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The New York State Department of Health (NYSDOH) announced that the upper Manhattan Legionnaires’ disease cluster has increased to 27 after five new cases were confirmed.

Three of the upper Manhattan Legionnaires’ disease cluster’s victims have been hospitalized, and one person has died. The illness has infected residents of northern Hamilton Heights and southern Washington Heights.

The cluster first made headlines on July 11, when the New York City Department of Health and Mental Hygiene (DOHMH) alerted the public about the first eight illnesses.

The 27 victims have ranged in age from younger than 40 to older than 80; the majority of people sickened are older than 50. The individual who died was older than 50 but they were not diagnosed early.

Upper Manhattan Legionnaires’ disease cluster: cooling towers

Officials are “actively looking” for the source of the upper Manhattan Legionnaires’ disease cluster, said DOHMH Commissioner Dr. Mary T. Bassett. “We worry about cooling towers,” Bassett said, indicating that the department considers cooling towers the suspected cause of the cluster.

Inspectors have taken water samples from 20 cooling towers from buildings between 145th and 155th Streets. According to Dr. Demetre Daskalakis, deputy commissioner of Disease Control for the DOHMH, the city already has treated the towers’ water.

City officials said that several building owners have been ordered to increase the use of biocides to kill Legionella, the bacteria that causes Legionnaires’ disease.

Regulations ‘ignored’
Recent data released by the DOHMH suggests that many owners are ignoring regulations put into place three years ago to prevent the spread of Legionnaires’ disease.

According to the “Annual Report on the Status of Primary Indicators Associated with Cooling Towers” compiled by the DOHMH and provided to WNYC.org, there were almost 6,500 cooling towers inspected last year. The city issued just shy of 76,000 violations — an average of nearly 12 violations for each tower inspected.

Of those violations, almost 5,500 were considered to be public health hazards, meaning that the building owner(s):

  • did not clean the tower when tests returned high levels of Legionella;
  • had not taken a recent water sample to test for Legionella, or
  • did not have a plan in place to clean the cooling tower regularly.

Watch for symptoms
Officials are warning people who live, work or travel through the area to be vigilant. Someone who contracts Legionella might not have started showing symptoms yet, because of the disease’s two-week incubation period. “It’s really important if you’re feeling sick to get attention,” Daskalakis said.

Legionnaires’ disease symptoms are similar to those of other types of pneumonia, and they can even resemble those of flu, such as:

  • coughing
  • shortness of breath
  • high fever
  • muscle pains
  • severe headaches
  • gastrointestinal symptoms, such as diarrhea, nausea, and vomiting.
Upper Manhattan Legionnaires' disease cluster hits 27

The upper Manhattan Legionnaires’ disease cluster increased to 27 after five new cases were confirmed by the New York State Department of Health.

Upper Manhattan Legionnaires’ disease cluster: disease info

Legionnaires’ disease is a severe type of pneumonia (lung infection). An estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur each year in the United States, according to the Centers for Disease Control and Prevention (CDC). However, only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms.

About 10 percent of patients infected with Legionnaires’ disease – which is also known as legionellosis or Legionella pneumonia – will die from the infection.

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

Legionella sources
Legionnaires’ disease clusters and outbreaks have been linked to numerous sources, such as:

  • air conditioning system cooling towers
  • large plumbing systems
  • water systems, such as those used in hospitals, nursing homes, hotels, and on cruise ships
  • hot-water heaters and tanks
  • bathroom showers and faucets
  • swimming pools, whirlpools, and hot tubs
  • physical-therapy equipment
  • mist machines, such as those used in the produce sections of grocery stores
  • hand-held sprayers
  • decorative fountains.

High-risk categories
“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.

“This disease is very treatable with antibiotics,” Bassett said. “I encourage anyone with symptoms of Legionnaires’ disease to seek care early.”

Other people who are the most susceptible to infection include:

  • heavy drinkers of alcohol
  • people with weakened immune systems
  • organ-transplant recipients
  • anyone on a specific drug protocol, such as corticosteroids.