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Screenshot of the now-closed Zen Day Spa on San Pablo Avenue in Richmond, showing the story sign and a picture of a woman getting a massage, as well as a window sign advertising the hot tub.

Richmond spa hot tub likely source of Legionnaires’ disease that killed two

on August 21, 2023

More than two weeks after Contra Costa Health Services shut down a Richmond spa’s hot tub following the deaths of two patrons, lab results on water samples confirmed high levels of legionella bacteria in the jacuzzi, county officials said Monday.

Health Services is working with the Contra Costa District Attorney’s office to determine if charges will be filed in the case. In addition to the deaths, two people who used the Zen Day Spa hot tub came down with Legionnaires’ disease and two others reported feeling sick.

Health Services was notified of the deaths on Aug. 3 and 4 and issued a news release on Aug. 5, saying the deaths possibly were linked to a jacuzzi at the San Pablo Avenue spa. In a news conference Monday, Health Services spokesperson Kim McCarl said department shut down the spa on Aug. 5, after finding it did not have a permit to operate a spa or hot tub. The following day, the spa voluntarily shut down, she said.

The spa had opened without submitting a plan for Health Services’ review as required, Kristian Lucas, assistant director of environmental health programs, said at the news conference. Even if the spa had, the county would not have signed off on that plan, Lucas said, because the spa was using a backyard-type hot tub, which did not have a disinfecting system that is required for commercial use.

There are nearly 10,000 cases of Legionnaires’ disease diagnosed annually in the United States, according to the Centers for Disease Control and Prevention. And the number has been rising since 2000.

A chart showing a sharp rise in Legionnaires' disease cases from 2000, when about 1,000 cases were diagnosed in the U.S., to 10,000 in 2018, the most recent year on the chart.
The U.S. has about 10,000 cases of Legionnaires’ disease. (CDC)

Legionnaires’ disease is a type of pneumonia caused by the legionella bacteria, which is found in water droplets. Most people can breathe in those droplets without developing Legionnaires’ disease. But for some — mostly people over 50 with a history of lung or immune system conditions — the bacteria can get into the lungs and cause pneumonia.

Symptoms include cough, fever, shortness or breath and headache. While antibiotics are effective in treating the sickness, Legionnaires’ disease is fatal in 1 out of every 10 people who contract it, according to the CDC. The most common sources of the bacteria are hot tubs, showers, air conditioning units and decorative fountains.

The illness became known as Legionnaires’ disease because of a major outbreak in 1976 that sickened more than 180 people, 29 of whom died, after attending an American Legion convention at a Philadelphia hotel. The bacteria eventually was isolated and found to be breeding in the hotel’s air conditioning system. It was later determined that legionella also is the bacteria that caused flu-like symptoms in health workers in Michigan in 1968, in what came to be known as Pontiac fever. None of those workers died.

Lucas said Health Services is working with the city to review other Richmond businesses with hot tubs to make sure they are permitted and following commercial standards.

He recommended that before visiting a pool or hot tub residents check the status of the facility in county’s database, which is available on Health Services’ website.

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