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The New York City Department of Health and Mental Hygiene (NYC Health) is investigating a Legionnaires’ disease outbreak at a Lower East Side condo complex after a second resident was confirmed with the disease in the past 12 months.

The outbreak occurred at the Two Bridges Condominium Complex at 251-253-255 Clinton Street, 291-305-307-309-311 Cherry Street, and 291-293-295 Jefferson Street.

The Centers for Disease Control and Prevention (CDC) defines a Legionnaires’ disease “outbreak” as two or more cases associated with the same possible source during a 12-month period.

“The Health Department and building management are promptly alerting residents of the situation and providing guidance on how to prevent exposure, especially for those at higher risk for disease,” NYC Health assistant press secretary Michael Lanza wrote in a statement released to the public.

Environmental testing results of the water system are expected back within two to three weeks. The tests will confirm whether Legionella, the bacteria that causes Legionnaires, is present in the system.

NYC outbreak: water ‘safe’

NYC Health stressed that it is safe for tenants to continue to drink and use the water. However, department officials recommend the following precautions:

• Don’t take a shower, since it could create water vapor (mist). Instead, take a bath but fill the tub slowly. Try to minimize time in the bathroom while the tub is filling.
• It’s OK to wash dishes but fill the sink slowly to avoid creating a mist.
• It’s fine to drink cold water from the tap but start with cold water when heating water for tea, coffee or cooking.

Legionnaires’ disease is usually caught by breathing in infected water vapor. It’s treatable with antibiotics.

NYC outbreak: disease symptoms

Legionnaires’ disease usually develops two to 10 days after exposure to Legionella. It frequently begins with the following symptoms:

• headache
• muscle pain
• chills
• fever, which can be 104 degrees Fahrenheit or higher.

By the second or third day, other symptoms develop, including:

• cough, which can bring up mucus and sometimes blood
• shortness of breath
• chest pain
• gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
• confusion and other mental changes.

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

NYC outbreak: multiple incidents

New York City has avoided large outbreaks this year, like the two outbreaks that infected Upper Manhattan in 2018, resulting in two deaths and 60 illnesses. Small outbreaks, however, have popped up around the city this year, including:

• In July, two cases of the respiratory illness were confirmed within the past 12 months at Manhattan Plaza (400 West 43rd Street) in Hell’s Kitchen.
• Also last month, two illnesses were reported in Queens at 20-02, 20-04, 20-06, 20-08, 20-10 and 20-12 Seagirt Boulevard.
• The Brielle at Seaview, a non-profit, assisted-living facility for seniors on Staten Island, also dealt with an outbreak last month when a second illness was diagnosed within eight months.
• In February, NYC Health confirmed that two cases occurred at the Bronx River Houses within the previous year.

NYC outbreak: disease info

An estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur in the United States every year, according to the CDC. However, only 5,000 cases are reported because of the disease’s nonspecific symptoms.

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

Other people more susceptible to infection include:

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

This list also includes anyone with an immune system weakened by:

• frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis or skin infections
• organ inflammation and infection
• blood disorders, such as low platelet counts or anemia
• digestive problems, such as cramping, appetite loss, diarrhea, and nausea
• delayed growth and development.

After Legionnaires’ disease has been diagnosed, hospitalization is often necessary. In the most severe Legionnaires cases, complications can include respiratory failure, kidney failure, septic shock, or even death.

According to CDC statistics, about one out of every 10 people (10 percent) infected with Legionnaires’ disease will die due to complications from the illness.

NYC outbreak: possible sources

Legionella bacteria are contracted by inhaling microscopic water droplets in the form of mist or vapor. The bacteria, which thrive in warm water, are found primarily in human-made environments, such as:

• water systems of large buildings (hospitals, nursing homes, hotels, etc.)
• large plumbing systems
• air-conditioning system cooling towers
• hot-water heaters and tanks
• bathroom showers and faucets
• swimming pools
• whirlpools and hot tubs
• physical-therapy equipment
• mist machines and hand-held sprayers
• decorative fountains.

Warm, stagnant water provides ideal conditions for growth, according to the Occupational Safety and Health Administration (OSHA). At temperatures between 68 degrees and 122 degrees Fahrenheit, the organism can multiply. Temperatures of 90 degrees to 105 degrees are ideal for growth.