Global & Disaster Medicine

Legionnaire’s in Queens

NYC

Health Department Investigates Community Cluster of Legionnaires’ Disease in Downtown Flushing, Queens

12 confirmed cases of Legionnaires’ disease have been reported in the area in the past two weeks

Legionnaires’ disease cannot be spread from person to person; those at high risk include people aged 50 or older, especially cigarette smokers, people with chronic lung disease or with weakened immune systems

New Yorkers with respiratory symptoms, such as fever, cough, chills and muscle aches, are urged to promptly seek medical attention

October 24, 2017 — The Health Department is currently investigating a community cluster of Legionnaires’ disease cases in downtown Flushing, Queens. A total of 12 patients have been confirmed with Legionnaires’ disease in the area in the past two weeks. Most patients had serious underlying health conditions. The patients range in age from early 30s to late 80s. Five persons are hospitalized and recovering, and seven have been discharged from the hospital. No patients have died. Two more cases are currently being investigated to determine whether they are part of this cluster. The Health Department is actively investigating these cases and has taken water samples from all cooling tower systems within the investigation zone to test for Legionella, the bacteria that causes Legionnaires’ disease. To raise awareness in the community, the Health Department and the Mayor’s Office are working with elected officials and sending outreach teams to transit hubs and senior centers in the area to distribute information about Legionnaires’ disease. The Health Department is also organizing a community meeting to inform residents, answer questions and address any concerns. The Health Department is urging residents in the area with respiratory symptoms, such as fever, cough, chills and muscle aches, to promptly seek medical attention. The Health Department has alerted health care providers in the area about this cluster. Legionnaires’ disease is a treatable infection using antibiotics for pneumonia. Every year, there are between 200 and 400 cases of Legionnaires’ disease in the city.

As of today, the Health Department has sampled all cooling towers in the investigation zone. Testing involves a two-step process that first identifies genetic evidence of the bacteria and then confirms if the bacteria are alive and able to cause disease. Positive results from the first step will enable the Health Department to identify towers that potentially have bacteria capable of making people sick. The owners of those buildings will be ordered to immediately increase the level of biocides that kill the Legionella bacteria or to change to a new biocide and report to the Department within 24 hours. This biocide remediation will be done as a precautionary step while the second step, growing the bacteria in culture, is being done to determine the presence of the live bacteria that causes Legionnaires’ disease. It takes two weeks to allow bacteria adequate time to grow. A positive culture indicates the presence of bacteria capable of causing disease. The Department will order the owner of any building with a positive culture result to fully clean and disinfect the cooling tower.

“The Health Department is currently investigating a cluster of Legionnaires’ disease cases in the downtown Flushing area of Queens, and I urge individuals in this area with respiratory symptoms to seek medical attention right away. People over the age of 50 and people with compromised immune systems are especially at risk,” said Health Commissioner Dr. Mary T. Bassett. “As with our previous Legionnaires’ disease investigations, we are in the process of investigating the source of the cluster and are working with building owners in the area to rapidly test and clean cooling towers.”

Legionnaires’ disease is caused by the bacteria Legionella. Symptoms include fever, cough, chills, muscle aches, 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 cooling towers, whirlpool spas, hot tubs, humidifiers, hot water tanks, and evaporative condensers of large air-conditioning systems.

Legionnaires’ disease cannot be spread from person to person. Groups at highest 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 medicines that weaken their immune systems (immunosuppressive drugs). Those with symptoms should call their doctor and ask about testing for Legionnaires’ disease.

Local Law 77
In response to the Legionnaires’ disease outbreaks of 2015, the Mayor and City Council passed Local Law 77 to reduce and contain Legionella growth in cooling towers, becoming the first U.S. municipality to adopt a set of robust requirements to ensure cooling tower maintenance. Changes to the Health Code went into effect in May 2016. In June of last year, the Health Department announced a plan to reduce the risk of Legionnaires’ disease outbreaks in the city, which, in addition to implementing the most aggressive cooling tower regulation in the nation, included the hiring of more inspectors and training of City personnel to inspect towers and better capacity to conduct lab testing. Since the implementation of the new law, the Department has identified and monitored over 4,000 cooling tower systems (over 6,100 cooling towers) in New York City.

To promote compliance, the Health Department has been educating building owners and managers in best practices for managing their cooling towers. The agency has distributed information about the Management Program and Plan template, how to build a cooling tower system team and general Frequently Asked Questions.

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

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MEDIA CONTACT: Christopher Miller/Julien Martinez: (347) 396-4177
pressoffice@health.nyc.gov


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