UPDATE: 3 CASES IDENTIFIED IN ROCKLAND COUNTY, 1 TRACED BACK TO THE BRONX. IS THE OUTBREAK REGIONAL NOW?
When will the Centers for Disease Control be called in?
The Banknote Building (which half of the building is leased by NYC’s HRA department serving people on public assistance), The Bronx Detective Bureau, Daughters of Jacob Nursing Home, and Department of Homeless Services Intake Center in The Bronx were found to have tested positive for Legionella as it has crossed over into East Harlem in Manhattan and found at Taino Towers, and Brooklyn House of Detention as mandatory testing of cooling towers is now in effect. According to Pix11 News a Riker’s Island inmate is also now among the infected.
As of yesterday, it brings the total to 15 sites that have been identified and made public although for whatever reasons, 3 sites identified by New York State Department of Health that are “outside” the impact zone have yet to be identified but according to a press release by the City and State, the identities of those sites will be released shortly.
Welcome2TheBronx called the New York State Department of Health’s Press office to see when these additional sites would be released to the public and we were simply told, “We don’t know.”
We asked why is there a delay in releasing the information if the sites were identified as of yesterday and we were simply told, “We really don’t have an answer as to why they haven’t been released yet.”
This lack of timely communication of information is a problem. People want and need to know where these sites are, it is our rights as residents of New York City and New York State to know where the potential hazards are being found IMMEDIATELY. It is precisely what The Opera House Hotel is upset with—this lack of any type of information.
List of sites that have tested positive for Legionella and locations of Legionnaires’ cases as per data provided by NYC Department of Health:
A nurse who works at Lincoln Hospital for the past 8 years reached out to us because they felt that they could no longer remain silent. In order to protect the nurse’s identity they have asked to remain anonymous, however, we have known the individual for years and can vouch that they are indeed a reliable source.
The Lincoln Hospital nurse wrote to us and said:
“I am in the trenches here at Lincoln with this outbreak. I’ve treated several patients with it and during its most active time. I will admit that even I was afraid and I don’t frighten that easily. I knew something was wrong because the pneumonia numbers were growing and nobody was saying anything. I kept bringing it up to my coworker and on the third day of me talking about it, the news broke. Lincoln did not inform its employees officially until two days after the news aired it and supposedly the first case walked into the hospital on July 4th which I believe is inaccurate. I walked through the halls and it seemed like every other person had pneumonia and everyone was coughing up phlegm and blood. And the ages varied from late 30’s to late 70’s, It was truly alarming. So I am with you on not trusting what they say. I’m really hoping that they find the actual source and get this under control.”
As of August 10th, according to the NYC DOH the following is known thus far:
Highlights:
- No new deaths have been reported in the last six days.
- No new cases diagnosed since August 3.
- Health officials remain confident that the source of the outbreak is from a location in the initial round of positive test sites, and that through disinfection of the source, the outbreak has been contained.
Cases
- Reported individuals with Legionnaires’: 113
- Individuals treated and discharged: 76
- Individuals with Legionnaires’ deceased: 12
- All deceased individuals were adults with underlying medical conditions.
Safety of Water Supply and Air Conditioning
- New York City’s drinking water supply and other water features, like fountains, shower heads and pools, are safe throughout New York City and are unaffected by legionella
- Water towers are unaffected by legionella
- Home air conditioner units are unaffected and walking into air conditioned environments is safe, as well.
Locations and Remediation
- All sites will submit long-term plans as to how they will maintain the cooling towers to protect against any future growth of legionella.
- The Health Department convened a panel of experts in the field of infectious disease to discuss the work the City has done so far and to ensure that all the appropriate steps are being taken to find and eliminate the source of the outbreak.
Ongoing Actions
- Continued monitoring for new cases
- Close collaboration with area hospitals
- Disease detectives conducting epidemiological investigation
- Interviews with all individuals reported with Legionnaires’ to support source identification
- Providing updates to elected officials and Bronx residents
- Outreach to vulnerable populations – senior centers, homeless shelters, and other locations
- Monitoring of disinfection of affected cooling towers
How does NYC DOH know that our water towers and drinking supply are safe if they have not tested them? What about the teacher who passed away in April that worked in the impact zone, why is his death not being counted and researched? Approximately 7 confirmed cases of Legionella infections are located within a 2 block radius around PS 325 where the late teacher worked.
