"Legionnaire's disease will affect a small proportion of the group," said Janet Stout, Ph.D., director of the Special Pathogens Laboratory in Pittsburgh. "In outbreaks, [that's] usually less than 5 percent of the total number exposed. It appears from these reports that the rapid onset of symptoms is more typical of the related illness called Pontiac fever."
Pontiac fever, or Legionellosis, is a milder form of Legionnaire's disease that causes flu-like symptoms.
"Legionella is a bacteria that lives in water and loves warm, wet environments," said Dr. Mary Nettleman, professor and chair of the department of medicine at Michigan State University. "Unfortunately, people also like warm, wet environments like hot tubs."
While hot tubs are a great addition to pool parties or some après-ski relaxation, hot tub owners should be aware of the bacteria that could be swimming in the water.
"Most residential hot tubs do not fall under any regulatory authority," said Stout. "If the outbreak source is found to be the hot tub, it is a wakeup call to owners of these devices to be sure Legionella is not present. A simple culture test can reassure both the owner and the users of the device."
And Dr. Tracy Zivin-Tutela, an infectious disease specialist at St. Luke's Roosevelt Hospital in New York, agreed that hot tub owners must pay close attention.
"The only way to prevent the bacterial contamination is proper disinfectant and maintaining appropriate pH levels," said Zivin-Tutela. (pH is a measure of acidity and alkalinity.) "This should be monitored at least two times per day or more often if there is heavy use of the tub."
Spa- and whirlpool-associated outbreaks are frequently implicated in larger outbreaks, particularly because the suspected mechanism of Legionella transmission in these outbreaks is through aerosols generated by air injected in the whirlpool, said Dr. Amir Afkhami, assistant professor in the global health division at George Washington University School of Public Health.
"Basically, the bubbles that soothe can also become bubbles of infection by giving Legionella a piggyback ride into our respiratory system and allowing it to infect our lungs," said Afkhami.
So, as conference goers wait for definitive results from the county health officials, doctors say Hef and his bunnies should keep a watchful eye on the famous hot tub for future guests.
"This literally took away a week of my life," said Castello. "I just hope everyone else gets better quickly and we find out where it started."