Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Legionnaires' Disease

Episode Date: November 16, 2017

This week on Sawbones, Dr. Sydnee and Justin visit Disneyland and the only souvenir they bring back is an investigation into the history of Legionnaires' Disease. Music: "Medicines" by The Taxpayers

Saubones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, time is about to books. One, two, one, two of Miss Guide Medicine. I'm your co-host Justin McAroy. And I'm Sydney McAroy. Welcome to Salvones, a man of two of Miss Guide Medicine.

I'm Sydney McAroy. Welcome to Salvones, a man of two of Miss Guide Medicine. Welcome to Salvones, a man of two of Miss Guide Medicine. Welcome to Salvones, a man of two of Miss Guide Medicine. Welcome to Salvones, a man of two of Miss Guide Medicine. Welcome to Salvones, a man of two of Miss Guide Medicine. Welcome to Salvones, a man of two of Miss Guide Medicine. Welcome to Salvones, a man of two of Miss Guide Medicine.

Welcome to Salvones, a man of two of Miss Guide Medicine. Welcome to Salvones, a man of two of Miss Guide Medicine. Welcome to Salvones, a man of two of Miss Guide Medicine. Welcome to Salvones, a man of two of Miss Guide Medicine. Welcome to Salvones, a man of two of Miss Guide Medicine. Welcome to Salvones, a man of two of Miss Guide Medicine. Welcome to Salvones, a man of two of Miss Guide Medicine. Welcome to Salvones, a man of two of Miss Guide Medicine.

Welcome to Salvones, a Marital Tour of Miss Guyed Medicine. I'm your co-host Justin McAroy. And I'm Sydney McAroy. Well, Sid, I didn't know that three-year-olds could be depressed, but that's certainly what we've got on our hands. Well, unfortunately, that's true, Justin.

We've tried our best. Yeah, we've tried to make up for it, but it is not working. We took our daughter. No, all the usual three-year-old tricks, like popsicles, poofs, the whole nine yards. Yeah. We took our daughter to Disney World for the first time,

and we didn't know if she would like be crazy about it or not. We didn't know if she was old enough yet. To really enjoy it, but we took her and, well, she loved it. And now. That's the good news. Let's start with the good news. The good news is she loved it. She met all the princesses, she loved it. And now, that's the good news. That's, that's a, let's start with the good news. The good news is she loved it. She met all the princesses, she loved it.

The bad news is that we sometimes will just find her crying and we'll ask what's wrong. And she'll say, our house isn't Disney World. She wants to live at Disney World now. Right. And that is as apparent, like I can't. I mean, obviously, they're roughly 40 people that live in Bay Lake that are disin employees. No, we can't go through all of the

Disney Bay Lake is a city town. I mean, Justin has been called by Disney, but they do have a municipal government with a duly-ledger mayor and all the regular things that they basically rubber stamp the things that Disney wants. I have heard this several times. Like when it is to is also obsessed with Disney World minutia. I think it's an interesting story. It's fascinating. There's no place like it on earth. Anyway, she's really depressed because she wants to go back to Disney World. So I don't know how we're going to make that happen. But I guess we legally have to now at this point. Well, you can go back. I mean, we can legally make that happen. But I don't think living in Disney world is going to.

We've learned, we've learned some things that will help us along the way. One is we don't want to stay at the resort that is literally a hundred thousand miles away from Disney world. We will try to avoid that. Yeah. And two, it was probably a good idea recently that we went to Disney World and not Disney Land. Why is that so? Well, because as you may have heard, unfortunately, Disney Land, which is in California, in Anaheim, probably, has had an outbreak,. Not in Disneyland, I should say, but people who went there, among them, there has been an outbreak of legionnaires disease. Okay, now, sometimes I have some base familiarity. I have to admit that I know literally nothing about what you're talking about.

