Legionnaire's Disease Breaks Out in the Bronx

Reports of cases of Legionnaire’s disease in the South Bronx have risen to 31, so it’s important to know the symptoms of this treatable illness.

Legionnaire’s disease is not rare. In fact, it is one of the most common causes of pneumonia (lung infection). I have seen one case of Legionnaire’s at Northern Westchester Hospital this month. Treatment usually involves an antibiotic like Erythromycin, Zithromax or Levaquin.

Symptoms of Legionnaire’s usually appear two to 10 days after significant exposure to the Legionella bacterium. New Yorkers with symptoms like fever, cough, chills and muscle aches should seek medical attention immediately. Other signs may include headache, fatigue, loss of appetite, confusion and diarrhea.

Three groups are at high risk for the Legionnaire’s:

1. Middle-aged or older people (especially cigarette smokers)
2. Chronic lung disease sufferers or patients with weakened immune systems
3. People who take medicine that weaken their immune systems (immunosuppressive drugs)

Thirty-one South Bronx cases of Legionnaire’s disease and two deaths have been reported since July 10, said the New York City Department of Health and Mental Hygiene. The Health Department is investigating the deaths and their relationship to the outbreak.

While Legionnaire’s is not rare, a cluster like this one is. The Health Department is likely seeking the common source for the outbreak because there is probably a common feature in this particular strain.

Cases of the disease often increase during the summer because of water sources associated with air conditioning. The bacteria that cause Legionnaire’s thrive in whirlpool spas, hot tubs, humidifiers, hot water tanks, cooling towers and evaporative condensers of large air-conditioning systems. They do not seem to grow in car or window air-conditioners, according to the Centers for Disease Control and Prevention. The Health Department is testing water from cooling towers and other potential local sources to find the source of the outbreak.

There are no vaccines against Legionnaire’s. Those at increased risk may choose to avoid exposure to places where the bacteria grow (cooling towers and decorative fountains, plus hot tubs and hot water tanks). 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.

This post was written by Debra Spicehandler, MD, co-chief of infectious diseases, Northern Westchester Hospital.

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