Updating The NYC Legionella Outbreak

Legionella Bacteria - Photo Credit CDC PHIL

 

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Last Wednesday, in NYC DOH: Investigating A South Bronx Legionella Outbreak, we saw a statement from the New York City Department of Health on an ongoing Legionnaire’s disease outbreak, which at that time had infected 31 people, and killed 2.

 

Today NYC media are reporting the number of cases has jumped to 71, and the number of deaths now sits at 4. 

 

Four dead in Legionnaires’ disease outbreak in New York

Posted 1:22 pm, August 3, 2015, by CNNwire

NEW YORK — The number of deaths in the New York City Legionnaires’ disease outbreak is up to four.

Seventy-one cases of the flu-like disease have been reported since mid-July in the South Bronx, up from 31 on Thursday, the city Department of Health and Mental Hygiene said Sunday.

Legionnaires’ disease is a respiratory bacterial infection usually spread through mist that comes from a water source, such as cooling towers, air conditioning or showers. It is not transmitted person to person. Symptoms of the disease include fever, chills and a cough.

Most people recover, but between 5% to 30% of those who get the disease die, according to the U.S. Centers for Disease Control and Prevention.

The four victims were all older adults with additional underlying medical problems, the city said. Fifty-five individuals are hospitalized.

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The Legionella bacteria thrives in warm water, such as is commonly found in air-conditioning cooling towers, hot tubs, and even ornamental water fountains. When water is sprayed into the air the bacteria can become aerosolized and inhaled.

 

Those who are susceptible (often smokers, immunocompromised, elderly, etc.) can develop serious – even life threatening – pneumonia.

 

Tonight, a town hall meeting is scheduled to inform residents on the progress of the investigation, and to assure them that this is not a contagious disease, and that it is not being spread by the city water supply.

 

The NYC Department of Health also posted the following update on their website today.

 

Updated 8/3/2015

South Bronx Legionnaires’ Disease Outbreak

Frequently Asked Questions

What is the difference between a water tank and a cooling tower?

A cooling tower contains water and is used by some buildings as part of their air conditioning, ventilation and/or heating systems.

A water tank is a totally separate system. Some taller buildings use a water tank to store water used for drinking, washing dishes and/or showering. No water tanks are associated with the current South Bronx outbreak.

Is the tap water in the South Bronx safe to drink, wash and bathe with?

Yes. It is safe to drink, wash and bathe with the tap water in the South Bronx and throughout the city.

What has the Health Department done at the South Bronx buildings with cooling towers that tested positive for Legionella?

There are five South Bronx buildings with cooling towers that tested positive for Legionella. These buildings have completed short-term cleaning and disinfection. The Health Department remains in constant contact with management at all five buildings and is working very closely with management on long-term procedures to keep those cooling towers free of Legionella.

Is it safe for people to remain in the five buildings that tested positive for Legionella, especially if they continue to run their air conditioning systems?

Yes. All cooling towers have been disinfected. That process immediately reduces or eliminates the likelihood of Legionella being released.

Will the Health Commissioner issue an order for the entire South Bronx or the entire City requiring all buildings with cooling towers to disinfect and clean their cooling towers, regardless of whether the towers were inspected/tested for Legionella?

The City is evaluating whether a wide-scale cleaning and disinfection program would be appropriate. Currently, only five buildings have tested positive for Legionella. All five have undergone rapid disinfection and cleaning. We will continue to monitor the outbreak and evaluate whether additional steps are necessary.

 

While large outbreaks of Legionella are often traced to specific causes, quite often the source of the infection for sporadic cases remains a mystery. 

 

A few outbreaks have been quite large, as with the 2001 Murcia, Spain outbreak that affected more than 800 people (killing 6), and last year’s outbreak in Portugal (see WHO: Legionnaire’s Disease Outbreak – Portugal) which saw at least 336 people infected and 11 fatalities.

 

Legionella got it’s name after it was identified as the bacterial cause of a large pneumonia outbreak at Philadelphia’s Bellevue Stratford Hotel during an American Legion convention in 1976. During that outbreak, 221 people were treated and 34 died.

 

We now know Legionella to be a major cause of infectious pneumonia, and that it can sometimes spark large outbreaks of illness. 

 

According to the CDC between 8,000 and 18,000 Americans are hospitalized with Legionnaire's Disease each year, although many more milder cases likely occur. For background information on the disease, the CDC maintains a fact sheet at Patient Facts: Learn More about Legionnaires' disease.