New York City - Health Department Investigating Outbreak of Legionnaires' Disease in the South Bronx

[Pathfinder]

[TABLE="border: 0, cellpadding: 0, cellspacing: 0"]
[TR]
[TD="width: 649, align: left"]FOR IMMEDIATE RELEASE
Press Release # 030-15
Wednesday, July 29, 2015

MEDIA CONTACT: Christopher Miller/Veronica Lewin (347) 396-4177
PressOffice@health.nyc.gov[/TD]
[TD="width: 105, align: left"]

[/TD]
[/TR]
[/TABLE]

Health Department Investigating Outbreak of Legionnaires' Disease in the South Bronx

31 cases of Legionnaires' disease have been reported since July 10 New Yorkers with respiratory symptoms, such as fever, cough, chills and muscle aches, are advised to promptly seek medical attention

The Health Department is currently investigating an outbreak of Legionnaires' disease in the South Bronx. Thirty-one cases have been reported since July 10. There have also been two deaths reported in patients with Legionnaires' disease in these neighborhoods. The Health Department is actively investigating these deaths and their relationship to the outbreak. The Health Department is testing water from cooling towers and other potential sources in the area to determine the source of the outbreak. New Yorkers with respiratory symptoms, such as fever, cough, chills and muscle aches, are advised to promptly seek medical attention.

“We are concerned about this unusual increase in Legionnaires’ disease cases in the South Bronx,” said Health Commissioner Dr. Mary Bassett. “We are conducting a swift investigation to determine the source of the outbreak and prevent future cases. I urge anyone with symptoms to seek medical attention right away.”

Legionnaires' disease is caused by the bacteria Legionella. Additional symptoms include: headache, fatigue, loss of appetite, confusion and diarrhea. Symptoms usually appear two to 10 days after significant exposure to Legionella bacteria. Most cases of Legionnaires’ disease can be traced to plumbing systems where conditions are favorable for Legionella growth, such as whirlpool spas, hot tubs, humidifiers, hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems.

Legionnaires' disease cannot be spread from person to person. Groups at high risk for Legionnaire’s disease include people who are middle-aged or older – especially cigarette smokers – people with chronic lung disease or weakened immune systems and people who take medicines that weaken their immune systems (immunosuppressive drugs). Those with symptoms should call their doctor and ask about testing for Legionnaire’s disease.

For more information about Legionnaires’ disease, please visit the Health Department website.


http://www.nyc.gov/html/doh/html/pr2015/pr030-15.shtml

 

[Shiloh]

Source: http://www.nydailynews.com/new-york...d-south-bronx-hospital-mall-article-1.2309718

Lincoln Medical Center, Concourse Plaza mall possible sources of South Bronx Legionnaires? disease outbreak: de Blasio
BY Erica Pearson , Jennifer Fermino
NEW YORK DAILY NEWS
Published: Thursday, July 30, 2015, 4:51 PM
Updated: Thursday, July 30, 2015, 5:21 PM

The city has zeroed in on Lincoln Medical Center and the Concourse Plaza shopping mall in the South Bronx as two possible sources of the city?s Legionnaires? disease outbreak, Mayor de Blasio said Thursday.

Cooling systems in both buildings tested positive for Legionella bacteria ? but because the bug is so common, it is unclear if it?s the same strain that has sickened dozens and killed two, officials said. The city's Health Department is also testing 10 other sites in the area.

There have been 46 reported cases of the respiratory disease in the South Bronx since July 10, officials said...

 

[Pathfinder]

NYC Officials: Third Person With Legionnaires? Disease In South Bronx Has Died

July 31, 2015 6:49 PM

NEW YORK (CBSNewYork) ? New York City officials say a third person infected with Legionnaires? disease in the South Bronx has died.

Officials said Friday the latest victim had additional underlying medical problems. City Health Commissioner Dr. Mary Bassett said the other two people who died were in their 50s and suffered from a host of other health issues as well.

