All 5 sites where Legionella has been detected have decontaminated but are cooling towers the only source? Research may indicate no.
All 5 sites where Legionella has been detected have decontaminated but are cooling towers the only source? Research may indicate no.

With a 4th death, along with additional sites having been identified as contaminated with Legionella—the bacteria that causes Legionnaires disease—and additional cases of individuals who have contracted the infection, tonight’s Town Hall meeting at The Bronx Museum from 6PM – 8PM on the issue is going to have to answer a lot of questions.

Is the city doing enough? Is our drinking water really safe?

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As of Sunday, the cases of Legionnaires had risen to 71 since July 10th. The 4 individuals who passed away from the disease were said to have suffered from other health ailments including heart and lung issues.

Although New York City Mayor de Blasio along with other officials have said that there is no need for panic because this is a highly treatable disease and it isn’t communicable, meaning transferred by human contact, residents are not taking any chances.

FINAL-LEGIONNAIRE'S-FLIER

Local supermarkets are reporting a slight increase in bottled water sales even New York City Health Commissioner Bassett is declaring our drinking water safe and is focusing on cooling towers which led to the discovery of the 5 infected areas, yet according to the New York Times:

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.”

And this is indeed the case as the United States Environmental Protection Agency released a health advisory in 2001 on drinking water and Legionella stating (PDF FILE):

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).”

According to Legionella.org, a website founded by healthcare professionals with over 30 years of experience with Legionairres‘, they caution the following:

“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. (‘Legionnaires’ Disease Contracted from Patient Homes: The Coming of a Third Plague?’/European Journal of Clinical Microbial Infectious Disease, ‘Cooling Towers & Legionellosis: A Conundrum and Proposed Solutions/International Journal of Environmental Health‘)

In another study conducted on Legionnaires’ in New York City between 2002-2011 and published in 2014 in the medical journal, ‘Emerging Infectious Diseases’ reported that New York City, as well as the rest of the nation, has seen an increase in Legionnaires’ infection. In NYC between 2002 and 2009 there was an increase of 230% with the highest incidents located in areas where poverty is concentrated the highest.

We already know that the South Bronx is in the poorest congressional district so this latest outbreak should not be a surprise when taking this latest study in to consideration. The study goes on to say that more research is needed to understand this link between poverty and higher incidents of the disease and states:

“Among patients with community-acquired cases, the probability of working in transportation, repair, protective services, cleaning, or construction was significantly higher for those with Legionnaires’ disease than for the general working population. Further studies are required to clarify whether neighborhood-level poverty and work in some occupations represent risk factors for this disease.”

So far none of the 4 victims and the 71 individuals with Legionnaires’ were in contact with the 5 identified contaminated water cooling sites: Lincoln Hospital, The Opera House Hotel, Concourse Plaza Multiplex, The Verizon Building on 165th Street and Streamline Plastics Company.

Would it be prudent to then begin testing our water supply of it hasn’t been tested already? Clearly the EPA has indicated that conditions in drinking water supplies are far more favorable for Legionella.

In a call we put to The Center for Disease Control, Welcome2TheBronx was told that New York State Department of Health has to formally ask the CDC to step in for assistance.

Although I am not a health care professional, I think after 4 deaths and perhaps one of the largest outbreaks in New York City history demands that the CDC becomes involved.

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