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At least three people have died in a Legionnaires’ disease outbreak in Harlem, authorities said in the most recent update, in the latest summer flare-up of the disease that officials say primarily impacts older people and is potentially linked to poorly maintained cooling towers.
Legionnaires’ is a perennial problem in New York City, especially in buildings that use water cooling towers as part of their air conditioning systems.
Most recently, five people died in a 2022 outbreak at the Amsterdam Nursing Home in the Bronx, a 409-bed facility that had been cited by city inspectors seven times in the previous six years for failing to maintain cooling towers, The New York Times reported.
The rate of Legionnaires’ disease in New York City has steadily risen over the last decade, according to a city Department of Health report published in 2022, with total cases peaking at 656 in 2018.
The largest outbreak in New York City’s history happened in 2015, when outbreaks of legionella in multiple apartment buildings in the Bronx infected a total of 138 people, killing 16, according to a case study from the National Institutes of Health.
Legionnaires’ is spread by the legionella bacteria, which causes both the pneumonia-like disease and Pontiac fever. Symptoms include a cough, fever, headaches, muscle aches and shortness of breath, according to the Centers for Disease Control and Prevention. The disease was named after the location of its first identified outbreak—a 1976 American Legion convention at the Bellevue-Stratford Hotel in Philadelphia, which sickened 182 people and led to 29 deaths.
Legionella grows in certain man-made water systems like showerheads, hot tubs, decorative water features and plumbing systems. It does not grow in window and car air conditioning units, both the CDC and the NYC Health Department confirmed. However, it can grow in large cooling towers for central air conditioning systems, like the kind commonly found on the roofs of buildings in parts of New York City. There is no issue with any building’s plumbing system in the impacted parts of Harlem, the Health Department said, and residents can continue using tap water to drink, bathe and cook. Legionnaires’ is spread by breathing mist that contains the bacteria, and cannot be spread person-to-person.
There is no vaccine to prevent Legionnaires’ disease. New York City requires building owners to register their cooling towers and pass routine inspections and testing for the disease. The CDC says legionella thrives in water between 77 degrees Fahrenheit and 113 degrees, and recommends buildings store cold water below 77 degrees and hot water above 140 degrees to prevent the bacteria’s growth. Individuals can also take steps to prevent the bacteria’s growth, the CDC says, including monitoring their own water heaters’ temperature and regularly flushing their units. The agency also recommends regularly cleaning faucets and showerheads, and flushing them by running cold water for at least two minutes, followed by running hot water until it gets hot.
The Northeast and Midwest recorded the highest rates of Legionnaires’ cases in 2019, the most recent year the CDC published a full review. Ohio recorded 785 cases in 2019, and other large states saw similar caseloads: 614 were reported in Illinois, 606 in New York state, 579 in Pennsylvania and 551 in Michigan.
People above age 50 are more at risk, according to the NYC Health Department. Over 82% of the 8,890 cases recorded across the country in 2019 occurred in Americans over 50, and men made up 63% of the cases. Black Americans have a higher incidence rate than white people, according to the CDC’s data. Smokers, people with chronic lung disease, diabetes, cancer, kidney failure, liver failure, weakened immune systems or are taking medication that weakens the immune system such as drugs for chemotherapy, are all also more at risk. Most cases of Legionnaires’ occur in the Northeast and Midwest in the summer and fall months.
At least 67 people have contracted Legionnaires’ disease in Central Harlem, the New York City Health Department said in its most recent update. Three deaths have been reported so far, according to authorities. The outbreak is localized in five New York City ZIP codes: 10027, 10030, 10035, 10037 and 10039. “All cooling towers in the area have been sampled, and work is underway,” Mayor Eric Adams said in a video posted on social media. The city’s health department said the risk for most people was low, but warned residents to seek medical attention immediately if they experience flu-like symptoms.