Do you even know why it's called legionnaires? I don't know what it is, so that would be very impressive if I knew what it was called that. That's good. That's a good jumping off point for me because I kind of assumed everybody already knew the story, but I think that's the kind of assumption you make. When you're new. When you're a nerd. When you're a medical history nerd who is immersed in the world of medicine all the time and goes, well, I mean, that's an average. Everyone heard those stories. I'm sure. I have the oldest, the most well known, beloved, fables, honestly. So I'm going to talk about Legionella

and the disease it causes, one of them, Legionnaires disease. Thank you to those who have recommended this topic, Sid, not me, other Sid, alternative Sid. Different parallel universe. Parallel, parallel universe me, Sid. Chris, Emily, Emily Claire and Stefan This is I would say this isn't one of our usual Topics on solbums. It is medical history. It isn't I think a really cool story

It's not really one where we mess up too much. Okay, good So that's kind of nice a nice refreshing change of pace. It really needs a little light Yeah, and they're solbons So that's kind of nice. A nice refreshing change of pace. Her body needs a little light. Yeah. And they're so bad. And it's a lot more modern too. So we, you know, we don't get to like feature plenty of the elder any weird, you know, poltuses in this one. Right.

So our story actually starts in 1968 in Pontiac, Michigan. Oh, okay. As most stories do. All the greatest medical fables. in Pontiac, Michigan. Oh, okay. As most stories do. All the greatest medical fables. There was an outbreak of some sort of febrile illness that occurred largely among people who worked at a local health department.

And then some people who had visited the health department didn't work there, but who had been there recently also developed the illness. It was a fairly mild febrile illness, febrile meaning they got feverish. Right. Fevers, body aches, felt unwell. Kind of what we'd think of like now

is a viral syndrome we would say. Okay. You know, no. It's got kind of puny. Yeah, got sick, got better later. It was a strange outbreak. There it is, felt like that. It was a straightening outbreak. That's on the center of that shell. Are you having it straight from the pros?

I mean, hopefully that's the end. Got sick, got better later, but nobody was sure what it was. It was very interesting because they couldn't pin it on a flu or a cold or any other kind of illness that was going around. So they called it Pontiac Fever. And yeah, well Pontiac Michigan. Sounds like a Pontiac ad. Pontiac Fever, this Labor Day weekend, we've got Pontiac Fever.

To be fair, they've got Pontiac Fever is not like the best ad anyway. No, I mean, it's not the most original. It's not the most racial shock. It's not the greatest tagline. But anyway, nobody knew what caused it, and so that was it. Now we fast forward a little bit in history to 1976. So we're in Philadelphia.

It's a hot summer, okay? It's July, it's hot. We are at the Bellevue Stratford Hotel. It's like the... I feel transported. Yeah. It's a beautiful old hotel. They call it like the Grand Dame or something.

It's a very well-known, I think like almost every sitting like modern American president has visited it or something to that effect. Anyway, very famous hotel and in this particular point in history the American Legion is holding their annual convention there. Okay, I guess you were going to see where we're headed now. And it's a very exciting year. It's the bicentennial. Oh yeah. But he's feeling very patriotic. Huge. There are more than 4,000 members of the American Legion there to

Do whatever you do at an American Legion meeting. I don't know. I really I honestly talk about America how the Legion is going and then Legion I'm not sure are there hats. I think they're Yeah, definitely hats So they so they were all present and it was very hot outside and many people were relieved to be staying in the luxury of the Bellevue star-off-for-hotel. I'm sure, yeah, hot day.

What better way to beat it than luxury eating an air-conditioned hotel? Exactly. Ice-cold air-conditioned hotel. And so everybody's in a great mood, everybody has a great meeting by all accounts, whatever you accomplish, whatever you seek to accomplish. They're wild about the they're all pumped up about lead jacktivities. They they they accomplish this these these goals and they all headed home and everybody was happy and everything seemed to have gone great except And everything seemed to have gone great except at this point several days later a strange illness begins to occur

It's Legionnaires disease, isn't it? Are you ruining it already? I'm sorry. I'm jumping ahead. Sorry. It's a strange illness begins to occur among people who were present at the meeting and then a couple people who weren't actually legionnaires, but who were around for some reason. And in some cases, this becomes quite severe. This is no Pontiac fever. This is a severe pneumonia that begins to develop. People become very ill. They were having fevers up to 107. Whoa! They were hospitalized. And unfortunately in some cases, people even began to die. Holy crap.

