A number of fecal related bacteria were isolated from the bathing, sauna, spa areas --Escherichia coli and Proteus sp. were on the top. In addition, staphylococcus aureus responsible for skin infections was found. Legionella sp. causes Legionnaire's disease (see picture of Legionella colonies growing on an agar plate and illuminated using ultraviolet light to increase contrast) was found in the airjets and pumps that recirculate the water (a perfect environment to harbor germs). Pseudomonas aeruginosa--responsible for skin, eye, ear, and lung infections was detected. Outside of bacteria, fungi were isolated and can be responsible for lung infections, nose bleeds etc.

The numerous pathogens found during the random sampling are responsible for: septicemia, urinary tract infections, intestinal infections, infections of the respiratory tract, burn wounds, ears and eyes, bacteremia, endocarditis, gastroenteritis, Legionnaire's disease, Pontiac fever, impetigo, folliculitis, furuncles, carbuncles, scalded skin syndrome, toxic shock syndrome, food poisoning, pneumonia, emphysema, osteomyelitis, septic arthritis and beyond.

Focusing on Legionella sp. testing and remediation:

Legionella testing involves collecting water samples/surface swabs from evaporative cooling basins, faucets, shower heads, sanitary bowls, air conditioners and any location that water can collect, condense and warm. The samples are cultured and colony forming units (cfu) are quantified as cfu/Liter of Legionella. Legionella is a parasite of protozoans (i.e. amoeba) and therefore requires conditions that will allow both to flourish. The bacterium forms a biofilm which is resistant to chemical and antimicrobial treatments including chlorine. Remediation for Legionella outbreaks can vary but often include hot water flushes of  (160°F) sterilization of standing water in evaporative cooling basin, replacing all water entry ways (i.e. shower heads, recirculating pumps).

Consumer knowledge:

Prior to using any water from a suspect bathroom/kitchen/spa/steamroom/sauna, allow for to run for 1-2 minutes and inspect to see if there is any colored build up. While this doesn't replace treatment, it can decrease the exposure load from Listeria. The best approach is to have reports of weekly test monitoring to ensure your safety.

Breathing, Bathing & Surrounded in Filth:

The next time you think about entering a bathing area, steam room or sauna, you should realize that warm water is going to enlarge your pores and the steam action creates an aerosolization into your lungs. Five (5) minutes into it and your surrounded by infectious lung bacteria (Legionaire's disease), urinary tract infections and skin infections. They have already been documented throughout history and the problem if you get an infection is the doctor will just treat it and not try to find the source. This is the perfect spot for an outbreak.

Numerous findings at saunas, spas and other facilities where large amounts of water is present and aerosolized are not checked regularly and there isn't any monitoring system. For the public, if you don't have something solid that's someone going to standby and be responsible, it is better to discontinue your membership vs. getting really very sick.

Food Source:

Stagnant, organic-containing body-contact water trapped and recirculated in an already rich biofilm provides the ideal environment and food source for bacteria to flourish.

Data from Foot Spas & Foot Massage Places:

Microbial Loads in Foot Spas: A Hidden Health Risk." 100% of the samples, taken from both private and public businesses of spas, steam rooms and saunas that provide foot massage therapy services contained microbial growth; 95% of the samples additionally contained enteric organisms; 81% had fungi; 69% had Pseudomonas sp.,; 46% had Legionella sp.,; and 44% had Staphlococcus aureus.