Sick with Legionnaires’ disease?
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The second Legionnaires’ disease outbreak of 2018 has now affected 20 residents of lower Washington Heights since the end of September, according to the NYC Department of Health and Mental Hygiene (DOHMH) website.

Although the DOHMH website states 20 people have been sickened in the current outbreak, updated statistics have not been released. Of the 20 people infected, one victim has died.

The DOHMH issued a notice to residents of lower Washington Heights that read:

“The Health Department is investigating a cluster of Legionnaires’ disease in lower Washington Heights. Twenty people have been diagnosed with Legionnaires’ disease since the end of September. The Health Department is investigating these cases and testing the water from all cooling tower systems in this section of Washington Heights. The risk to most people is low, but if you have flu-like symptoms, please see your medical provider right away.”

(Note: The DOHMH is classifying this event as a “cluster” because the cases are linked in time and space but no common source has been identified. If that happens, the event will be recategorized as an “outbreak.” This blog is classifying this as an “outbreak,” because the probability is high that a specific source will be found.)

Lower Washington Heights outbreak hits 20 Legionnaires cases
The year’s second Legionnaires’ disease outbreak has now affected 20 residents of lower Washington Heights since the end of September. One victim has died. (Upper Manhattan is the northernmost region of Manhattan, and Washington Heights is a neighborhood in the area.)

Low risk, but be mindful
Despite the continuing increase in numbers of cases, DOHMH officials said they believe the risk of contracting Legionnaires’ disease in the area is “very low,” although they also said they expect more cases could be confirmed.

“The Health Department has identified a second cluster this season of Legionnaires’ disease in the lower Washington Heights area, and we are taking aggressive steps to ensure the safety of residents,” acting DOHMH commissioner Dr. Oxiris Barbot said in a statement Oct. 5.

Nonetheless, if you live in upper Manhattan, or work or travel in the affected neighborhoods, it’s essential that you remain vigilant. A person infected by the bacterium might not have developed symptoms because of the disease’s long incubation period (up to two weeks).

Don’t ignore symptoms
Because symptoms of Legionnaires’ disease are so similar to those of other forms of pneumonia (lung infection) or influenza (flu), many cases go unreported. Centers for Disease Control and Prevention (CDC) statistics show that only about 20 percent (5,000) of the estimated 25,000 yearly cases in the United States are reported, because of its nonspecific signs and symptoms.

About 10 percent of people infected with Legionnaires’ disease will die from the infection.

Early symptoms of Legionnaires’ disease generally include:

  • severe headaches
  • fever (104 degrees or higher) and chills
  • muscle aches
  • suppressed appetite.

Symptoms, however, can worsen to include:

  • pleuritic chest pain (pain caused by inflamed lungs)
  • dyspnea (difficulty breathing)
  • cough, which can produce blood and mucus
  • gastrointestinal problems such as diarrhea, nausea, and vomiting (about one-third of Legionnaires cases produce these symptoms)
  • mental agitation and confusion.

Summer outbreak
The investigation into the area’s first outbreak identified a cooling tower at Sugar Hill Project (898 St. Nicholas Avenue) as the cause for 27 illnesses – and one death – over the summer. Twenty-five of the 27 patients were hospitalized. A strain of Legionella bacteria, which causes Legionnaires’ disease, was common between six victims and a cooling tower at Sugar Hill Project.

Because of the current outbreak’s proximity to Sugar Hill Project, the DOHMH has ordered that building’s owners to re-clean and re-disinfect the cooling system. That process reportedly was finished Oct. 5.

That date was when the current outbreak first started making headlines. The DOHMH announced that eight Washington Heights residents had contracted Legionnaires’ disease over a five-day span. That initial group of victims ranges in age from younger than 40 to older than 80.

No information has been provided on the other 15 victims, including the victim who died.

Disease info

Legionnaires’ disease – also called legionellosis and Legionella pneumonia – is treatable with antibiotics, although if it is not diagnosed early, it can lead to severe complications. It is not contagious; that is, it cannot be passed from person to person.

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and other parts of the body, including the heart. It also can lead to life-threatening complications, including respiratory failure, septic shock, and acute kidney failure.

Bacteria sources
Legionnaires’ disease outbreaks and clusters have been linked to numerous sources of Legionella, including:

  • cooling towers of air conditioning systems
  • large plumbing systems
  • water systems (apartment complexes, hospitals, nursing homes, and hotels)
  • hot-water heaters and tanks
  • showers and faucets
  • swimming pools, hot tubs, and whirlpools
  • equipment used in physical therapy
  • mist machines (for example, the produce section of a grocery store)
  • hand-held sprayers
  • decorative fountains.

High-risk categories
Legionella bacteria are contracted by inhaling microscopic water droplets in the form of mist or vapor. Legionella grow best in warm water and are found primarily in human-made environments.

Anyone can become ill from Legionella, although the majority of healthy people exposed to the bacteria do not. Those most susceptible to infection include:

  • people 50 years old or older
  • people with chronic lung disease or COPD (bronchitis or emphysema)
  • smokers, either current or former
  • people with compromised immune systems
  • heavy drinkers of alcoholic beverages
  • recipients of organ transplants
  • people on specific drug protocols (for instance, corticosteroids).