Infectious Diseases Expert Explains Legionnaires’ Outbreak in the Bronx

Posted on: July 30, 2015

Infectious Diseases Expert Explains Legionnaires’ Disease

By Dr. Debra Spicehandler

With reports of cases of Legionnaires’ disease cases rising to 31 in the South Bronx, individuals should know the symptoms, and that it is treatable. I have seen one case at Northern Westchester Hopsital this month. Legionnaires’ disease is not rare. In fact, it is one of the most common causes of pneumonia. However, it can be treated with antibiotics including Erythromycin, Zithromax, or Levaquin.

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

According to a press release from the New York City Department of Health and Mental Hygiene, “The Health Department is currently investigating an outbreak of Legionnaires’ disease in the South Bronx. Thirty-one cases have been reported since July 10. There have also been two deaths reported in patients with Legionnaires’ disease in these neighborhoods. The Health Department is actively investigating these deaths and their relationship to the outbreak. The Health Department is testing water from cooling towers and other potential sources in the area to determine the source of the outbreak. New Yorkers with respiratory symptoms, such as fever, cough, chills and muscle aches, are advised to promptly seek medical attention.”

The release continues, “Legionnaires’ disease is caused by the bacteria Legionella. Additional symptoms include: 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 whirlpool spas, hot tubs, humidifiers, hot water tanks, cooling towers, and evaporative condensers of large air-conditioning systems.”

According to the Health Department, groups at high risk for Legionnaires’ disease include:

  • People who are middle-aged or older – especially cigarette smokers – people with chronic lung disease or weakened immune systems
  • People who take medicines that weaken their immune systems (immunosuppressive drugs).

If you have these symptoms, call your doctor and ask about testing for Legionnaires’ disease.

While Legionnaires’ disease is not rare, a cluster like the one we’re seeing is rare. The Health Department is likely seeking the common source for this because there is probably a common feature in this particular strain. Summer is also the time of year to expect to see more cases because of the water sources in air conditioning.

While we can’t prevent exposure to external sources of legionella, there are some things we can do. At Northern Westchester Hospital, we regularly check our water supply to ensure the safety of all of our patients. Additionally, all patients in the area who are diagnosed with pneumonia should now be screened for Legionnaires’ disease with a simple blood and urine test.

Editor’s Note: Debra Spicehandler, MD, is an infectious diseases specialist and Co-Chair of the Infection Control Committee at Northern Westchester Hospital.