All in all, when we look back, there were around, and these numbers, every source I looked at, they were slightly different. They're somewhere around 200 cases. I've seen like 189 and 221 both quoted with similar frequency, but one way or another, there were around 200 cases. I've seen like 189 and 221 both quoted with similar frequency, but one way or another, there were around 200 cases. And again, the number who actually, who actually died from the outbreak somewhere between 29 and 34, I've seen cited. One of the epidemiologists who actually was around at the time says 34. So I feel like that's probably.

That's where I would go with. Probably right. But right but anyway about that number So as you can imagine people began to panic because it seemed to be kind of random Everybody went home from this convention to their families to their hometowns wherever that may be and even though you swear to each other Hey, listen this year we're definitely gonna keep in touch. I had such a chill hang with you at the Legionnaires meeting They didn't necessarily so they weren like, lived in with each other. No, no, no, actually the only way they began to, they noticed that it was an outbreak and not just a bunch of random cases of pneumonia. There was one physician who had three patients

who lived in the same area, went to this convention, came back and all got sick with similar symptoms. And so that physician was the one who actually put it together and then reported it and said, I think there's something going on. And then they began to link all the cases together. And this of course caused a panic. Of course.

Because it seemed mysterious, nobody knew why people were getting sick. It didn't spread like you think of an outbreak. The people's families weren't getting sick. So it wasn't necessarily people you were around, right? So it seemed random There had been an outbreak of swine flu earlier that year and everybody was very worried about that coming back That lines. Yeah, that was on their minds Parrot fever which we've talked about before Yeah, was was something that was prominent at this point in history

So there were a lot of things I also saw mentioned that Michael Crite and Sandra Amada strain was popular to be fair I checked that out that was 1969 when that was published so we're like a few years past Yeah, I think it was that but wasn't there was the mega man maybe but anyway I was out around around that time period. Well, mega man was 71. I just looked it up. So, but there were rumors flying everywhere. People began to think was this some kind of an attack point being that everybody was freaking out. There were all these rumors. Was it an anti war activist attack? Was there it was a poison?

Was this a toxin? Some people thought it was radiation. Sure. Bob Dylan wrote a song about it. Okay. And tears disease. Okay. Not one of his biggest hits, I'm assuming. The hotel ended up closed at a fear for a while for like two years. Because they thought something was coming from the hotel.

A skew in there somehow? Yeah, something was coming from the hotel. That's you in there somehow? Yeah, something was coming from the hotel. The CDC launched what was the largest investigation in its history. Twenty epidemiologists were sent to the city, which sounds very dramatic, but I mean, and I mean this with all the love in my heart, like twenty epidemiologists. It's not like, you know, like oceans 11. Right. So yeah. I. So, yeah. I love you epidemiologists.

I think you're very cool, but yeah. But look at your talking too. Right. So anyway, researchers spread out all over Pennsylvania. They traced where all the attendees went, were from and went to their houses if they were sick and interviewed them. They did. They were all maps with the string on it.

They did. They had maps with pins for cases, the yellow for cases, red for deaths. They interviewed everybody about their symptoms, every move during the convention, how many times did you write in an elevator, did you eat breakfast and wear, who was your roommate, all that stuff, extensive histories, they checked everything,

kitchens, ice machines, toothpicks, cooling systems, they crawled around and air ducts, everything to try to find the source of this illness. Now was it a persistent thing or I guess, or was it just like this one outbreak? Like it wasn't like, it was a, it was a self limited outbreak. It seemed to be that there was a limited number of people who got sick. Now, they didn't all get sick at the exact same time

because as we'll learn, the incubation period is somewhat varies from person to person. But they all got sick and then they either got better or didn't and that was it. And it did not continue to spread from there. So it wasn't like something they were trying to contain. It was more a mystery to solve. Okay.

Think about it more like from the perspective of a murder has occurred and we need to solve it. Oh, and we need to call no rate is detective. Have you borrow. I shouldn't have even said that. Look is a green eyes shimmer Sydney as the case because it's come to me. He says little gray cells, order and method. So the illness was, this was highly covered by the press.

As you can imagine. Yes. Yes, the press was all over this. There were like time magazine cover articles. I mean, like a time magazine cover was about the search, was about the epidemiologists. They were kind of rock stars. I guess, yeah.

