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The New York City Department of Health and Mental Hygiene (DOHMH) is investigating a Legionnaires’ disease community cluster in upper Manhattan after 11 people were confirmed with the illness in the past week.
“We may continue to see additional cases,” DOHMH Commissioner Dr. Mary T. Bassett said at a community meeting at Saint Luke’s African Methodist Episcopal Church (1872 Amsterdam Avenue).
The illness has affected individuals from a 20-block area that includes southern Washington Heights and northern Hamilton Heights. Ten of the 11 people infected were hospitalized, and eight of them remain in the hospital.
Ages of the patients range from younger than 40 to older than 80; the majority of victims are older than 50 years old.
A “cluster,” not an “outbreak”
The illnesses are categorized as a “cluster” and not an “outbreak” because the cases are linked in space (a 20-block area) and time (a seven-day period). If a common source is found to be the cause for all of the illnesses, officials would then categorize this incident as an “outbreak.”
Upper Manhattan cluster: cooling towers suspected
Also known as Legionella pneumonia and legionellosis, Legionnaires’ disease is a sometimes-deadly lung infection – about 10 percent of people infected will die.
“Thankfully, there have been no fatalities yet,” New York City Council member Mark Levine said.
Officials are “actively looking” for the Legionella source, Bassett said, and “we worry about cooling towers.”
Cooling towers are suspected to be the source of this cluster.
Said Bassett: “The department has already identified all of the cooling towers that are registered with the city in this geography, and (we have) tested all of these cooling towers.”
Levine attempted to clarify the difference between cooling towers and water towers.
“Don’t confuse this with water towers, which are in almost every building,” he said. “This has nothing to do with water towers. This is cooling towers that are used in buildings with central air conditioning, that give off a water vapor, and when it’s hot out – and it’s been really hot the last couple of weeks – this bacteria thrives.”
Inspectors have taken water samples from 20 cooling-tower systems from buildings between 145th and 155th Streets. The results from preliminary tests are expected soon. Full results – which require using cultures, where bacteria is grown in a laboratory – take two weeks to complete.
The city already has treated the towers’ water, said Dr. Demetre Daskalakis, deputy commissioner of Disease Control.
Upper Manhattan cluster: addressing concerns
During the community meeting, officials informed residents of the community that Legionnaires’ disease is not transmitted person-to-person.
“While most people exposed to Legionella don’t get sick, individuals ages 50 and above – especially those who smoke and have chronic lung conditions – are at a higher risk,” Bassett said in a statement.
“This disease is very treatable with antibiotics. I encourage anyone with symptoms of Legionnaires’ disease to seek care early.”
Others who are more susceptible to Legionella include:
- heavy drinkers of alcohol
- people with weakened immune systems
- organ-transplant recipients
- people on specific drug protocols (for example, corticosteroids).
NYC’s largest outbreak killed 12 in 2015
The largest outbreak in New York City history occurred just three years ago. In 2015, contaminated cooling towers were blamed for producing Legionnaires’ disease that killed 12 people and sickened more than 120 others in the South Bronx.
Every year, between 200 and 500 people are diagnosed with the disease in New York City, according to health officials. The majority of those cases, however, involve individuals who are not associated with a cluster or outbreak.
Upper Manhattan cluster: Legionnaires’ info
Legionnaires’ disease is a severe type of pneumonia (lung infection). According to the Centers for Disease Control and Prevention (CDC), about 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur every year in the United States. Because of the disease’s nonspecific signs and symptoms, however, only 5,000 cases are reported.
Legionella bacteria are contracted by inhaling microscopic water droplets (vapor or mist). The bacteria grow best in warm water, and they are found primarily in human-made environments.
Legionnaires’ disease outbreaks and clusters have been linked to numerous sources, including:
- cooling towers of air conditioning systems
- large plumbing systems
- water systems, like those used in hospitals, nursing homes, and hotels
- hot-water tanks and heaters
- showers and faucets
- swimming pools
- hot tubs and whirlpools, like those on cruise ships and in hotel pool areas
- physical-therapy equipment
- mist machines, like those in grocery store produce sections
- hand-held sprayers
- decorative fountains.
Legionnaires’ disease is similar to other types of pneumonia, and its symptoms can resemble those of flu. Those symptoms can include:
- chest pain and shortness of breath
- high fever
- muscle aches and pains
- severe headaches
- gastrointestinal symptoms (nausea, vomiting, diarrhea, etc.)
- confusion, or other mental changes.