At least 22 people have fallen ill, including one person who has died, from Legionnaires’ disease in New York City over the last two weeks, according to the city’s health department.
City health officials believe that the people most likely became ill after breathing in bacteria sprayed from a cooling tower in central Harlem. The city health department said in a news release on Wednesday that it was testing the cooling towers in the area and continuing to investigate the outbreak.
Legionnaires’ is a severe form of pneumonia that can cause a cough, shortness of breath and fever. The risk is low for most people, said Dr. Celia Quinn, the deputy commissioner of the division of infectious diseases at the New York City Department of Health and Mental Hygiene, but people who live or work around the affected area should see a health care provider immediately if they develop flulike symptoms. There will most likely be additional cases linked to this cluster, Dr. Quinn added.
The city health department said that it was safe to continue drinking water, bathing, showering, cooking and using air-conditioning.
Around 6,000 cases of Legionnaires’ are reported each year in the United States, but scientists think the disease is underdiagnosed because it can be hard to distinguish from other types of pneumonia or respiratory issues. And cases have been rising over the last two decades. There is no clear reason for the increase, but some researchers have pointed to aging water systems, inadequate maintenance of systems, rising water temperatures and greater awareness of the disease.
And cases tend to pop up during the summer months, as more buildings use cooling towers for air conditioning.
“I wouldn’t be as worried if this was February,” said Dr. Bernard Camins, the medical director for infection prevention at the Mount Sinai Health System. “But it is peak Legionella season and we’re seeing cases — that’s why people just need to be vigilant.”
What are the symptoms of Legionnaires’ disease?
People usually develop symptoms between two days to two weeks after breathing in Legionella bacteria. That bacteria naturally occurs in streams, creeks and lakes, but it can rise to dangerous levels in warm, artificial environments such as hot tubs, humidifiers and cooling and water systems.
Early symptoms tend to resemble those of the flu: fever, chills, muscle aches, headaches, dry cough and shortness of breath. People with Legionnaires’ also sometimes develop gastrointestinal symptoms like nausea and diarrhea, said Dr. Emily Abdoler, a clinical associate professor of infectious diseases at Michigan Medicine.
Most healthy people who are exposed do not get sick, but certain groups are at higher risk, including people who are 50 and older; current and former smokers; and people with weakened immune systems or chronic conditions such as cancer, lung disease, diabetes or kidney and liver failure.
Legionnaires’ tends to worsen during the first week or so. In severe cases, Legionnaires’ patients may be hospitalized and require oxygen treatment. People who are seriously ill can develop lung failure and heart damage. About one out of every 10 people who gets sick with Legionnaires’ die, according to the Centers for Disease Control and Prevention.
Is it contagious?
You cannot get Legionnaires’ from other people. It commonly spreads through mist or vapor that contains the bacteria. Several outbreaks have been linked to cooling towers in big cities. People can also fall ill after breathing in bacteria from hot tubs, hospital plumbing systems, fountains and pools.
In rare cases, you can contract the disease from breathing in contaminated soil.
How is Legionnaires’ treated?
Doctors prescribe antibiotics. The sooner someone starts antibiotics, the more effective the treatment will be, said Dr. Ben Singer, a pulmonary and critical care specialist at Northwestern Medicine. Most people who take antibiotics will recover from the disease, but some can continue to feel certain symptoms for months.
“Any pneumonia can cause a lingering type of fatigue,” Dr. Singer said. “People can take a long time to get better.”
How can people stay safe?
There is no vaccine for Legionnaires’. The most important thing people can do is monitor their symptoms.
Dr. Abdoler advised reaching out to your primary care provider if you live or work in an area with a Legionnaires’ outbreak, like central Harlem, and have symptoms such as a cough or fever. If you do not have a primary care provider but are experiencing symptoms, consider going to an urgent care clinic or the emergency room. Doctors usually take chest X-rays and diagnose the disease by testing mucus or urine samples.
In general, people can lower their risk of the disease by frequently deep cleaning hot tubs, humidifiers, windshield wiper fluid tanks, shower heads and faucets.
Dani Blum is a health reporter for The Times.
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