For the second time in less than 12 months, a North Waco, TX, hotel is under investigation for a Legionnaires’ disease outbreak after two guests were confirmed with the illness.

The out-of-state guests were diagnosed upon their return home. They stayed separately earlier this month at the Fairfield Inn & Suites by Marriott Waco North, 4257 N. Interstate 35 in Lacy Lakeview.

No further information was available on the condition of the two or whether they required hospitalization.

As it did last year, the Waco-McLennan County Public Health District (WMCPHD) issued a “control order” to the hotel and is requiring hotel administrators to notify all guests and staff of the risk of the disease. They also will be required to allow the WMCPHD to conduct an environmental investigation of the property.

The bacterial disease is a severe form of pneumonia and is typically contracted through inhalation of mist or vapor from water contaminated with Legionella.

“Although a direct source for the disease has not been determined at this time,” health officials said, “it is important that all guests are notified of any potential risk while staying at the Fairfield Inn and Suites.”

Kelly Craine, public information officer for the WMCPHD, told KWTX News 10: “It could be anywhere. So you’re looking at all of the water sources: air conditioning, plumbing, hot water heaters, pool, hot tub. Every area that has water involved in it. Our investigators will be checking that, swabbing that, looking for a definitive source.”

The hotel was investigated last year after four cases were connected to the facility between October 2016 and August 2017.

Hotel given three orders
At that time, in cooperation with the Centers for Disease Control and Prevention (CDC) and the Texas Department of State Health Services, the WMCPHD required the Fairfield Inn to implement three actions to comply with the control order:

  • Hire a qualified consultant to assist with the development and implementation of a water maintenance plan.
  • Maintain water temperature at 140 degrees Fahrenheit.
  • Notify all guest of the risks of Legionnaires’ disease.

A comprehensive test of the hotel’s water system last August included the taking of 34 samples of the different sources of possible contamination. The results came back negative for Legionella.

CDC: About 25,000 cases of Legionnaires’ annually

Legionnaires’ disease is a severe type of pneumonia or lung infection. According to the CDC, an estimated 25,000 cases of pneumonia caused by Legionella bacteria (Legionella pneumophila) occur in the United States yearly. However, only 5,000 cases are reported because of its nonspecific signs and symptoms.

Legionella bacteria are contracted by inhaling microscopic water droplets in the form of mist or vapor. The bacteria are found primarily in human-made environments, such as cooling towers, air-conditioning systems, hot tubs, and spas, to name a few.

Warm, stagnant water provides ideal conditions for growth, according to the Occupational Safety and Health Administration (OSHA). At temperatures between 68 degrees and 122 degrees Fahrenheit, the organism can multiply. Temperatures of 90 degrees to 105 degrees are ideal for growth.

Complications of Legionnaires’ disease

After Legionnaires’ disease has been diagnosed, hospitalization is often necessary. In the most severe cases, complications can include respiratory failure, kidney failure, septic shock, or even death.

Anyone can get the disease, but those at the most significant risk of infection include:

  • people 50 or older
  • smokers (current or former)
  • heavy drinkers of alcoholic beverages
  • people with chronic lung disease
  • people with weakened immune systems.

Symptoms of Legionnaires’ disease

Legionnaires’ disease usually develops two to 10 days after exposure to Legionella bacteria. It frequently begins with the following signs and symptoms:

  • headache
  • muscle pain
  • chills
  • fever, which can be 104 degrees Fahrenheit or higher.

By the second or third day, other signs and symptoms develop, including:

  • cough, which can bring up mucus and sometimes blood
  • shortness of breath
  • chest pain
  • gastrointestinal symptoms, such as nausea, vomiting and diarrhea
  • confusion and other mental changes.

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and in other parts of the body, including the heart.

A mild form of Legionnaires’ disease — known as Pontiac fever — may produce signs and symptoms including a fever, chills, headache and muscle aches. Pontiac fever doesn’t infect your lungs, and symptoms usually clear within two to five days.