It seems that the mystery has been partially solved, as to the cause of the respiratory illness that plagued many conference attendees after a February 2011 Playboy Mansion fundraiser. The Los Angeles County Health Department presented their outbreak investigation results at the Centers for Disease Control and Prevention’s annual Epidemic Intelligence Service conference in Atlanta this month (L.A. times, see http://latimesblogs.latimes.com/lanow/2011/04/playboy-mansion-outbreak-bacteria-traced-to-whirlpool-spa.html).
While one would not want to think about what other types of infections might lurk in the Playboy Mansion hot tub (ewwww!), Legionella bacteria was isolated from the whirlpool spa, and from some of the sick people that attended the party. Overgrowths of Legionella, which is found naturally growing in aquatic environments, can cause Legionnaires’ disease, a reportable lung infection/pneumonia (CDC Legionellosis Resource Site, http://www.cdc.gov/legionella/top10.htm), or Pontiac fever, a milder lung infection without the pneumonia. As Legionella bacteria like warm water, it can be found in improperly disinfected hot tubs, large plumbing and air conditioning systems, and even hot water tanks (CDC Patient Fact Sheet, http://www.cdc.gov/legionella/patient_facts.htm ). The Playboy party was held in the enclosed cave-like pool area, known as the “Grotto”. There were several potential infection sources/reservoirs of Legionella, including a fog machine, pool, hot tub, and the air conditioning system. Legionellosis is spread by water vapor, not from person to person (luckily), as once it progresses to pneumonia, it has a case-fatality rate of 5-40%!
What was really interesting about this outbreak investigation was that the health department officials tracked down 439 people (of the 715 at the conference), in 30 different countries, using social media, such as Twitter, Facebook, and blogs. Online surveys were used to establish who was ill, what type of symptoms they had, & if they had been diagnosed by a healthcare provider with Legionellosis, pneumonia, or the flu. 79 people reported varying levels of respiratory illness (fever, cough, headache, chills, chest pain, shortness of breath) within the 2 to 14 days incubation period (http://www.forbes.com/feeds/ap/2011/04/15/entertainment-us-playboy-mansion-health-probe_8411341.html). The use of new technology to find hundreds of people in 30 different countries is amazing to me. In the recent past, this would not have been possible! I had not previously thought of the use of social media for epidemiological purposes, other than as a possible tool for health promotion, or public service announcements. This is an excellent example of quick thinking in a outbreak investigation, using existing resources. I have a newfound respect for the usefulness of Twitter and Facebook!
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