Why would I have to settle? I'm not going to sit in here trying to calm down. No, I just, it sounded very dramatic. Like the CDC launched the biggest investigation in history, sending 20 epidemiologists to the city of Philadelphia. Anyway, it was considered this big, cool mystery they were trying to solve.

Most of the press started referring to the illnesses Legionnaires disease because it was Abinne to Legionnaires. Some started to call it things like the killer fever or the Philly killer boring Philly killer killer is a little bit killer drifts off the terms off the tongue a little bit better, but But it was very dramatic everybody was very scared and researchers were not immediately turning up many results. They had not figured it out.

So this even actually led to like a congressional hearing. They had to like testify before Congress as to why they hadn't figured this out. Okay. And what was going on and where were they in their investigation? I mean, people were taking this very seriously. Yeah. Which again, it does seem kind of strange considering that it was a self-limited thing. It wasn't like continuing to spread. But people wanted to know what happened. And at one point, one of the leading epidemiologists

actually kind of made the public comment, we might never know what caused this. And people did not like no, you can't leave as hanging. No, no one like that answer. That was very, I like that. It's a very honest science answer, but people don't like that. So amid all this public pressure and criticism, a microbiologist named Joseph McDade was taking a night off, hanging out at a Christmas party. This is how long this has been going on, by the way, this happened in July. We're now at Christmas. He's like they hear it, right?

He'd be like played by Josh Brolin in the movie. Sure. Okay. Yes. And he's hanging out at a Christmas party. And another guest, we'll give him the benefit of that doubt and assume that maybe he'd had one too many glasses of champagne or something starts kind of giving him crap and saying like

his CDC, you guys are really great, huh? Yeah. You and all your epidemiologists, you're really cracking this case. It starts to give him a hard time. And this must have gotten to him because shortly after Christmas, McDade decides to skip his vacation. Whoa. And just lock himself up in the lab to follow up on some hunches he's had. So they have all these samples, right?

They've collected all this stuff from both the hotel and from patients. They've gone to visit all these people who were sick and Got probably samples of every bodily fluid that they could find and it even had like slides of their lung tissue had gotten samples of their lungs and put them on slides and to look at them under a microscope. To look for. Dr. Calpher. Yeah, to look for terms. So he started re-examining all the evidence and going through it and this took a while, but he finally noticed a bacteria that he hadn't really noticed before. And he started to compare samples and he found it in multiple cases. And they

called the bacteria Legionella, pneumophila. Colleges like taking the lead from the press. The Legionnaires, Legionella. So there you go. And we finally had the culprit. It's interesting because they looked back. This bacteria had actually been isolated before. They had slides of this on record at various like government health organizations, but it was thought to be something that only affected animals and didn't have any clinical significance. So we'd had the culprit all along. We had it.

We were so close. We had him remember we wanted him. These are so Z. That you know what's funny is they never actually were able to find the source in the hotel Despite what I'm going to tell you was the air conditioning system They weren't ever actually able to isolate it despite the fact that like I told you they were crawling around up They're swabbing all those ducks Because it had been cleaned prior to all of the investigation being launched because people were sick

Oh, I'm sorry to cleaned everything the perfect being launched because people were sick. They started to clean everything. The perfect getaway, the perfect crime in and out. But the, but the reason for the emotions 11 this whole time, they actually even isolated it to a specific air duct that they think that was responsible that both filtered out into the lobby, where a lot of, where we're pretty much all of the people had been at some point in the lobby. And then also onto the street outside, which is why there were a couple cases among people who hadn't actually been attendees. So, and it was probably because it was spraying little droplets of air onto the street outside as well. Grody. Under the sidewalk.

So, I got to hear more. Certainly this isn't the end of the Legionnaire story. outside as well. Grody. Under the sidewalk. So, I got to hear more. Certainly, this isn't the end of the Legionnaire story. It's not, but before I tell you the end of the story, let's go to the billing department. Let's go. The medicines, the medicines that ask you let my God before the mouth. Okay. Sydney, I need more Legionnaires disease.

