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New York City health officials confirmed that two cases of Legionnaires’ disease are being investigated in Hell’s Kitchen, a neighborhood on the west side of Manhattan.

The NYC Department of Health and Mental Hygiene (DOHMH) is testing the water for Legionella, the bacteria that causes Legionnaires’ disease, at two buildings: 535 West 51st Street and 540 West 52nd Street.

Both buildings are part of Clinton Manor, a two-building housing complex developed in 1981. The eight-story property totals 235 residential units for Section 8 tenants, and includes alternate addresses between 538 and 550 West 52nd Street.

The two individuals who were sickened in July are residents of Clinton Manor. Both were hospitalized but have since been released. No information was provided on their ages or genders.

People at increased risk
Most people exposed to Legionella do not get sick, but people 50 years old and older, especially those who smoke and have chronic lung conditions, are at a higher risk.

Other people more susceptible to infection include:

  • heavy drinkers of alcoholic beverages
  • people with compromised immune systems
  • recipients of organ transplants
  • individuals who are on specific drug protocols (corticosteroids, to name one).

Residents given warnings
The DOHMH is urging Clinton Manor residents to avoid using hot water until testing results prove the system is clear of Legionella. 

Residents who are feeling flu-like symptoms (see below) should seek immediate care from their health-care provider. According to the Centers for Disease Control and Prevention (CDC), Legionnaires’ disease is often under-reported, so the full extent of the outbreak might never be known.

Legionella plaguing the city
It has been another busy summer for Legionnaires’ disease in New York City.

On July 8, the DOHMH confirmed eight cases of Legionnaires’ disease in lower Washington Heights and upper Hamilton Heights. Since then, the case count has more than tripled, and currently, the Legionnaires’ cluster stands at 27 with one death.

In addition, health officials have confirmed that Legionella bacteria recently were found in the water supply of the Jacobi Medical Center in the Bronx.

Bronx outbreak killed 12 in 2015
The largest outbreak in New York City history occurred in 2015. Contaminated cooling towers were blamed for producing Legionnaires’ disease that killed 12 people and sickened more than 120 others in the south Bronx.

Every year, between 200 and 500 people are diagnosed with the disease in NYC, city health officials said.

Legionnaires’ primer

Legionnaires’ disease – also called legionellosis and Legionella pneumonia – is a severe type of lung infection. According to the CDC, an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur yearly in the U.S. Only 5,000 cases are reported, however, because of its nonspecific signs and symptoms.

Legionella bacteria are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor. The bacteria, which grow best in warm water, are found primarily in human-made environments.

Why is this happening?
Legionnaires’ disease occurs more frequently in hot, humid weather, because the bacteria grow best in warm water and are found primarily in human-made environments.

According to Laura Cooley, MD, MPH from the CDC’s Respiratory Diseases Branch, Legionnaires’ disease is “an emerging disease in the sense that the number of recorded cases of Legionnaires’ in the United States continues to increase.”

Cooley said she believes the increase is due to an increase in the susceptibility of the population – that is, more and more people are using immunosuppressive medications. She also said there could be more Legionella in the environment, because warmer temperatures are creating the right conditions for bacterial growth.

Where do Legionella live?
Outbreaks have been linked to a number of sources:

  • water systems, such as those used in apartment complexes, hospitals, nursing homes, and hotels
  • the cooling towers of air conditioning systems
  • large plumbing systems
  • hot-water tanks and heaters
  • showers and faucets
  • swimming pools
  • hot tubs and whirlpools
  • equipment used in physical therapy
  • mist machines and hand-held sprayers
  • decorative fountains.

What are the symptoms?
Legionnaires’ disease develops anywhere from two to 10 days after exposure to Legionella. Symptoms frequently begin with the following:

  • severe headache
  • muscle aches and pains
  • chills
  • high fever, which can be 104 degrees Fahrenheit or higher.

By day two or three, other symptoms develop, including:

  • coughing, which often brings up mucus and sometimes blood
  • difficulty breathing, also known as dyspnea
  • chest pains
  • gastrointestinal symptoms, including diarrhea, vomiting and nausea
  • confusion and other mental changes.

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and in other parts of the body, including the heart.