ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Friday, November 15, 1996 TAG: 9611150055
SECTION: VIRGINIA PAGE: A-1 EDITION: METRO
DATELINE: RADFORD
SOURCE: MARK CLOTHIER STAFF WRITER
Health officials traced the source of Virginia's first Legionnaires' disease outbreak to a display hot tub at the Lowe's store in Christiansburg.
Dr. Jody Hershey, director of the New River Health District, said the New River Valley outbreak that sickened at least 15 people and killed one is over.
"Because the incubation period is two to 10 days, anyone who visited the store while the hot tub was in use and who didn't develop flu-like symptoms or pneumonia by now should be reassured that he or she didn't contract the disease," he said.
Hershey said the hot tub in question was removed Oct.8 or Oct.9 for unrelated reasons: it was a part of a two-tub display deemed too large for company guidelines.
A spokesperson for the North Carolina-based chain was not sure how long the display had been in place. He said tub manufacturers' maintenance guidelines were followed, but he didn't know if a maintenance record was kept.
On Oct.11, the larger hot tub was drained, cleaned and refilled by Lowe's employees.
By Oct.28, health officials pegged the source as Lowe's. By then, the hot tub in question - the smaller of the two displayed - had been sold to an employee. The remaining hot tub was drained and covered by health officials.
Although there are guidelines for the upkeep of publicly used hot tubs and manufacturers' guides for hot tubs used at home, there are none for displayed hot tubs, Hershey said.
As a precaution, Lowe's spokesperson David Oliver said the company will no longer keep water in hot tubs displayed in any of its 390 stores.
Oliver said none of the 85,000-square-foot store's 155 employees contracted the disease.
Cliff Oxford, senior vice president of human resources at Lowe's North Wilkesboro, N.C., headquarters, said he didn't know whether the company was liable for any damages or expenses incurred by the 16 infected patients. Two patients are still hospitalized, one in critical condition at the Veterans Affairs Medical Center in Salem and one in stable condition in Carilion Radford Community Hospital.
Hershey said officials suspected Lowe's early in their attempt to confirm their theories on the outbreak's source.
Fourteen of the 15 confirmed patients interviewed by health officials said they had been in Lowe's for an average of 78 minutes per visit within 10 days of becoming sick. Of those 14, 10 recalled walking by the hot tub, which sat in one of the store's main aisles.
Of the 45 control patients - New River Valley residents who shared similar age, gender and health backgrounds with the confirmed patients - 12, or 27 percent, had been to Lowe's in the same period, for an average visit of less than 30 minutes.
Officials from the federal Centers for Disease Control and Prevention in Atlanta then matched a sample of Legionella bacterium taken from one of the Legionnaires' patients with a sample taken from the hot tub's still-moist paper filter, which by then was in the house of the Lowe's employee, who had not yet used the tub.
A bit of good fortune was involved. If the hot tub been used or the filter thrown out, the sample might have been difficult to get, decreasing the chance investigators could genetically match the bacterium, Hershey said.
Officials were unable to interview the family of the Pearisburg man who died from Legionnaires' Oct. 27 and don't know if he contracted the disease from Lowe's.
Legionnaires' is contracted from inhaling water mist containing the Legionella bacterium. It is not spread from person to person.
The disease most often strikes men 50 and older, especially those with existing medical conditions.
Of the 16 Legionnaires' patients in the New River Valley outbreak, 14 were men. Their ages ranged from 42 to 86, with an average of 68.
The disease is typically reported in isolated cases. Including the New River outbreak, 34 have been confirmed in Virginia this year. Last year, 28 were reported in the state.
Legionnaires' outbreaks - like one last month in suburban Detroit and the 1976 case at a Pennsylvania American Legion convention that gave the disease its name - usually are traced to cooling towers and other areas where water accumulates: evaporative condensers, humidifiers, whirlpool spas, respiratory therapy devices, grocery store vegetable misters and decorative fountains.
Legionnaire's Time Line
Sept. 28: onset of first confirmed case of Legionnaires' disease in New River Valley outbreak.
Oct. 8 or 9: hot tub in question removed from display for unrelated reasons.
Oct. 9-11: Seven of the 16 patients said they began to feel sick.
Oct. 15: investigation begins.
Oct. 18: onset of last confirmed case.
Oct. 24: Health officials confirm first four Legionnaires' cases.
Oct. 25: Four more patients confirmed. Officials begin interviewing patients.
Oct. 27: a 50-year-old Pearisburg dies from Legionnaires', the outbreak's only fatality.
Oct. 28: remaining hot tub from Lowe's display drained and covered. Environmental testing begins.
Oct. 30: increased testing confirms two more cases.
Nov. 1: two more cases confirmed for a total of 15.
Nov. 4: 16th case confirmed.
Nov. 8: legionella bacteria isolated from display hot tub.
Nov.11: lab studies match filter bacteria with bacteria from patient.
Nov. 14: officials confirm source of the outbreak is a hot tub at a Lowe's store in Christiansburg.
LENGTH: Long : 109 lines ILLUSTRATION: PHOTO: NHAT MEYER\Staff. Officials traced the outbreak to a hotby CNBtub display at this Christiansburg Lowe's store and said the threat
is over. color.