Hot tub displays no longer will be allowed in Harvey Convention Center.
City leaders made the decision after health officials identified water-filled hot tubs displayed in the exhibit hall during the East Texas State Fair as the likely source of an outbreak of Legionnaires’ disease.
Although the source of the contaminated water that caused eight people to become sick has not been identified, the city is banning hot tubs as a precaution, City Manager Ed Broussard said Thursday.
All who were sick attended the East Texas State Fair and went in the city-owned exhibit hall where hot tubs were among the displays. People who breathe in mist contaminated by a bacteria can get Legionnaires’ disease. One of the people who became sick died of related health complications.
Health officials say it is unlikely that more people who attended the fair will get Legionnaires’ disease.
Broussard said city representatives were notified by Northeast Texas Public Health, the local health department, on Oct. 25 that the outbreak likely was connected to Harvey Convention Center.
“In ensuing conversations, it kind of centered on the kind of hot tub expo that was done there at Harvey Hall and ... being around that kind of thing,” Broussard said.
He said health officials “started to push toward that (hot tubs) as a possible reason for that (outbreak). ... It looks to be that is how it was spread.”
The Centers for Disease Control and Prevention has identified hot tubs as one of the more common sources of bacteria-contaminated water. Ventilation systems, humidifiers and misters also can be a source.
“The question now becomes was there cross-contamination that occurred, how was that presence of the bacteria there to begin with or continues if it was there?” he said. “Those are the things that were brought up and caused us to take the actions we have.”
The city has closed Harvey Convention Center until a company it hired can take “remedial” action to ensure the water supply in the building is safe.
“If any facility presents a danger, we are going to move mountains to make sure that gets taken care of,” Broussard said. “We take that very seriously, and will do anything we have to do.”
The key to preventing Legionella bacteria is properly maintaining water systems, according to recommendations from the Texas Department of State Health Services.
Cooling towers should be drained when not in use and mechanically cleaned periodically to remove scale and sediment. Appropriate biocides should be used to limit the growth of Legionella and the formation of protective biofilms. Maintaining hot water system temperature at 122 degrees F or higher may reduce the risk of transmission, according to state guidelines.
The search for the source of the outbreak continues.
Health district employees took samples from multiple water sources on the fairgrounds and sent them to the CDC in Atlanta to be tested.
“We still await the reception of test results from the most recent samples sent to the CDC last week,” Terrence Ates, the health department’s public information officer, said Thursday.
Nothing has yet been identified as the source or eliminated as the source of the contaminated water, the health district has said.
The health department did not advise the city to close Harvey Convention Center and ban hot tubs. The closure “was an independent decision made by the city of Tyler,” Ates said Thursday.
In an earlier statement, the health department said it has “identified no evidence of any public health risk that would interrupt current or future events from occurring at Harvey Hall and its neighboring properties.”
Initial testing conducted by NET Health Oct. 25 revealed appropriate chlorine levels were present in water samples collected in Harvey Convention Center, Ates has said. Chlorine is one of several items used to ensure public water is safe, and is the only element that is tested within the initial sampling process.
After putting out a statement that Harvey Convention Center’s water was not believed to be contaminated, Ates days later said the hall had not been ruled out as the source of contamination and that more testing was taking place.
NET Health is committed to “definitively identifying the exact source of our local Legionella cases, yet we ask everyone to exercise patience with the scientific process of testing and confirming the exact source of contamination,” Ates has said.
East Texas State Fair
John Sykes, president of the company that stages the fair, said Thursday suggesting that a hot tub display in Harvey is the source of the outbreak is “total speculation.”
“I don’t want to say anything and will not say anything about the source until we know,” he said.
Sykes said the phones at the fair office have been “ringing off the walls” since NET Health identified the outbreak with the fair.
“People are scared,” he said.
Sykes said he understood the city’s decision to exercise caution by banning the use of hot tubs in Harvey.
The East Texas State Fair has always made it “the highest priority” to ensure the health and safety of fairgoers and will review its practices involving spraying water at the fairgrounds, he said.
Providing hand-sanitation stations on the fairgrounds and thoroughly cleaning the petting zoo area during the fair’s run are among health practices already in place, he said.
Sykes is a past chairman of the International Association of Fairs and Expositions and past president of the Texas Association of Fairs. He said adopting safe practices has been and continues to be a focus of the industry.
Last month, health officials identified a hot tub display at a fair in Fletcher, North Carolina, as the most likely source of an outbreak of 120 cases of Legionnaires’ disease and eight cases of Pontiac fever, a milder form of the disease. Four people died.
North Carolina Health Department’s investigation found that many of those who got sick reported “having walked by the hot tub displays” in a building at the Mountain State Fair held Sept. 6-15.
According to information from the Centers for Disease Control and Prevention, each year from 8,000 to 18,000 people in the United States are hospitalized with Legionnaires’ disease. The disease is usually treated successfully with antibiotics, but can be fatal, especially in those who are old, have a lung disease or a weak immune system.
The Legionella bacteria is naturally found in water, especially warm water. Hot tubs that are not cleaned and disinfected enough can become contaminated with Legionella, according to the CDC.
Because high water temperatures make it hard to maintain the disinfectant levels needed to kill germs like Legionella, making sure that the hot tub has the right disinfectant and pH levels is essential, said the CDC information.