Dr Joe D’Souza
In an earlier article dated July 31 entitled ‘Wake up call for tourism sector’, I had highlighted the threat of infectious disease as one of the major causes of impediment to the growth of quality tourism in Goa. I had referred to specifically the threat of Legionnaires Disease, a pneumonia caused by inhalation of aerosols emanating from contaminated water system in institutional complexes.
Earlier this week, reports have come from the globally reputed CBS network, mentioning a Legionnaires Disease outbreak in one of the five star hotels located in Atlanta, USA with one death and 12 confirmed cases, and dozens of other hotel guests suspected to be infected. The hotel itself was closed pending investigations with lawsuits been filed for claims by the affected individuals and their families.
This news item was splashed across the internet and assumes significance for Goa, which boasts of being on the tourism map of the world. With approx 10-12 new high-end starred hotels expecting to open for business in the next 2 -3 years in Goa, the time has come for us to introspect and arrive at suitable solutions to mitigate the impending threat of water-borne diseases including Legionnaires outbreaks in Goa.
It is also pertinent to note that Goa’s champion swimmers Talasha Prabhu and Jerry D’Mello were reported very sick a week ago after swimming in the Peddem Swimming Pool which is ironically managed by the State Sports Authorities. Can we as Goans take the incidences of water borne diseases lying down? Or must we pull up our socks and act accordingly?
Now, coming back to water-borne diseases in Goa in particular. We have to understand the problems in totality so that neither our society suffers nor should we allow our tourism-dependent economy to take a hit due to bad and unscientific sanitary practices.
The hotel industry players in a bid to outperform the competition are coming with innovative ways to retain clients viz : provision of superior amenities as a value proposition to the guests, which include water features such as spas, lobby fountains, splash pools in guest rooms etc. These water sources and supply lines running into and within the building provide locations for the growth of Legionella bacteria and pathways for potential exposure to infection and contraction of Legionnaires Disease.
In addition, hotels with modern central air-conditioning systems which utilize high-efficiency water cooled chillers connected to cooling towers require high standards of water hygiene to be maintained in the circulating water, which otherwise could emanate contaminated drifts (aerosols) “one of the main causes for the proliferation of Legionella bacteria. We must realize the complex piping systems causes deposition of corrosion products, scaling, slime and bacterial films.
The above mentioned bio-films developed in the metal water supply pipelines provide the ambience and nutrition necessary for the Legionella bacteria to grow to infective levels. The bio-films act as nurseries for all pathogenic bacteria, predominantly Legionella Pnuemophila, which is presently causing concerns to the tourism sector, especially in Goa.
Ironically, while food safety and kitchen cleanliness and hygiene are maintained by reputed hotels being subjected to rigorous audits from FDA( Food and Drug Administration ) and related agencies, the status of water contamination status and pathogenic bacteria risk assessment is not conducted with the same fervor in spite of it being a potential health threat.
The high end tourists paying big bucks for the comforts and visually appealing decors and interiors with snazzy restaurants offering white glove services are blissfully unaware of the “backyard institutional mess” in terms of the polluted water from garbage leachates, sewage percolations and infectious bio-films.
During the monsoons in Goa particularly, the ambience around institutions like hotels, hospitals, swimming pools, etc are water logged with nutrients available from overflowing sewage pipelines, garbage leachates and terrestrial run offs which enter the complex pipelines within the built environment of the above mentioned institutions, giving rise to various types of enteric and other waterborne disease like typhoid, dysentery, diarrhea, leptospirosis, skin and lung infections including Legionnaires disease.
In view of the heavy losses to the high-end hotel sector as well as sophisticated hospitals focusing on health tourism, it is pertinent for us to know more about the spread of specific infective and deadly diseases including Legionnaires disease. Legionnaires disease which infects the lungs and the respiratory tract of the victim is caused by the gram negative aerobic bacteria which disseminates in the polluted environments mentioned earlier.
When water is brought in to the hotel water storage tanks which typically are not cleaned to appropriate levels owing to partly lack of knowledge and also at times because of apathy towards this critical aspect of maintenance. The contamination caused feeds the Legionella bacteria which then grow and proliferate through various risk systems having aerosolisation potential such as faucets, showers and various water bodies across the hotel premises including lagoons, spas and swimming pools.
The high spending foreign tourists, acclimatized to a high level of hygienic environment in the US and Europe, have lower levels of immunity and easily fall prey to the infection, especially if they already have an underlying disease such as diabetes, cardiovascular problems, etc which suppresses their immunity.
The recent spate of cases highlighted on the public domain is a warning signal for the Goan hospitality sector to “wake up and read the writing on the wall”. The Public Health Department and state government too needs to take cognizance of the dangers looming large, if tourism business has to survive in Goa in the years ahead.
In larger public interest, we in Goa must also ensure that our hospitals and pubic institutions are safe from the above mentioned challenges, or else the immuno-compromised patients entering the hospital may suffer hospital and institution-induced infections.
In conclusion, the way forward is to see that services of engineers competent in water treatment technologies are judiciously utilized for evolving remediation strategies.
Fortunately in Goa, we have qualified engineers with expertise in procedures outlined in the standards developed by leading professional institutions such as American Society of Heating refrigeration and air-conditioning engineers, etc which the government and institutional bodies should engage with in the larger interest of the health of the society at large and economy of Goa in particular.
