing in contaminat­ed water vapor.

Approximat­ely 6,000 people are diagnosed with Legionnair­es’ disease nationwide each year, and about 1 in 10 die from it. It is not contagious.

Cooling towers, which are part of air- conditioni­ng systems, are often culprits in outbreaks. The towers create a warm environmen­t in which Legionella bacteria thrive, and they release a mist that can carry the bacteria into people’s lungs.

In 2015, 16 people died and more than 100 others were infected in the largest Legionnair­es’ disease outbreak ever in New York City

— one that was ultimately linked to a cooling tower.

Orange County health officials discovered last month that a number of people had been diagnosed with Legionnair­es’ disease after spending time in Anaheim. They contacted Disney after learning that several had gone to the theme park.

Disney reported that two cooling towers in the park were found to have elevated levels of Legionella bacteria in early October. The towers were disinfecte­d and shut down, Disney officials said.

In a statement to The Times, Dr. Pamela Hymel, chief medical officer for Walt Disney Parks and Resorts, said health officials had informed the company that “there is no longer any known risk associated with our facilities.”

Good, the county health agency spokeswoma­n, said health officials were visiting hotels, motels and businesses not associated with Disneyland along the busy Harbor Boulevard corridor as part of their investigat­ion.

Though the people infected at Disneyland visited the park in September, the likely exposure dates for the other cases range from late August through late October, she said.

“To date, no other issues have been identified and there is no known, ongoing risk,” Good said in an email.

Daryn Cline, director of technology and science for the Alliance to Prevent Legionnair­es’ Disease, said officials needed to thoroughly investigat­e other parts of the water supply.

He said there could be elevated levels of bacteria in water sources that feed the theme park.

“To address it with one piece of equipment off the bat is a little shortsight­ed,” he said.

Anaheim city spokesman Mike Lyster said officials had reviewed tests of bacteria levels in the city water supply prior to and since the outbreak and hadn’t detected any issues.

Plus, Good said, the cooling towers hadn’t been ruled out as the cause for the 15 cases. The mist they release travels into the atmosphere and can spread, she said.

“Though it will not be possible to definitely link the cases to the cooling towers, the level of contaminat­ion and their location suggests that they are a potential source for some or all cases,” she said.

UCLA’s Mohanty said that seemed unlikely. The cooling towers are in a backstage area — near the New Orleans Square Train Station — that was more than 100 feet from areas accessible to guests, according to Disney officials.

The bacteria would have had to travel even farther to infect people outside the park, he said.

“If that’s the case I would expect more people to get sick, not only four,” Mohanty said. “It’s a mystery.”

The number of Legionnair­es’ cases nationwide each year is more than four times higher than it was in 2000, according to the Centers for Disease Control and Prevention.

In Orange County, more than 50 people were infected with Legionnair­es’ disease last year, compared with 33 the year prior. Experts are unsure what is driving the increase.

Most people who come into contact with Legionella don’t know it. People most susceptibl­e to developing Legionnair­es’ disease are those 50 and older, smokers, people with chronic lung disease or weakened immune systems or with cancer, according to the CDC.

The two people who died in the Orange County outbreak had “additional health issues,” Good said.

She said health officials were alerting doctors and health department­s to help identify more Legionnair­es’ cases among people who may have become sick after traveling to Anaheim, and particular­ly to Disneyland.

So far, the outbreak “indicates a pattern but does not identify that specific location as the common source of infection for all cases,” Good said. “Our investigat­ion is ongoing.”

 ?? Allen J. Schaben Los Angeles Times ?? DISNEYLAND shut two air- conditioni­ng cooling towers when it was discovered they contained elevated levels of the bacteria that causes Legionnair­es’ disease.
Allen J. Schaben Los Angeles Times DISNEYLAND shut two air- conditioni­ng cooling towers when it was discovered they contained elevated levels of the bacteria that causes Legionnair­es’ disease.

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