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With an incubation period of up to 10 days, it is always possible that additional cases will be identified, but the epi curve (see above) for New York City’s Legionnaire’s Disease outbreak is moving in a reassuring direction. So much so, that yesterday CBSNewYork/AP reported Mayor De Blasio Says Legionnaires’ Outbreak Is Contained.
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, the elderly and the immunocompromised, etc.) can develop serious – even life threatening – pneumonia.
After a number of cooling tower’s in the affected area tested positive for Legionella, on August 6th the New York City Department of Health Commissioner ordered a city-wide blanket order to all owners of buildings with cooling towers to take the following steps:
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If you own a building with a cooling tower:
You must disinfect all of your building's cooling towers within 14 days of receiving the order in the mail. You must also keep records at the building or buildings you own of the inspection and disinfection of all cooling towers. If City officials ask for these records, you must show them. If the tower was already inspected and disinfected within the last 30 days, you must maintain records of the inspection and remediation, and make them available to the City upon request.The City issued this order because of an outbreak of Legionnaires' Disease in the South Bronx. Several cooling towers in the affected neighborhoods tested positive for Legioinella. The outbreak has not affected the City's drinking or bathing water; it is safe for building residents to drink and bathe with tap water. It is also safe to use home air conditioning units and to be in air conditioned environments.
The most recent update from the Mayor’s office cites 108 cases, and 10 deaths.
Bronx Legionnaires’ Disease Cluster Updated Facts 8/8/15
Download a PDF graph of the Legionellosis Cluster in the South Bronx
Highlights:
- No new deaths have been reported in the last day.
- Emergency department visits for pneumonia are decreasing in the South Bronx.
- The one new reported case of Legionnaires’ disease was diagnosed in prior days – not in the last 24 hours
Cases
- Individuals with Legionnaires’ deceased: 10
- All deceased individuals were adults with underlying medical conditions.
- These patients are connected to the current cluster.
- Reported individuals with Legionnaires’: 108
- Individuals with Legionnaires’ hospitalized: 101
- Of the 101, the number of individuals with Legionnaires’ treated and discharged: 76
Safety of Water Supply and Air Conditioning
- New York City’s drinking water supply and other water features, like fountains, shower heads and pools, are safe throughout New York City and are unaffected by legionella
- Water towers are unaffected by legionella
- Home air conditioner units are unaffected and walking into air conditioned environments is safe, as well.
Locations and Remediation
- All sites will submit long-term plans as to how they will maintain the cooling towers to protect against any future growth of legionella – those plans are due Friday.
- The Health Department convened a panel of experts in the field of infectious disease to discuss the work the City has done so far and to ensure that all the appropriate steps are being taken to find and eliminate the source of the outbreak.
Ongoing Actions
- Continued monitoring for new cases
- Close collaboration with area hospitals
- Disease detectives conducting epidemiological investigation
- Interviews with all individuals reported with Legionnaires’ to support source identification
- Providing updates to elected officials and Bronx residents
- Outreach to vulnerable populations – senior centers, homeless shelters, and other locations
- Monitoring of disinfection of affected cooling towers
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