Harrah’s Laughlin Hotel & Casino in Laughlin is being investigated by the Southern Nevada Health District (SNHD) after it learned of two cases of Legionnaires’ disease that occurred at the property since November of last year.

The two individuals sickened visited the hotel separately from one another, one in November 2017 and the other in March 2018. Harrah’s was alerted to the outbreak by the Centers for Disease Control and Prevention (CDC) after it confirmed the second case last month.

Information was not provided on the health status of the two individuals who were sickened. Their ages and genders also were withheld.

The CDC considers this to be a Legionnaires’ disease outbreak because two or more cases are “associated with the same possible source during a 12-month period.”

It’s the second outbreak at a Caesars Entertainment property within the last year. There were seven confirmed and 29 suspected cases of the disease at the Rio in Las Vegas last year in an investigation that started in June.

Tests positive for infectious bacteria
Officials have tested the Laughlin property for Legionella bacteria, the bacteria that causes Legionnaires’ disease, and initial tests were positive.

The hotel began aggressive remediation efforts to deal with the dangerous bacteria, including hyper-chlorination (disinfecting) of the water system and proactive water-management efforts.

“We will continue to monitor our water quality in accordance with the SNHD’s guidance to ensure the safety of the water system and our guests,” Caesars Entertainment wrote in a statement.

The SNHD is working with the property to notify current and past guests of the outbreak. Guests who stayed at Harrah’s Laughlin property dating back to Oct. 15, 2017, and who experienced symptoms (see list below) up to 14 days after their stay can report their illness using a survey posted on the Southern Nevada Health District website.

If guests (or employees) of the property developed symptoms within 14 days of their visit but did not receive medical care, they should see their health-care provider to be correctly diagnosed.

Legionnaires’ symptoms
The symptoms of Legionnaires’ disease look like other forms of pneumonia or even the flu, which is why so many cases go unreported every year. Early symptoms can include the following:

  • chills
  • fever (potentially 104 degrees or higher)
  • headaches
  • loss of appetite
  • muscle aches.

After the first few days of the disease presenting, symptoms can worsen to include:

  • chest pain when breathing (called pleuritic chest pain, due to inflamed lungs)
  • confusion and agitation
  • a cough, which may bring up mucus and blood
  • diarrhea (about one-third of all cases result in gastrointestinal problems)
  • nausea and vomiting
  • shortness of breath.

The incubation period – the amount of time between breathing in the bacteria and developing symptoms – is usually 2 to 10 days after exposure and can be as much as 16 days. On average, however, the incubation period is 3 to 6 days.

(Note: There is also a mild form of Legionnaires’ disease called Pontiac fever, which can produce symptoms that include fever, chills, headache, and muscle aches. Pontiac fever doesn’t infect the lungs, however, and symptoms usually clear within two to five days.)

What is Legionnaires’ disease?

Legionnaires’ disease – also called legionellosis and Legionella pneumonia – is a severe type of pneumonia or lung infection. According to the CDC, an estimated 25,000 cases of pneumonia due to the Legionella bacteria (Legionella pneumophila) occur each year, but only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms, and 10 percent of those will die from the infection.

How do you catch the disease?
Legionella bacteria are contracted by inhaling microscopic water droplets in the form of mist or vapor. The bacteria, which grow best in warm water, are found primarily in human-made environments. Outbreaks have been linked to a range of sources, such as:

  • cooling towers in air conditioning systems
  • water systems like those used in hotels, hospitals, and nursing homes
  • large plumbing systems
  • hot water tanks and heaters
  • showers and faucets
  • swimming pools
  • hot tubs and whirlpools
  • equipment used in physical therapy
  • mist machines in grocery stores’ produce sections
  • decorative fountains.

People also can contract Legionnaires’ disease by the aspiration of contaminated drinking water – that is, choking or coughing while drinking can cause water to go down the wrong pipe into the lungs. It’s also possible to contract Legionnaires’ disease from home plumbing systems, although the vast majority of outbreaks have occurred in large buildings because complex systems allow the bacteria to grow and spread more easily.

Who is most at risk for infection?
Anyone can get the disease, but those at the highest risk of infection include:

  • people 50 years old or older
  • smokers (current or former)
  • heavy drinkers of alcoholic beverages
  • people with chronic lung disease (such as chronic obstructive pulmonary disease or emphysema)
  • people with weakened immune systems (those suffering from conditions such as diabetes, cancer, kidney failure, or infected with HIV)
  • organ-transplant recipients (kidney, heart, etc.)
  • individuals following specific drug protocols (for instance, corticosteroids)

Even relatively healthy individuals have been known to contract the disease, although less typically.