Feb. 16, 2011 -- Two days after partying and networking at a conference Feb. 3 in Los Angeles, David Castello suddenly fell ill with uncontrollable chills and a 102 degree fever. Part of the conference took place at the Playboy Mansion.
"I went from zero to not a good place in 15 to 20 minutes," said Castello. "It was like somebody flipped a switch."
Castello, co-founder of Castello Cities Internet Network, was among the hundreds of people to get sick after the conference.
But could the Playboy Mansion, a place of lurid fantasies, really have such an adverse effect on a person's physical health? For some, it is the dream of all dreams to hit up a shindig at Hugh Hefner's famous bachelor pad.
The Los Angeles County Department of Public Health said approximately 200 partygoers there, including Castello, became sick with flu-like symptoms. At least four were diagnosed with a mild form of Legionnaire's disease, a type of pneumonia characterized by fever, headaches and achiness all over.
Now health officials are combing the premises trying to locate the source of a relatively common bug that made these revelers uncommonly ill.
Legionella pneumophila, or LP, are bacteria that cause Legionnaire's disease. They are found naturally in the environment, usually in warm water, like that in hot tubs, cooling towers, hot water tanks and large plumbing systems.
"This infection is self-limited and does not require antibiotic therapy," said Dr. Richard Besser, ABC News' chief medical editor. "Patients are rarely hospitalized. Hot tubs have been implicated in the past but investigators will look for any possible source."
People can get the disease after breathing in the mist or vapor from the bacteria-ridden water. Those with weakened immune systems and lung disease, those who smoke, and the elderly are more susceptible to the illness.
In a statement, the health department said, "The department is investigating several locations associated with this conference, including the Playboy Mansion in Holmby Hills. At this time, Public Health has not determined that the source of exposure is limited to a specific location. The department is working to conclusively identify the source of exposure and the likely cause of illness for this suspected outbreak."
Each year, between 8,000 and 18,000 Americans are hospitalized with Legionnaire's disease, according to the Centers for Disease Control and Prevention.
Playboy Enterprises said in a statement, "The Playboy Mansion continues to cooperate fully with the Dept. of Public Health in their investigation."
The DOMAINfest Global Conference ran from Feb. 1 to Feb. 3. People attended events at the Fairmont Miramar Hotel in Santa Monica, Skybar at the Mondrian Hotel in West Hollywood and the Playboy Mansion.
Maybe Not the Hot Tub
Castello rode out the illness until his fever broke five days later. Although he has weathered the worst of it, he says he continues to feel fatigued. He said he has received a letter from L.A. County that recommended he go to the hospital to undergo several diagnostic tests, including a chest X-ray and a rapid influenza swab.
"Legionnaire's disease will affect a small proportion of the group," said Janet Stout, Ph.D., director of the Special Pathogens Laboratory in Pittsburgh. "In outbreaks, [that's] usually less than 5 percent of the total number exposed. It appears from these reports that the rapid onset of symptoms is more typical of the related illness called Pontiac fever."
Pontiac fever, or Legionellosis, is a milder form of Legionnaire's disease that causes flu-like symptoms.
Love that Dirty Water
"Legionella is a bacteria that lives in water and loves warm, wet environments," said Dr. Mary Nettleman, professor and chair of the department of medicine at Michigan State University. "Unfortunately, people also like warm, wet environments like hot tubs."
While hot tubs are a great addition to pool parties or some après-ski relaxation, hot tub owners should be aware of the bacteria that could be swimming in the water.
"Most residential hot tubs do not fall under any regulatory authority," said Stout. "If the outbreak source is found to be the hot tub, it is a wakeup call to owners of these devices to be sure Legionella is not present. A simple culture test can reassure both the owner and the users of the device."
And Dr. Tracy Zivin-Tutela, an infectious disease specialist at St. Luke's Roosevelt Hospital in New York, agreed that hot tub owners must pay close attention.
"The only way to prevent the bacterial contamination is proper disinfectant and maintaining appropriate pH levels," said Zivin-Tutela. (pH is a measure of acidity and alkalinity.) "This should be monitored at least two times per day or more often if there is heavy use of the tub."
What Made Playboy Mansion Visitors Ill?
Spa- and whirlpool-associated outbreaks are frequently implicated in larger outbreaks, particularly because the suspected mechanism of Legionella transmission in these outbreaks is through aerosols generated by air injected in the whirlpool, said Dr. Amir Afkhami, assistant professor in the global health division at George Washington University School of Public Health.
"Basically, the bubbles that soothe can also become bubbles of infection by giving Legionella a piggyback ride into our respiratory system and allowing it to infect our lungs," said Afkhami.
So, as conference goers wait for definitive results from the county health officials, doctors say Hef and his bunnies should keep a watchful eye on the famous hot tub for future guests.
"This literally took away a week of my life," said Castello. "I just hope everyone else gets better quickly and we find out where it started."