According to dr. Sumeth Onwandee, the head of the Municipal Institute of Disease Prevention in Chiang Mai, a European tourist fell ill with Legionella bacteria contracted in a hotel in the northern city. The source of the infection is the hot water system in the hotel. The system including hot water tanks, taps and shower heads will be checked.
Dr. Sumeth says that most Thais are immune to the Legionella bacteria, while foreigners are susceptible. The bacteria spread at temperatures of 25 to 45 degrees. You can get sick by breathing in the bacteria. You will not get sick from drinking water with Legionella.
Veterans disease
Most people do not become ill after exposure to the Legionella bacteria. Sometimes people get mild, flu-like complaints (legionella flu or Pontiac fever). This will go away on its own after a few days. In a number of cases, the legionella bacteria causes serious pneumonia: Legionnaires' disease or legionella pneumonia. The illness usually starts with fever, chills, headache and muscle aches, followed by a dry cough. If pneumonia develops afterwards, there are complaints such as:
- high fever
- shortness of breath, shortness of breath or pain during breathing
- cold shivers
- sometimes confusion or delirium
- sometimes suffer from headache, vomiting and diarrhea
Anyone can contract legionellosis, it is rare for people under the age of 40 to get pneumonia due to legionella. The risk of legionella pneumonia is very low, but the risk increases with age. The disease is more common in men than in women. Some people have a higher risk of legionella pneumonia:
- people over 60 years old
- smokers
- someone in poor health
- people who use medicines that weaken the immune system
You can become seriously ill from legionella pneumonia. Usually hospitalization and treatment with antibiotics is required. It can take a long time after an illness before someone feels completely well again. In the Netherlands, approximately 2 – 10% of patients with legionella pneumonia die. The risk of death is particularly high in elderly people.
How does Legionella arise?
Water usually contains very few legionella bacteria. But sometimes legionella can grow very fast in water, especially if the water is stagnant and between 25 and 45 degrees warm. If sprayed with water containing a lot of Legionella, someone can inhale very small droplets of water (aerosols). This way someone can become infected. This can be done, for example, while showering or by using a high-pressure sprayer. Whirlpools also produce many small water droplets that can be inhaled.
There is no vaccine against the disease. By quitting smoking you reduce the risk of pneumonia caused by legionella. Hospitals, nursing homes and hotels in the Netherlands, among others, are obliged to implement preventive measures to prevent the growth of legionella bacteria. How that works in Thailand is not known to the editors.
Source: Der Farang and RIVM
Well,
Most smaller guest house / hotels have a heater next to the shower head and provide hot water directly to the shower head. In large hotels this is done via a central system, I think this is a risk, because everyone knows that maintenance in Thailand is not taken very seriously.
In Chiang Mai, I therefore always prefer the "Dutch Guesthouse" which has heaters and there are always Dutch and Belgians to have a chat.
Read Dick's response below. In Thailand, cold water is often lukewarm, unlike in the Netherlands, the "cold" water in Thailand is therefore risky. Legionella bacteria feel most comfortable at temperatures between 25 and 45 degrees (see the section above), in Thailand the cold water is often warmer than 25 degrees, so riskier than in the Netherlands.
In my 40+ years in water treatment in Europe, Africa and Middle East and now in ASEAN I have (had) a lot to do with Legionella prevention. In the Netherlands, after a number of deaths and many long-term illnesses among visitors to a horticultural fair in Blokker, North Holland, a lot was done in the early 90s to prevent contamination. Before that, it was a barely recognized problem.
In the early 2000s, many Turkish hotels were blacklisted because they were infected and often did nothing.
I myself equipped a nuclear power plant in France with a very large installation because the river water for cooling was heavily contaminated and the cooling towers blew a plume of vapors with Legionella into the valley near Poitiers. Campsites downstream were also closed. After starting the installation, the problem was gone.
The bacteria can be found almost everywhere in natural water such as reservoirs and rivers and they thrive in Thailand's climate. That the Thai are not bothered by it is crazy; the pneumonias and deaths are simply not linked to this phenomenon. I live in Chiang Mai myself and make sure that the city water, originating from reservoirs, is cleaned of all bacteria, viruses and other micro-organisms as well as floating dirt and oxidized iron and manganese before it enters my underground tank.
When backwashing my filter, dark brown sludge comes out!
I therefore no longer have black and slimy deposits in cisterns of toilets, pipes and shower heads, a sign of biofilm (dead and living micro-organisms, including Legionella).
The irregular chlorination of city water does not provide adequate protection. Chiang Mai is no exception and coincidentally it has now been discovered by a tourist here and an observant doctor has diagnosed Legionella. A paracetamol is often prescribed if one has complaints and the disease only manifests itself in all its severity after returning from vacation and all kinds of causes are linked to it, but still not always contamination in a hotel (or plane)
RIVM's claim that it is usually only acquired by the elderly is related to the Dutch situation where city water is usually quite cool, and it then occurs almost exclusively in hot water pipes and air conditioners, which is why these are now strictly controlled and disinfected. In the tropics, cold water is also lukewarm to warm, so the critters feel comfortable. Young people can also get the disease.
Thank you,
You give a clear explanation. What people can still do is turn on the tap for a minute before taking a shower (and wait outside the shower area themselves) before stepping under it. After all, the bacteria causes pneumonia caused by inhaling the mist.