The city also increased the number of cases from 46 to 57; 42 of which have been hospitalized.
...
The Health Department said a third location, the Opera House Hotel, has tested positive for the bacteria Legionella. The hotel?s cooling system was being treated and flushed Friday afternoon, officials said.
...
None of the 57 cases were guests at the Opera House Hotel, officials said.
...

http://newyork.cbslocal.com/2015/07/31/south-bronx-legionnaires-disease/

 

[Shiloh]

Source: http://www.ny1.com/nyc/all-boroughs...ies-sources-of-bronx-legionnaires--cases.html


Hunt Continues for Source of Legionnaires' Outbreak in South Bronx
By Vivian Lee
Updated Friday, July 31, 2015 at 05:11 PM CDT

Health officials say they have not determined Lincoln Hospital to be the source of the Legionnaires' disease outbreak in the South Bronx that has killed three people, even though Legionella bacteria was discovered there?so the hunt continues for the outbreak's origin. NY1's Vivian Lee filed the following report.

Ask a worker at city-owned Lincoln Medical Center about the discovery of the bacteria that causes Legionnaires' Disease in a hospital cooling tower, and you get a lot of this:

"We're not allowed to share any information with press. Sorry," said one man...

 

[Shiloh]

Source: http://www.nbcnewyork.com/news/loca...tbreak-in-NYC-Health-Officials-320385721.html

4th Death in "Unusual" Legionnaires' Outbreak in NYC: Health Officials
By Sheldon Dutes
Updated 10 minutes ago

A fourth person has died in what the New York City Health Department is describing as an "unusual" spike in Legionnaires' disease in the Bronx, officials said Saturday. The news comes as two more Bronx buildings tested positive for the legionella bacteria.

A Verizon office building at 117 E. 167th St. is the fourth location to test positive, according to Verizon spokesman John Bonomo. Streamline Plastic Co. at 2590 Park Ave. is the fifth location to test positive. Remediation is complete at the Verizon location and has begun at the plastic company, officials said. Verizon said that it is performing checks on all cooling systems at all its facilities in the Bronx...

 

[Pathfinder]

US | Sat Aug 1, 2015 4:49pm EDT Related: U.S., HEALTH

Four dead, 65 sick in New York City Legionnaires' disease outbreak

NEW YORK | BY KATIE REILLY

A deadly outbreak of Legionnaires' disease, a severe type of pneumonia, has now killed four people and sickened 65 in the Bronx section of New York City since July 10, New York City health officials said on Saturday.

This wave of Legionnaires', which officials have called unusual, is now more than five times the number of cases recorded in the last outbreak, in which 12 people in the Bronx fell ill in December 2014.
...
In response to the outbreak, the city's health department has inspected 22 buildings in the Bronx, 17 of which have cooling towers. Five buildings, including the historic Opera House Hotel, Lincoln Medical Center and the Concourse Plaza mall and movie complex, tested positive for Legionella.
...
Julio Vargas, general manager of the Opera House Hotel, said the water in the cooling tower used by the hotel has been treated and disinfected, and there have been no reports of hotel guests falling ill.
...

http://www.reuters.com/article/2015/08/01/us-usa-health-legionnaires-idUSKCN0Q63E420150801

 

[Pathfinder]

DOHMH

Cases

• Individuals with Legionnaires' deceased: 7
• All deceased individuals were older adults and had additional underlying medical problems.
• These additional deaths occurred in prior days and were reported to the Health Department yesterday. These patients are connected to the current cluster.
• Reported individuals with Legionnaires': 81
• Individuals with Legionnaires' hospitalized: 64
• Of the 64, the number of individuals with Legionnaires' treated and discharged: 28

FAQ

• New York City's drinking water supply and other water features, like fountains, shower heads and pools, are safe throughout New York City and are unaffected by legionella
• Water towers are unaffected by legionella
• Home air conditioner units are unaffected and walking into air conditioned environments is safe, as well.

