11 Aug 2015

Legionnaires’ disease: South Bronx, New York

An outbreak of Legionnaires’ disease has been reported in the South Bronx, New York Legionnaires’ disease: South Bronx, New York

The New York City Department of Health and Mental Hygiene is investigating a large outbreak of Legionnaires’ disease. Between 10 July and 10 August 2015, a total of 113 cases of Legionnaires disease have been reported, of which twelve have died [1-2].

The affected area is located in the South Bronx of New York City. Local public health services are undertaking a wide ranging programme of environmental testing and disinfection of potential sources including cooling towers.

About Legionnaires’ disease

Legionnaires’ disease is a bacterial infection usually causing pneumonia. Symptoms include cough, shortness of breath, and fever; gastrointestinal upset can also occur. The disease is more frequent in the elderly, smokers and those with pre-existing lung disease or chronic medical conditions.

Legionella spp. bacteria are distributed widely in the environment. They can live in many types of water including natural sources such as rivers and streams, and in artificial sources such as water-cooling towers, hot and cold water systems and spa pools. People can become exposed to the bacteria if the water systems are not properly maintained and become contaminated.

Advice for travellers

The risk to most travellers to New York is low, and no special precautions are currently advised by public health authorities.

Travellers visiting Bronx (New York) who develop an influenza-like illness (fever, cough, shortness of breath) during their stay or up to 14 days after their return home, and who believe they may be infected, should seek medical care for appropriate investigations and possible antibiotic treatment..

Advice for health professionals

Legionnaires’ disease should be considered as a potential diagnosis for cases of atypical pneumonia throughout the year. When appropriate symptoms are present, a history of travel should act as a specific prompt for clinicians to evaluate for Legionella infection. A urinary antigen test should be conducted for an initial diagnosis to be made.

Information for health professionals assessing individuals with suspected Legionnaires’ disease is available from the Public Health England.

All cases of Legionnaires’ diseases (regardless of travel history) should be reported to the local health protection team (or equivalent in devolved administrations).

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