I wonder who is responsible for the tower on the Opera House Hotel and if the hotel owns the building. The hotel--which gets good reviews-- is a sign of hope for the South Bronx and is attracting guests who do not want to, or cannot afford to, pay Manhattan prices. I was hoping to stay there on my next visit to the city and the borough in which I was raised.
1
I'm a 9/11 family member. And tho I know, personally, how well planned and maintained the 9/11 Memorial is, I had a moment of pause just considering -- again -- were the fountains / waterfalls really the best idea. All that water, in Lower Manhattan, to me, was always problematic, an accident waiting to happen .. what if it leaks, ruptures, it's already on low ground buttressed against the 'bathtub wall' ... but the inhaled mist concept offers a whole new way to consider it risky.
I surely hope no one gets ill due to visiting or spending time on the 9/11 plaza.
I surely hope no one gets ill due to visiting or spending time on the 9/11 plaza.
2
People, please. Until now we have had almost no incidence of Legionnaires' in NYC. There was no reason to have a robust testing program. Personally I am wondering if the outbreak is at least in part a result of the unusually hot and humid weather we've had this summer which may have caused AC systems and their cooling towers to operate differently than they have in the past. As far as it happening in the South Bronx and not the rest of the city I am quite sure that enquiring minds in the Health Department are puzzling over that and enlisting whatever expert help there is to figure it out. [Absolutely the headlines would be still more prominent if it were happening on the Upper West Side, but that is not a fair measure of where the city is putting resources.]
5
As I've survived Legionnaires', I've studied up on it, and I might be able to offer some advice. First though my condolences to the family and friends of Mr. Quiles, this is an unfortunate and unforeseeable passing, and I hope they can deal well with their grief.
For everyone who's concerned that they might be at risk for Legionnaires let me assure you, you probably are not. Not only do you need to get a pretty good inhalation of the aerosolized bacteria (in suspended water droplets that weren't boiled), you need to have a somewhat weakened immune system or other respiratory conditions for it to take root.
But there is a chance of catching it, and it's not always clear what the source is, so what people should be on the lookout for is primarily a high fever. If you get a fever of over 102 degrees for over a day, and joints start to hurt, and it gets hard to think clearly, then get to an ER without delay, and calling 911 for an ambulance is not unreasonable. When I caught this it took three days to really take hold, and I shrugged off the growing fever, which was a big mistake.
There won't be other symptoms, not really coughing, no vomiting, weirdly no trouble breathing initially, and so on. The main thing is fever and bodily pain that will be impossible to ignore, and if it doesn't go away after 24 hours don't take chances.
Best of luck to everyone out there and I'd caution people not to blame Mayor de Blasio, this is just one of those things, always around.
For everyone who's concerned that they might be at risk for Legionnaires let me assure you, you probably are not. Not only do you need to get a pretty good inhalation of the aerosolized bacteria (in suspended water droplets that weren't boiled), you need to have a somewhat weakened immune system or other respiratory conditions for it to take root.
But there is a chance of catching it, and it's not always clear what the source is, so what people should be on the lookout for is primarily a high fever. If you get a fever of over 102 degrees for over a day, and joints start to hurt, and it gets hard to think clearly, then get to an ER without delay, and calling 911 for an ambulance is not unreasonable. When I caught this it took three days to really take hold, and I shrugged off the growing fever, which was a big mistake.
There won't be other symptoms, not really coughing, no vomiting, weirdly no trouble breathing initially, and so on. The main thing is fever and bodily pain that will be impossible to ignore, and if it doesn't go away after 24 hours don't take chances.
Best of luck to everyone out there and I'd caution people not to blame Mayor de Blasio, this is just one of those things, always around.
11
I'm glad you survived your illness, however I would disagree with you regarding your view that LD is a matter of fate and is unavoidable. First of all, while Legionella is present in virtually all fresh water sources and even in municipal water systems, it is present at very low levels which do not present a risk of disease.
The major risk of contracting disease is exposure to warm water sources in which Legionella bacteria have multiplied to high concentrations. While the exact level of exposure which causes an infection in an non-immune compromised individual is not known, it is clear from data on outbreaks caused by cooling towers that water concentrations in the 100 to 1000 plus colony forming unit per milliter of water can cause disease. These concentrations represent a failure to properly maintain the cooling tower and are largely preventable without implementing burdensome measures.
LIkewise proper maintenance of hot water systems should also reduce risk of disease.
I think it is important to understand that even relatively healthy people can be susceptible to LD. A case of the flu can put a person at increased risk, especially if the exposure is to a highly contaminated water source.
The major risk of contracting disease is exposure to warm water sources in which Legionella bacteria have multiplied to high concentrations. While the exact level of exposure which causes an infection in an non-immune compromised individual is not known, it is clear from data on outbreaks caused by cooling towers that water concentrations in the 100 to 1000 plus colony forming unit per milliter of water can cause disease. These concentrations represent a failure to properly maintain the cooling tower and are largely preventable without implementing burdensome measures.
LIkewise proper maintenance of hot water systems should also reduce risk of disease.
I think it is important to understand that even relatively healthy people can be susceptible to LD. A case of the flu can put a person at increased risk, especially if the exposure is to a highly contaminated water source.