Locations and Remediation

• 17 cooling towers were tested and 5 returned positive
• Remediation has been completed at all 5 locations
• Lincoln Hospital remediation completed
• Concourse Plaza remediation completed
• Opera House Hotel remediation completed
• Verizon remediation completed
• Streamline Plastic Co. remediation completed
• All sites will submit long
• term plans as to how they will maintain the cooling towers to protect against any future growth of legionella – those plans are due Friday.
• All sites will be resampled by DOHMH today and tomorrow to verify remediation was successful.

Ongoing DOHMH Actions

• Continued monitoring for new cases
• Close collaboration with area hospitals
• Disease detectives conducting epidemiological investigation
• Interviews with all individuals reported with Legionnaires' to support source identification
• Providing updates to elected officials and Bronx residents
• Outreach to vulnerable populations – senior centers, homeless shelters, and other locations
• Monitoring of disinfection of affected cooling towers

Community Affairs Unit

• Flyers were distributed over the weekend to update Bronx residents about today's Town Hall and provide fact sheet on Legionnaires' disease – flyers in English and Spanish
• Flyers handed out at major Bronx hubs on Saturday and Sunday
• Continued communication with local elected officials
• Communication with local community boards 1, 2, 3, and 4
• Hosting Town Hall on Monday for area residents with Council Member Vanessa Gibson

OEM

• Hosting daily interagency calls to coordinate operations
• As a precautionary measure, distributing messaging and information to OEM's Advanced Warning System distribution list – a collection of more than 4,000 healthcare and service providers
• Will be distributing health information throughout the week, including National Night Out events in the Bronx this Tuesday

http://www1.nyc.gov/nyc-resources/br..._content=nycmo

 

[Shiloh]

Source: http://pix11.com/2015/08/05/8th-person-with-legionnaires-disease-dies-in-outbreak-97-sickened/


8th person with Legionnaires? disease dies in outbreak, 97 sickened
Posted 7:14 PM, August 5, 2015, by PIX11 Report, Updated at 07:17pm, August 5, 2015

NEW YORK ? New York City health officials say eight people with Legionnaires? disease have died amid an outbreak that has sickened dozens more.

All of the people who have died were older adults with underlying medical problems, according to officials.

Health officials presented updated figures Monday at a public town hall meeting. They say there have been more than 97 reported diagnoses. They say 92 people have been hospitalized, 48 of whom have been treated and discharged...

 

[Shiloh]

Source: http://www.nbcnews.com/health/healt...outbreak-city-offers-free-inspections-n405371


10 Dead In New York Legionnaires' Outbreak; City Offers Free Inspections
by Maggie Fox

Ten people have died from Legionnaires' disease in an outbreak traced to five air conditioning systems, New York City health officials said Thursday.

More than 100 people have been diagnosed with the infection, caused by bacteria breathed in with contaminated water droplets. All the affected buildings are in New York's Bronx borough...

 

[Shiloh]

Source: http://nypost.com/2015/08/09/7-more-confirmed-cases-in-legionnaires-crisis/

7 more confirmed cases in Legionnaires? crisis
By Tom Wilson, Amanda Lozada and Aaron Short
August 9, 2015 | 9:36am

Seven additional cases of Legionnaires? disease have been confirmed and five more South Bronx sites ? including a high school ? have tested positive for the bacteria that cause it, city officials said Saturday...

 

[Shiloh]

Source: http://www.nbcnewyork.com/news/loca...Tower-Test-Symptom-Death-Cases-321257921.html


2 More Dead in NYC Legionnaires' Outbreak
Death Toll in Legionnaires' Outbreak Rises to 12 as 2 More Buildings Test Positive
Updated 9 minutes ago

Twelve people have died from Legionnaires' disease amid the largest outbreak the city has experienced in its history, Mayor de Blasio said Monday as he introduced plans to combat future spreads of the severe, often lethal, form of pneumonia.