Okay. So, they figured it out, right? Yeah. We have finally, we found the bacteria, we know what caused it. It was one that we had in our grasp all along and we just hadn't pieced it together. And then there's brilliant epidemiologists did it. I feel really bad about what I said about the epidemiologist now. You got to let it go. I know. I wanted to be one for a long time, I kind of shifted gears, but can I get that out there? I really admire epidemiologists. That's, no, that's wonderful.

They're like, they're like scientific Sherlocks and they're brilliant. And anyway, I just needed to say that. Great. I love epidemiologists. So they were able to go back and figure out that there had been passed out breaks of Legionella that had occurred that they just didn't know that's what they were, right? Oh, because we didn't have, we didn't, yeah. We weren't able to isolate the bacteria, well now we did, so now we could figure things

out based on symptoms and pattern. And in addition to the fact that sometimes in outbreaks they would collect blood samples and then hang on to them, blood samples, body samples, spit samples, whatever samples they could get. And then hang on to them in the lab in case maybe someday we'll crack this case, right? One of those cases that they cracked is the Pontiac Fever case. They had old samples, they analyzed, they found the Legionella bacteria in there too, which is why Legionella, the bacteria, can cause two distinct illnesses, Pontiac fever, as well as Legionnaires disease. Same bacteria just slightly different

presentations depending on what gets infected. In addition, they also cracked an old case from, not that old, just a couple years before 1974, where three people had died after a meeting at the same hotel. Wow. There was a meeting at this exact same hotel in 1974 of the independent order of odd fellows. The I-O-O-F. Yes, and three people had died after that meeting and they went back and realized that

that had been also an outbreak. A podated just sitting there dormant the whole time. Probably the ducts had been cleaned in between. Okay. Why? I mean, otherwise like why did you have an outbreak in 74 and then an outbreak in 76 and another? Why did it? Okay, yeah. I mean, yeah, but like why was it happening? Why was like why at the same place would it happen twice? It probably has to do with how often they were cleaning these systems. Ah, all right. So there you go. I'm sure they're very clean now. I am not throwing you in. Oh yeah, you think after 30 people died there, they're probably real good about duck cleanliness

of this hotel. I think it's like a hi-hat now. Okay. So I don't think it has the same name. I think it's it's some sort of hi-hat. Okay. But I know it's quite a hi-it now. Okay. So I don't think it has the same name. I think it's some sort of hi-it. Okay. But I know it's quite funny. Too many Google apps. I haven't Googled something in a long time. If you want to Google it, you can. I didn't know if you wanted to tell everybody what the independent order of odd fellows

was. Or just let everybody look it up for themselves. You can fill everybody in if you want. There is a building that says, I only know about it because there's a building called the, there's a building labeled IOF downtown and I got curious about it one day because I'm a curious young man. Well, let's just let everybody Google that figure out. Just Google, that's a good idea.

I did because I mean, it's an interesting name. You come across, you don't come across names like that all the time. So here's the thing about Legionella. High at the Bellevue. There you go. Legionella likes fresh water. So it can live out where there is fresh water out in ponds and lakes and whatnot, right? And they typically live inside little protozoa, like amoebas and things like that. The bacteria actually live inside of them. They have a symbiotic relationship. Is that creepy? Does that bother you? I don't like symbiotic relationships. So, so they're just out there. Except ours, but other than that. But they can. Although

ours is really more parasitic, I kind of just like leached onto you and I go, that's not true. I don't think that at all. We're definitely in symbiosis. I added the show, I guess. But they can they can grow in man made water sources as well. Like air ducts. Like air conditioning systems like cooling towers, showers, faucets, hot tubs, fountains, hot water heaters, plumbing systems, anything like that. Legionella can grow in. This is tripping me out. Yeah. There's a lot of places with water, so do you have any thought about this? I know, there's lots of places with water.

One of the places that gets a lot of press are hot tubs. Oh, yeah, I think I've actually heard that before. Yeah, so Legionella in connection with hot tubs. Now, this is not... Wouldn't it cook them though? It seems like they get hot enough that it... They like warm water. Oh, man, but it gets really hot though.

It doesn't get hot enough to kill them. I'd have to get like over 140 I guess. Right? Wouldn't that do it? I don't know exactly what temperature kills Legionella. I know they like warmer water. Different bacteria of different thresholds. Of course, yeah, that makes sense.

