This past summer, five nursing home residents succumbed to Legionnaires' disease according to a published report in the NY Times.
The outbreak at Amsterdam Nursing Home, a 409-bed facility in upper Manhattan, was the city's worst since 2015 when a cooling tower in the Bronx was blamed for an infection that caused 16 deaths. The New York City nursing home that had been cited repeatedly for improper maintenance of the cooling towers where the Legionella bacteria can spread.
Legionnaires’ (LEE-juh-nares) disease is a serious type of pneumonia (lung infection) caused by Legionella (LEE-juh-nell-a) bacteria. People can get sick when they breathe in small droplets of water or accidently swallow water containing Legionella into the lungs.
According to the CDC, "
Legionella bacteria are found naturally in freshwater environments, like lakes and streams. The bacteria can become a health concern when they grow and spread in human-made building water systems like
- Showerheads and sink faucets
- Cooling towers (structures that contain water and a fan as part of centralized air cooling systems for buildings or industrial processes)
- Hot tubs
- Decorative fountains and water features
- Hot water tanks and heaters
- Large, complex plumbing systems
Home and car air-conditioning units do not use water to cool the air, so they are not a risk for Legionella growth.
However, Legionella can grow in the windshield wiper fluid tank of a vehicle (such as a car, truck, van, school bus, or taxi), particularly if the tank is filled with water and not genuine windshield cleaner fluid.
Learn four key steps that can lead to Legionella growing in building water systems and spreading to people.
How It Spreads
After Legionella grows and multiplies in a building water system, water containing Legionella can spread in droplets small enough for people to breathe in. People can get Legionnaires’ disease or Pontiac fever when they breathe in small droplets of water in the air that contain the bacteria.
Less commonly, people can get sick by aspiration of drinking water containing Legionella. This happens when water accidently goes into the lungs while drinking. People at increased risk of aspiration include those with swallowing difficulties.
In general, people do not spread Legionnaires’ disease and Pontiac fever to other people. However, this may be possible under rare circumstances.
Following the 2015 outbreak in the Bronx, New York City passed strict rules for maintaining cooling towers that include requiring building managers to register the towers with the city and submit to regular testing.
A review by the Times found that Amsterdam Nursing Home was cited seven times in the past six years for rules violations ranging from not conducting routine maintenance to using inadequate start-up procedures for the towers. One infraction resulted in a $500 fine related to record keeping for water sample analysis, while the other six were dismissed after hearings.
Dozens of other nursing home in the city have also been cited for violating cooling tower regulations. The Times found that 43 nursing homes have been fined a total of $164,000 since 2015 and they have paid about $120,000 of that amount.