That total adds two deaths to the previous tally. Officials have said those who died were middle-aged or older adults with underlying health conditions. One-hundred-thirteen people have been sickened in the outbreak that has rocked the south Bronx since July 10 and many remain hospitalized...

 

[Pathfinder]

[h=5]...
Bronx Legionnaires? Disease Cluster Updated Facts 8/10/15[/h] [h=6]Download a PDF graph of the Legionellosis Cluster in the South Bronx by diagnosis date[/h] [h=6]Download a PDF graph of the Legionellosis Cluster in the South Bronx by onset date[/h] Highlights:

• No new deaths have been reported in the last six days.
• No new cases diagnosed since August 3.
• Health officials remain confident that the source of the outbreak is from a location in the initial round of positive test sites, and that through disinfection of the source, the outbreak has been contained.

Cases

• Reported individuals with Legionnaires': 113
• Individuals treated and discharged: 76
• Individuals with Legionnaires' deceased: 12
• All deceased individuals were adults with underlying medical conditions.

Safety of Water Supply and Air Conditioning

• New York City?s drinking water supply and other water features, like fountains, shower heads and pools, are safe throughout New York City and are unaffected by legionella
• Water towers are unaffected by legionella
• Home air conditioner units are unaffected and walking into air conditioned environments is safe, as well.

Locations and Remediation

• All sites will submit long-term plans as to how they will maintain the cooling towers to protect against any future growth of legionella.
• The Health Department convened a panel of experts in the field of infectious disease to discuss the work the City has done so far and to ensure that all the appropriate steps are being taken to find and eliminate the source of the outbreak.

Ongoing Actions

• Continued monitoring for new cases
• Close collaboration with area hospitals
• Disease detectives conducting epidemiological investigation
• Interviews with all individuals reported with Legionnaires? to support source identification
• Providing updates to elected officials and Bronx residents
• Outreach to vulnerable populations ? senior centers, homeless shelters, and other locations
• Monitoring of disinfection of affected cooling towers

...
http://www.nyc.gov/html/doh/html/diseases/cdlegi.shtml#factsheet

 

[Pathfinder]

Testimony of Mary T. Bassett, MD, MPH, Commissioner New York City Department of Health and Mental Hygiene before the New York City Council Committee on Housing and Buildings regarding Cooling Towers Registration, and Inspection and Testing for Microbes and Preconsidered

Intro
August 11, 2015
Council Chambers ? City Hall
New York City

Good morning Chairperson Williams and members of the Committee on Housing and Buildings.

I am Dr. Mary Bassett, Commissioner of the New York City Department of Health and Mental Hygiene.

I am joined by Dan Kass, Deputy Commissioner for Environmental Health. Thank you for the
opportunity to testify today on the proposed legislation, which will require the registration of the City?s
cooling towers as well as routine inspections and testing for the presence of microbes.

Background and Current Outbreak

As you know, the Health Department is currently investigating an outbreak of Legionnaires?
disease in the South Bronx. Legionnaires? disease, caused by the bacteria Legionella, is a severe
respiratory illness similar to other community-acquired pneumonias. Groups at high risk for
Legionnaires? disease include people who are middle-aged or older ? especially cigarette smokers ?
people with chronic lung disease or weakened immune systems, and people who take immunosuppressive
drugs. Most healthy people do not become ill even if exposed.

I am happy to report that we have no new deaths today, and no one in the past seven days has
reported an onset of symptoms. To date, there have been 115 reported cases of individuals with
Legionnaires? disease, 79 people have been discharged from the hospital, and tragically 12 people have
died. In the impact zone, our disease detectives determined cooling towers were the likely source of
exposure. Initially, we identified 17 cooling towers in the area and immediately tested them for
Legionella. Five of these locations tested positive, and building owners were ordered to immediately
disinfect the towers and undertake a longer-term remediation plan. As of yesterday evening, a total of 18
sites have tested positive for Legionella, 11 of these inside the impact zone. Regardless of test results,
every cooling tower identified in the impact zone has been immediately ordered disinfected and
remediated, and any site that has tested positive has been immediately ordered disinfected and
remediated.

