Legionnaires’ disease outbreak in the Bronx exposes safety issues

By Sandy English
6 August 2015

Seven people in the South Bronx have died and 86 have taken ill since July 10, from the rare but severe form of pneumonia known as Legionnaires’ disease.

The disease is transmitted when humans inhale airborne droplets of water that are contaminated with the legionella bacteria. City health officials have confirmed that the bacteria have been incubated in water-cooling towers. Water in these towers is used to cool heating and electrical systems in large buildings.

The fatality rate for Legionnaires’ disease, first identified about four decades ago, is between 5 and 30 percent, with the greatest risk among the elderly and people with preexisting respiratory diseases. While the names of those who recently died have not been revealed, the deaths in the Bronx outbreak are reportedly among these groups.

The South Bronx is one of the poorest areas of New York City. Respiratory diseases and conditions are more common in these areas than in other parts of the United States or New York City. Asthma is such a pervasive problem, particularly among the young, that the area is known as “Asthma Alley.”

Water-cooling systems in five buildings in the South Bronx, including a hospital, a hotel and a plastics manufacturer, have tested positive for the bacteria and have been decontaminated.

The outbreak has alarmed residents in the Bronx, and the city has sponsored public meetings to explain the nature of the disease and field questions on its own role in containing it.

Mary Bassett, New York City’s health commissioner, told one crowded meeting on Monday: “There are industry standards that are left to the owners, and what we’ve all been talking about this evening is the government role.”

There is, however, no government role in monitoring the health conditions of these facilities to begin with. The city, state, and federal government have all left the cooling towers completely unregulated. Inspections do not regularly take place.

These conditions have shocked many of those who attended the meetings, as well as disease control specialists. Some have asked why the de Blasio administration has not asked for assistance from the federal Centers for Disease Control (CDC).

Charles Haas, an expert on the disease at Drexel University, told the Daily News, “I think the city or state needs to call the CDC. This is really their forte. In terms of the cases, it’s getting to be quite substantial.”

The number of Legionnaires’ cases diagnosed in the five boroughs of New York City each year has recently totaled between 200 and 300 cases each year. The latest spike in cases is expected to reach half or more of this annual total in the space of only one month. Nationally, the number of Legionnaires’ cases has quadrupled since 2000. In that year there were about 1,100 cases reported, while the number for 2013 was more than 4,500.

There have been other recent spikes of the disease in New York, though not on the scale of the current outbreak. Last winter, 12 cases of the disease were diagnosed in Co-Op City, the enormous co-operative housing development in the northeast Bronx. According to the Riverbay Corporation, responsible for Co-Op City’s cooling systems, the New York City Health Department ordered the decontamination of these systems in January.

In May of this year, nine people were diagnosed with Legionnaires’ after falling ill at buildings operated by the New York City Housing Authority in the borough of Queens. The cause there was also traced to water-cooling towers.

There were no fatalities in either of these smaller recent outbreaks in New York. The city, however, led by the administration of Democratic Mayor Bill de Blasio, issued no directive to broadly inspect other water-cooling systems throughout the city.

While the de Blasio administration and the City Council are now rushing to pass legislation that would require building owners to inspect water-cooling towers for the bacteria, there is not even a comprehensive list of buildings in the city that use such towers.

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