| A Bacterial Problem with Indoor Hot Tubs |
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By Lee Bowman
Scripps Howard News Service
May 2000 Microscopic organisms that bubble up from indoor hot tub jets can cause lung disease in some people who regularly use them, according to case studies documented by lung specialists. Doctors at National Jewish Medical and Research Center in Denver recently treated nine people, including four children, for lung disease caused by nontuberculosis mycobacteria found in hot tub water or in the air of their homes. "The jets from hot tubs aerosolize the bacteria, which is how this becomes a problem,'' said Dr. Cecile Rose, a specialist in environmental and occupational lung diseases, who reported the illnesses this week at the American Thoracic Society's International Conference in Toronto. Unlike tuberculosis, which is transmitted from person to person, this bacteria isn't contagious. Normally, the organisms live only in brackish ocean water, such as tidal pools. But researchers at National Jewish say several strains of the bacteria have been found to thrive in floating "slime layers'' in hot water heaters, indoor pools, ornamental waterfalls and hot tubs, and they've been treating more and more people for the disease. According to the federal Centers for Disease Control and Prevention, the infections are most common in the Southeastern United States. In many instances, "if you just turn on your shower you can aerosolize these organisms,'' said Dr. Gwen Huitt, another physician at the center familiar with the bacteria. "If you're healthy, it may mean nothing to be exposed to the bacteria. But if you already have a lung disease, you may have a greater chance of becoming infected.'' Rose suggested that the substantial mist produced from hot tub bubbles "disperse the bacteria throughout a room,'' and give people in the home a steady spray. People with this bacterial infection often experience a fever, tiredness, night sweats, coughing and weight loss. "For people with mild cases removing the hot tub from the home is the primary treatment,'' she said. However, the respiratory problems are often misdiagnosed as being caused either by tuberculosis or other lung diseases, and they may stay in their homes and continue to be exposed to the bugs. Rose said she believes with hot tubs becoming more common, "I believe there will be an increasing recognition and understanding of the risk associated with their use'' among both physicians and consumers. In severe cases like those described by Rose, the infections require treatment with corticosteroids and antimycobacterial antibiotics, sometimes three or four antibiotics at once, given intravenously. In some cases, doctors have to surgically remove part of a patient's lung to stop the disease. (Contact Lee Bowman at bowmanl@shns.com or www.shns.com.)
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