On August 6, in an effort to prevent any other outbreaks of Legionnaires? disease, I issued an
order to all building owners to either disinfect their cooling towers within 14 days or provide evidence
that their towers had been disinfected in the past 30 days. We do not know exactly how many cooling
towers there are in the five boroughs, but we estimate that there could be several thousand. The City will
conduct random audits to ensure compliance with this order, and failure to comply could result in notices
of violation and fines. Every building owner has complied with our orders to date, and we expect broad
cooperation going forward.

The decrease of reported new cases along with a decline in emergency department visits for
pneumonia in the South Bronx signals the effectiveness of our efforts in collaboration with other city,
state, and federal agencies in containing the outbreak. We should not be surprised to see sporadic cases in
this or other parts of the city as the bacteria is normally found in the environment, but we are confident
that through our established surveillance systems we will be able to respond quickly to all reports. .

Collaboration with partners and other experts has also played a key role in our response to this
outbreak. We have taken several steps to provide clear, timely information to residents of the South
Bronx. These include:

- Convening a panel of experts in the field of infectious disease to discuss the work the City
has done so far and to ensure that all the appropriate steps were taken to find and eliminate
the source of the outbreak;
- Sending teams of outreach staff and volunteer doctors with the Medical Reserve Corp to
more than 85 clinics, residences and other locations in the South Bronx where vulnerable
populations live, speaking to administrators and residents, and delivering nearly 9,000 copies
of frequently-asked questions, or FAQs, in English and Spanish to ensure that critical
information on symptoms and treatment of Legionnaires disease is communicated clearly and
directly to residents in the impact zone;
- Distributing over 15,000 flyers and conducting 46,000 robocalls, in multiple languages, to
residents of the South Bronx to educate them about this outbreak;
- Coordinating with the Department for the Aging, the New York State Nurses Association and
the Medical Reserve Corp to offer clinic hours in 13 senior centers in the South Bronx;
- Working with the Human Resource Administration, Department for the Aging, Health and
Hospitals Corporation, the NYC Housing Authority and other City agencies to distribute
FAQs to their clients;
- Participating in a town hall meeting hosted by Council Member Gibson and the Mayor?s
Community Assistance Unit on August 3rd attended by nearly 400 people;
- Participating in a tele-town hall meeting with Bronx residents on August 7th; and
- Participating in a Spanish-language tele-town meeting with Bronx residents on August 10th
.
- This evening, our First Deputy Commissioner Dr. Oxiris Barbot, and Bronx District Health

Office Assistant Commissioner Dr. Jane Bedell will participate in another town hall meeting,
and we will continue to meet with residents to answer their questions and provide information
and assistance.

In the coming weeks we will continue to monitor for new cases and work in close collaboration
with area hospitals, as well as provide updates to elected officials and Bronx residents. I want to take a
moment to thank Speaker Mark-Viverito, Borough President Diaz Jr., Council Member Gibson, and other
local elected officials for their leadership and engagement of Bronx residents. In addition, I want to thank
the State Health Department, whose lab at Wadsworth has provided incalculable assistance and the
Centers for Disease Control and Prevention, which has offered crucial advice and staff support in recent
days.

Before turning to the legislation before us, I want to reiterate some key messages that the Council
and others have helped us disseminate. New York City?s drinking water supply is safe and unaffected by
Legionella. In addition, water tanks and home air conditioner units are also unaffected by Legionella.
And walking into air conditioned environments is safe, as well.