The following are facts about Legionella and Legionnaires’ Disease which are not being disclosed by DOH and in turn the media and it is imperative that everyone is fully aware of all the facts:
Fact:
“Despite advances in water management and sanitation, waterborne disease outbreaks continue to occur in the United States. CDC collects data on waterborne disease outbreaks submitted from all states and territories* through the Waterborne Disease and Outbreak Surveillance System.† During 2009–2010, the most recent years for which finalized data are available, 33 drinking water–associated outbreaks were reported, comprising 1,040 cases of illness, 85 hospitalizations, and nine deaths. Legionella accounted for 58% of outbreaks and 7% of illnesses, and Campylobacter accounted for 12% of outbreaks and 78% of illnesses. The most commonly identified outbreak deficiencies§ in drinking water-associated outbreaks were Legionella in plumbing¶ systems (57.6%), untreated ground water (24.2%), and distribution system deficiencies (12.1%), suggesting that efforts to identify and correct these deficiencies could prevent many outbreaks and illnesses associated with drinking water. In addition to the drinking water outbreaks, 12 outbreaks associated with other nonrecreational water** were reported, comprising 234 cases of illness, 51 hospitalizations, and six deaths. Legionella accounted for 58% of these outbreaks, 42% of illnesses, 96% of hospitalizations, and all deaths. Public health, regulatory, and industry professionals can use this information to target prevention efforts against pathogens, infrastructure problems, and water sources associated with waterborne disease outbreaks.”
Fact:
“Legionella love water systems, particularly old, clunky and corroded ones that are not well maintained and have a little sludge,” said Dr. Glenn Morris, the director of the Emerging Pathogens Institute at the University of Florida and a specialist in infectious disease. “Cooling towers in particular are a great place to live from a legionella’s perspective, because it’s nice, warm water year-round.”
But experts said cooling towers account for a relatively small proportion of Legionnaires’ outbreaks. More often, they said, the disease spreads through the systems that supply water for drinking, cooking and bathing.”
Fact:
Legionella also grow symbiotically with the aquatic bacteria attached to the surface of biofilms (Kramer and Ford 1994). Biofilms provide the bacteria with nutrients for growth and also offer protection from adverse environmental conditions (including during water disinfection). The concentration of Legionella in biofilms depends upon water temperature; at higher temperatures, they can more effectively compete with other bacteria. Because biofilms colonize drinking water distribution systems, they provide a habitat suitable for Legionella growth in potable water, which can lead to human exposure.
The advisory went in to further state:
“Colbourne and Dennis (1989) stated that although Legionella are not thermophilic, they exhibit thermo-tolerance at temperatures between 40 and 60°C, which gives them a survival advantage over other organisms competing in man-made warm water systems. Although temperatures between 45 and 55°C are not optimal for Legionella, these temperatures enable them to reach higher concentrations than other bacteria commonly found in drinking water, thus providing Legionella with a selective advantage over
other microbes (Kramer and Ford 1994).”
Fact:
“Public health authorities downplay the significance of Legionella infections because most originate from drinking water. It is easier to target a cooling tower and harder to discuss with the general public the implications of Legionella in the drinking water. Note that the investigators said “probably”. All you have to do is ask the investigators “Did you culture the homes of the patients and their workplaces for Legionella?” If they refuse to answer, you will have learned something.”
The implication is that the actual source is not the cooling tower, but the home or workplace of the patients with Legionnaires’ disease. In order to be thorough, the health department should have cultured the drinking water that the patients had been exposed. ”
From the Centers for Disease Control:
“Despite advances in water management and sanitation, waterborne disease outbreaks continue to occur in the United States. CDC collects data on waterborne disease outbreaks submitted from all states and territories* through the Waterborne Disease and Outbreak Surveillance System.† During 2009–2010, the most recent years for which finalized data are available, 33 drinking water–associated outbreaks were reported, comprising 1,040 cases of illness, 85 hospitalizations, and nine deaths. Legionella accounted for 58% of outbreaks and 7% of illnesses, and Campylobacter accounted for 12% of outbreaks and 78% of illnesses. The most commonly identified outbreak deficiencies§ in drinking water-associated outbreaks were Legionella in plumbing¶ systems (57.6%), untreated ground water (24.2%), and distribution system deficiencies (12.1%), suggesting that efforts to identify and correct these deficiencies could prevent many outbreaks and illnesses associated with drinking water. In addition to the drinking water outbreaks, 12 outbreaks associated with other nonrecreational water** were reported, comprising 234 cases of illness, 51 hospitalizations, and six deaths. Legionella accounted for 58% of these outbreaks, 42% of illnesses, 96% of hospitalizations, and all deaths. Public health, regulatory, and industry professionals can use this information to target prevention efforts against pathogens, infrastructure problems, and water sources associated with waterborne disease outbreaks.”
As more and more sites are identified that are “outside” the impact zone, we must demand answers as to how this disease has spread so far in our communities and to what extent is it present in our everyday environments.
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