So yes, at 140 is a general, I mean, you're thinking of like boiling the water. Yeah. So that's like a generally good idea, I mean, you're thinking of like boiling the water. Yeah. Yeah. So that's like a generally good idea, but I don't want to, I don't know what temperature is. It's boiling hot water. What is it? That's silly.

No, hot tub is not boiling hot water. You would die. The bubbles are from the jets. Right. Got it. Yes. Sorry. Okay.

Moving on. Let's face mother science. So hot tubs are not like the biggest source of Legionella, but when it happens, I think it's scary. And a lot of people have hot tubs. So you hear a lot about it. You can get it from being in the hot tub, but you can also get it from just being around the hot tub, which is I think what makes it especially scary, because what it is is, so you know, how when you're in a hot tub, and it's like, there's all that like mist coming up from the hot tub, is all those bubbles are, you know, when you're in a hot tub, and it's like there's all that like mist coming up from the hot tub as all those bubbles

are bubbling around and popping around you and all that. So you're inhaling some of that. Okay. You're never gonna wanna go in a hot tub again when you start thinking about this. You're inhaling some of this like sweaty. Sweaty bubble air. The sweaty bubble air is,

you're just like, you're inspiring this into your airways and your lungs. And so if they're... I don't feel inspired. If there is bacteria clinging in those little water droplets, you're also inhaling that. So that happens if you just walk past a hot tub. I mean, if you get close enough hot tub... So I can't even get close to hot tub.

It's what you're saying. I'm saying that it's possible if the hot tub has not been properly clean. For instance, 140 people at a Dutch flower show got it from just walking past the spa's that were on display that had not been clean. There've been cases of people in like showrooms, like going to places where they sell hot tubs and they just like walk by the hot tubs and then people get sick because the hot tubs aren't being cleaned regularly. And so they get cases of legionella. As a result, there is a way, the CDC has issued guidelines on how to care for hot tubs.

They're very easy to find. If you have a hot tub and this is scary in you now, go to the CDC website and look up hot tub care. There's a whole handbook on legionella and hot tubs. You just have to clean it and keep it at a certain pH and the Legionella won't grow. So wait, if there's, if there's a source of it and a bunch like say, there's a source of it like a hundred people walk by it. Is it, is everybody gonna get it? No, that's a great question. So it, it actually, it, like it's specifically that case I mentioned where 140 people got it. I think the attack rate that they that they claim that they called was like 0.2%.

So of people who walked by it, 0.2% got sick, which is pretty low. Yeah, all things considered. The reason being that not everybody who is exposed to Legionella is going to get it. It's largely people who we would kind of think of at more vulnerable populations. So people over 50 are more likely smokers or people with any kind of underlying lung disease. So like COPD, infosima, chronic bronchitis,

that kind of thing are more likely to get it. People with diabetes, any kind of reason that you might have a compromised immune system. So because you have cancer, you're on some kind of cancer treatment or you have an immunodeficiency, anything like that, kidney disease, liver disease, that kind of thing. So for most people who don't have any underlying illness or younger, you probably won't get it. Probably. More than likely, you'll be fine. And as I already mentioned, it can't spread from person to person. There's been one reported case

of transmission from person to person ever. Generally speaking, it cannot be transmitted from person to person. You have to inhale it yourself. How, how I know if I have it or not. So the symptoms are similar to a lot of pneumonia. You get cough, you get shortness of breath, fever, chills, body aches, headaches, you might get some nausea, some diarrhea, confusion is actually reported a lot with legionaires disease, but a lot of it is like a pneumonia, you know, you probably would go to the doctor because you would feel like you have pneumonia, you'd be pretty sick, like I mentioned the fever can get really high.

The symptoms usually start a couple days after exposure. So fairly quickly, although it can be a little longer, most of the time the symptoms start pretty quickly. And like I said, you can also get from that same bacteria legionally, you can get Pontiac Fever, which is the same illness without the pneumonia. So you don't get a sick. Pontiac Fever generally does not require treatment. Oh, good. If you get that version of it, you'll get, like I said, you get sick, you get better. You may not even necessarily go to the doctor. I would probably want to go just to make sure I don't leave you in the disease. No, I mean, you might not get sick enough to think you need to go to the doctor.