With respect to the proposed legislation, the Administration strongly supports the registration of
cooling towers and routine inspection and testing for microbes in order to help prevent and investigate
future outbreaks of Legionnaires? disease. The scale of this outbreak has shown us that the risk of

Legionnaires? disease is one that we can no longer accept and long term action is needed. In regards to the
airborne release of Legionella bacteria, cooling towers represent a source of particular concern because
they are outdoors and can produce mist that can contain bacteria, such as Legionella. When conducting
our epidemiological investigations in the South Bronx related to this recent outbreak, we quickly realized
the number and location of cooling towers in the impact zone was unknown and required intensive leg
work by City staff to determine. A registry of cooling towers maintained by the Department of Buildings
will improve our response to future outbreaks.

The proposed legislation also addresses two other issues ? ensuring adherence to industry
standards for maintenance, cleaning, application of biocides and testing for microbes, and reporting
samples with elevated levels of microbes to the Health Department ? that are intended to reduce the risk
of future outbreaks.

Specifically, this bill will:
- Require owners to develop and follow a maintenance program and plan that is in accordance
with the American Society of Heating, Refrigeration and Air-conditioning Engineers
(ASHRAE) standard;
- Require inspections and testing of cooling towers on a quarterly basis while a building?s
cooling tower is in use, and within 15 days before the initial use of the cooling tower during
any year;
- Require that all inspections be performed by a person qualified in applying the relevant
industry standards related to microbial testing and evaluating cooling systems for the
presence of Legionella bacteria; and
- Include in each inspection a test for the presence of microbes in the water of the cooling
tower. The Health Department will establish by rules the targets and acceptable methods of
microbial testing and laboratory analysis; the acceptable methods of cleaning and disinfecting
cooling towers; the levels of microbes in cooling towers that require mitigation to prevent
health risks; and the levels of microbes in cooling towers that present a serious health threat
and require immediate reporting to the department and cleaning and disinfecting.

In order to ensure compliance with these requirements, the proposed legislation allows the Health
Department to enter any property to inspect the cooling tower for compliance and levy significant
penalties for violations. In cases where an owner fails to disinfect or otherwise remediate as ordered, the
Health Department would clean the tower and bill the owner.

This is groundbreaking legislation. Currently, no other large city or state in the country has
passed a law regulating cooling towers, despite the fact that they have been implicated in Legionnaires?
disease outbreaks across the United States. It is clear that this bill will advance our certainty of the
location of cooling towers, improve our ability to rapidly investigate potential sources of outbreaks, and
most importantly, reduce the potential for exposure to pathogens associated with respiratory illness.

Legionella exists in the environment, and we will continue to see sporadic cases of Legionnaires?
disease in New York City. But we believe that this important legislation will go a long way towards
reducing the number and severity of these outbreaks.

Thank you again for the opportunity to testify and also for your support and assistance during this
outbreak. We are happy to answer any questions.

http://www.nyc.gov/html/doh/downloads/pdf/public/testi/testi20150811.pdf

 

[Shiloh]

Source: http://www.theglobeandmail.com/news...deadly-legionnaires-outbreak/article26004123/


Unprecedented NYC law signed after deadly Legionnaires? outbreak
Katie Reilly
NEW YORK ? Reuters
Published Tuesday, Aug. 18, 2015 3:15PM EDT
Last updated Tuesday, Aug. 18, 2015 3:20PM EDT

New York City Mayor Bill De Blasio signed an unprecedented law regulating cooling towers throughout the city on Tuesday following an outbreak of Legionnaire?s disease that killed 12 people in the city?s South Bronx area.

City health officials said the outbreak, which sickened 124 people, was caused by Legionella bacteria in several air conditioning cooling towers in the area...

 

[Shiloh]

Source: http://newyork.cbslocal.com/2015/08/20/bronx-legionnaires-outbreak-source/


City Officials: Opera House Hotel Cooling Tower Source Of Bronx Legionnaires? Outbreak
August 20, 2015 3:00 PM

NEW YORK (CBSNewYork/AP) ? City officials say they have pinpointed the source of the Legionnaires? disease outbreak in the South Bronx that left 12 people dead.

The Legionella strain found at the historic Opera House Hotel?s rooftop cooling tower matched the strain found in 25 patients, officials announced Thursday...