The Source of a Legionnaires’ Disease Outbreak in New York City Not Yet Determined
by Sheryl Monks
The New York Times reports that one person has died and 17 others have been sickened in New York City by an outbreak of Legionnaires’ disease in Upper Manhattan between 145th and 165th streets. Health department officials and city council members are urging anyone with flu-like symptoms to seek medical advice immediately. Dr. Demetre Daskalakis, NYC Deputy Commissioner of Disease Control, told the Times that 20 cooling towers have been tested, but as of July 17, 2018, when the article was published, no source of bacteria had been identified.
Legionnaires’ disease is a severe form of pneumonia typically contracted by inhalation of aerosol water droplets contaminated with L pneumophila bacteria, often via cooling towers, showers, hot tubs, air conditioning systems, humidifiers, etc. Approximately 5-15% of reported cases are fatal.
Two outbreaks in June 2017, one on the Upper East Side, which killed one person and sickened six others, and another, smaller outbreak, which was later traced to a contaminated water system in an East Harlem police station, as well as other outbreaks across the country in recent years, confirm that legionellosis is on the rise. A study published in the Journal of Public Health Management and Practice in September 2015, which examined policies and guidelines for the primary prevention of legionellosis in the US, concluded that the disease deserves a higher priority for public health policy development and research.
The largest outbreak of Legionnaires’ disease in New York City history occurred in 2015. Fifteen people died and more than 70 others were afflicted in the South Bronx, an historic case that led to the first large US jurisdiction to regulate the management of cooling towers to help prevent bacterial contamination.
“After the 2015 Legionnaires’ disease outbreak, the city worked hard to locate and register all the city’s cooling towers,” said Allison Chamberlain, Assistant Director of the Emory Center for Public Health Preparedness and Research and lead author of “The 2015 New York City Legionnaires’ Disease Outbreak: A Case Study on a History-Making Outbreak,” published in the July 2017 issue of the Journal of Public Health Management and Practice.
Chamberlain and the study’s co-authors examined the NYC Department of Health and Mental Hygiene’s response to the outbreak to help inform other public health departments facing similar conditions. “We’d hope to see that their historic efforts to require building owners to routinely test their towers for Legionella would prevent large outbreaks,” Chamberlain said. “If this outbreak ends up being traced to a cooling tower, then the city may need to revisit its regulations.”
The first ordinance to mandate routine testing for the bacteria in the cooling towers of multi-family housing units occurred in Garland, Texas. Findings of that study, also published in the Journal of Public Health Management and Practice, suggest that timing is crucial in suspected Legionella outbreaks and that leadership buy-in and good communication between local death departments and multi-residential building owners is key to promoting the health and safety of occupants.
To read these and other studies on Legionnaires’ disease, visit the Journal of Public Health Management and Practice:
- The 2015 New York City Legionnaires’ Disease Outbreak: A Case Study on a History-Making Outbreak
- Legionellosis on the Rise: A Review of Guidelines for Prevention in the United States
- Implementation of a Legionella Ordinance for Multifamily Housing, Garland, Texas
Sheryl Monks is the Editorial Associate of the Journal of Public Health Management & Practice. She manages JPHMP Direct.