Okay. Does that make sense? Yes, yes, I actually. Yeah, you wouldn't know you had it. I guess you could just tough it out, but. Well, while Legionnaires, you will get sick enough to go to the doctor, you will need antibiotics for this, which we do have antibiotics that treat it very effectively nowadays. And we did it.

We did when this happened, which is people didn't know what they were treating, but we did have antibiotics then too that worked. And then supportive care. I mean, some people if they get sick enough might need ventilator support or IV fluids or all kinds of things. But the sad thing about Legionnaires is that one in 10 people with Legionnaires can die. So the fatality rate is not- If let them treat it or-

Just period. It's a serious illness. Yeah, no kidding. Yeah, so I mean, and certainly our rates are better now than they used to be now that we can identify it faster. And then with some specific outbreaks, they'll have only like 1% mortality rates as opposed to this. But the point is that you need to take it very seriously.

Okay, I will do. The world's largest outbreak, because it had happened since then. I mean, we've had isolated cases periodically ever since then. The world's largest outbreak occurred in Merca, Spain in July 2001 and there were 449 confirmed cases although it was estimated there may have been up to 800 Wow, just not all were confirmed like I said not everybody always gets tested and proven right away. They you know It still happens of course in the US. There were about 6000 cases reported in 2015 But again, it's under reported.

People don't test for it. They treat you with antibiotics because you have pneumonia and you get better and you never knew you had legionaires disease. That kind of thing. Because you do have pneumonia, so you get treated. So it may be as many as 18,000 cases a year. It's estimated. And it usually happens in the summer and early fall.

And as I mentioned in Disneyland this past month, they have had an outbreak of legionnaires that led to the closing of two cooling towers in part of the park. So far, and I saw this update from like three hours ago, there have been 15 cases reported. And 11 of the people had actually gone to Disney land. So some of them had were in Anaheim, but had not actually been in Disneyland. They were just hanging on the hot dumps. Maybe. I don't know. How could that be though if they were not there? I don't know. I mean, I think this is still unfolding. All they know is at least the majority of the people who got sick had definitely been a Disneyland

They traced it to these two cooling towers which were tested and did in fact have elevated levels of Legionella inside them But we're not exactly what's happening, but we're not sure all exactly And and those two cooling towers have been closed down and Cleaned and they're going to retest them and if they're okay, they're going to reopen them is my understanding. No, all right. Well, that's something. So, Disney's got it locked down. They've got it under control.

Of course. Mickey's going to go up there and clean them himself. How he does it. I don't think that happens. Folks, that's going to do for us this week. We hope you've enjoyed yourself. I want to thank the taxpayers for these, so their song medicines is the intro natural program.

Hey, we're going to be at podcon December, I think ninth and 10th. All right. Eighth and ninth. Tell what that Saturday. I should make sure I'm going to be there. It's nice and 10th. Yes, confirmed. Nineteenth and Seattle, Washington at the Washington State Comments Center. It is going to be really fun. And a lot of great shows are gonna be there. Still buffering, solbans, my brother, my brother, me, welcome to Night Vale, a 99% of Israel, so many great shows. You're gonna go wild for it.

And you can get tickets right now. Just go to podcon.com. And that's the summer night and 10th. So you know, check that out. It comes here, our shows. It comes here, shows. And thank you to you so much for listening. That is going to do it for us, but thanks for racking it out.

And until next week, my name is Justin McRoy. I'm Sydney McRoy. And as always, don't drill a hole in your head. Maximumfund.org Comedy and Culture, Artistone Listener Supported Oh, sorry about that. Just had to dispatch some goons real quick.

Hi, I'm April Wolfe, lead film critic at LA Weekly, and when I'm not kicking butt, I'm hosting the new Maximum Fund podcast switchblade sisters. Do you love genre films? Do you love female filmmakers? Do you love discussions on craft? If your answer is yes, you'll love Switchblade Sisters. Every episode, I invite one female filmmaker on, and we talk in depth about their Fave genre film

and how it influenced their own work. So we're talking horror, action, sci-fi, fantasy, visarro, and exploitation cinema. Mothers, lock up your sons because the Switchblade Sisters are coming for you, available at maximumfund.org or wherever you find your podcasts.