Second upper Manhattan outbreak of Legionnaires claims first life

New York City officials announced that 2018’s second upper Manhattan outbreak of Legionnaires’ disease has resulted in the death of a victim. They also said the case count has increased to 16.

The victim who passed away has not been identified. Of the other 15 victims, seven are still hospitalized, seven have been discharged from the hospital, and one was an outpatient.

The NYC Department of Health and Mental Hygiene (DOHMH) said last Friday that eight Washington Heights residents were infected during a five-day span. Those victims range in age from younger than 40 to older than 80; no information was provided on the second group of eight victims.

Second upper Manhattan outbreak:
more cases are possible

DOHMH officials said they believe the risk of contracting Legionnaires’ disease in the area remains “very low,” although they also said they expect more cases could be confirmed.

“The Health Department has identified a second cluster this season of Legionnaires’ disease in the lower Washington Heights area, and we are taking aggressive steps to ensure the safety of residents,” acting DOHMH commissioner Dr. Oxiris Barbot said in a statement last Friday.

(Note: The DOHMH is classifying the current event as a “cluster” because the cases are linked in time and space but no common source has been pinpointed. If a common source is found, the event will be recategorized as an “outbreak.” This blog, however, is classifying this as an outbreak, simply because the probability is high that there is a specific source.)

Second upper Manhattan outbreak:
cooling towers inspected

The DOHMH said it had sampled 20 cooling towers, and conducted a closer inspection of 11. WPIX-11 News reported that one cooling tower was not being inspected regularly because it was not registered with the city.

Owners of the 11 cooling towers were ordered to remediate them “based on preliminary results and out of an abundance of caution,” Barbot said.

Second upper Manhattan outbreak:
summer outbreak – 27 ill, 1 dead

The investigation into upper Manhattan’s first outbreak pinpointed a cooling tower at the Sugar Hill Project (898 St. Nicholas Avenue) as the cause for 27 illnesses – and one death – that affected residents of Washington Heights and Hamilton Heights during the summertime. A strain of Legionella – the bacteria that causes Legionnaires’ disease – was common between a Sugar Hill Project cooling tower and six of the victims.

Because of Sugar Hill Project’s proximity to the current outbreak, the DOHMH has ordered the building’s owners to re-clean and re-disinfect their cooling system. That process reportedly was completed Oct. 5.

Second upper Manhattan outbreak:
DOHMH issues warning

Barbot warned the public in his Friday statement that “although the risk is very low, we urge residents and people who work in the area to take precautions.”

“Legionnaires’ disease is not contagious, and (it) can be treated with common antibiotics if caught early,” Barbot was quoted as saying. “Anyone with flu-like symptoms – such as cough, fever or difficulty breathing – should seek medical attention immediately.”

If you live in upper Manhattan, or work or travel in the affected neighborhoods, it’s essential that you remain vigilant. Someone who is infected might not have developed symptoms yet because the disease’s incubation period can be as long as two weeks.

Second upper Manhattan outbreak:
another record year projected

According to the Centers for Disease Control and Prevention (CDC), 2017 was a record year for Legionnaires’ disease in the state of New York. More than 1,000 residents were sickened.

With more than 128 cases reported in the state over the previous three weeks, the Alliance to Prevent Legionnaires’ Disease has projected that the state record again will be broken. As of the end of September, 875 cases have been reported in 2018, and 1,180 are projected by the end of the year.

NYC contributes an annual average of 200 to 500 Legionnaires’ disease cases to the state total. Last year, the five boroughs reported 441 cases, a 64 percent increase from the 268 reported in 2016.

The largest outbreak in NYC history happened in 2015. Contaminated cooling towers were blamed for an outbreak in which 12 people died and more than 120 others were sickened in the south Bronx.

Second upper Manhattan outbreak:
Legionnaires information

Because Legionnaires’ disease symptoms are similar to those of other forms of pneumonia (lung infection) or flu, many cases go unreported. CDC statistics show that only about 5,000 of the estimated 25,000 yearly cases in the U.S. are reported. In addition, about 10 percent of victims will die from the infection.

Early symptoms generally include:

• fever (104 degrees or higher) and chills
• severe headaches
• muscle pains
• lack of appetite.

Symptoms can worsen to include:

• pleuritic chest pain (pain caused by inflamed lungs)
• dyspnea (shortness of breath)
• coughing, which can bring up mucus or blood
• gastrointestinal problems (most commonly diarrhea, nausea, and vomiting)
• mental agitation and confusion.

Susceptible people
Anyone can become ill from Legionella, but those most susceptible to infection include:

• people 50 or older
• people with a chronic lung disease or COPD (bronchitis or emphysema)
• smokers, current or former
• people with compromised immune systems
• heavy drinkers of alcohol
• organ-transplant recipients
• people on specific drug protocols.

Sources of Legionella
Legionella bacteria are contracted by inhaling microscopic water droplets (vapor or mist). The bacteria grow best in warm water and are found primarily in human-made environments, including:

• cooling towers of air conditioning systems
• water systems (apartment complexes, hospitals, nursing homes, and hotels)
• large plumbing systems
• hot-water heaters and tanks
• bathroom showers and faucets
• swimming pools, hot tubs, and whirlpools
• equipment used in physical therapy
• mist machines (for example, the produce section of a grocery store)
• hand-held sprayers
• decorative fountains.