5
Dear Kevinjcummins,
Thanks, and sorry I didn't mean to give that impression. LD is avoidable if water that meets its necessary conditions is checked for it having taken up residence, as you say, but it's not avoidable by individuals. The only way to avoid it is for building owners to check and clear their HVAC systems, heated pools, and so forth, it can't be easily dodged by someone working in a building that's got LD in the pipes. That's how I got it myself, in the workplace. And the only things that lowered my immune system enough to contract it were that I'm a smoker and I'd had a cold (not even flu) just beforehand, and I was 42 so not terribly old and frail.
So yeah it's really up to building maintenance to prevent this disease, and thanks again for the additional info.
Thanks, and sorry I didn't mean to give that impression. LD is avoidable if water that meets its necessary conditions is checked for it having taken up residence, as you say, but it's not avoidable by individuals. The only way to avoid it is for building owners to check and clear their HVAC systems, heated pools, and so forth, it can't be easily dodged by someone working in a building that's got LD in the pipes. That's how I got it myself, in the workplace. And the only things that lowered my immune system enough to contract it were that I'm a smoker and I'd had a cold (not even flu) just beforehand, and I was 42 so not terribly old and frail.
So yeah it's really up to building maintenance to prevent this disease, and thanks again for the additional info.
1
But, Dan Stackhouse, what do you do when you live in an area where the first health center that the ambulance takes you to is too crowded to see you? And where the second clinic--presumably ER at St. Barnabas--holds you overnight and then sends you home the next morning?
These are the compound problems of US health and medical care for poor people and other underserved groups: If you're poor, you're more likely to live, work, and eat in places with health hazards. You're more likely to have chronic health problems and those problems are less likely to be well treated and monitored by health care professionals. You're less likely to have a primary care provider and more likely to end up at a clinic or ER that doesn't know your history. The facilities near you are more likely to be overcrowded, understaffed, and to have poorer infrastructure and resources than facilities in more affluent areas. You are less likely to have insurance and therefore more likely to be turned away from a facility or released too soon, no matter how illegal that is. If you don't speak English well, or do not have high education levels, or have mental health issues, you are less likely to provide all the information a diagnostician needs, less likely to ask questions to clarify your diagnosis and treatment, and less likely to resist being sent home even if you think you still need care.
These are the compound problems of US health and medical care for poor people and other underserved groups: If you're poor, you're more likely to live, work, and eat in places with health hazards. You're more likely to have chronic health problems and those problems are less likely to be well treated and monitored by health care professionals. You're less likely to have a primary care provider and more likely to end up at a clinic or ER that doesn't know your history. The facilities near you are more likely to be overcrowded, understaffed, and to have poorer infrastructure and resources than facilities in more affluent areas. You are less likely to have insurance and therefore more likely to be turned away from a facility or released too soon, no matter how illegal that is. If you don't speak English well, or do not have high education levels, or have mental health issues, you are less likely to provide all the information a diagnostician needs, less likely to ask questions to clarify your diagnosis and treatment, and less likely to resist being sent home even if you think you still need care.
1
If eight people from the Upper East Side or Battery Park City had lost their lives instead of The Bronx, all these ineffective DoH people would now be looking for new jobs. I've never heard such callousness and lack of urgency.
5
If you've never tried to track down legionella, maybe it's not a great idea to jump to conclusions. People in rich neighborhoods catch this too.
4
Trust me that that there are probably many other hospitals in NYC area and around the country which also have problems related to Legionella contamination. Unfortunately, the U.S. Leader in public health policy, the Centers for Disease Control, CDC, has opposed water sampling of cooling towers for Legionella as a means of ensuring that the maintenance practices being used are effective.
Other nations have mandated Legionella control programs which include testing of water systems to ensure minimal levels of growth. These include but are not limited to: the UK, France, and Australia.
CDC more recently may have softened their position on water testing, however, they argue that no detectable Legionella levels in water is the only acceptable measure of control. This largely ignores the evidence that the vast majority of cooling towers which contain less than one organism per milliter, are holy unlikely to have caused disease.
Demanding a non-detectable level of Legionella in cooling tower water systems, or for that matter in residential and commercial hot water systems is probably not feasible.
Practical standards of prevention in the U.S. Should greatly reduce the incidence of LD, and avoid outbreaks from uncontrolled cooling towers which probably contained Legionella concentrations in excess of 100 to 1000 plus colony forming units per milliter of water.
Other nations have mandated Legionella control programs which include testing of water systems to ensure minimal levels of growth. These include but are not limited to: the UK, France, and Australia.
CDC more recently may have softened their position on water testing, however, they argue that no detectable Legionella levels in water is the only acceptable measure of control. This largely ignores the evidence that the vast majority of cooling towers which contain less than one organism per milliter, are holy unlikely to have caused disease.
Demanding a non-detectable level of Legionella in cooling tower water systems, or for that matter in residential and commercial hot water systems is probably not feasible.
Practical standards of prevention in the U.S. Should greatly reduce the incidence of LD, and avoid outbreaks from uncontrolled cooling towers which probably contained Legionella concentrations in excess of 100 to 1000 plus colony forming units per milliter of water.
How does a NYC public hospital that has engineering and maintenance departments with senior management directors, not have responsiblity in maintaining the water tower?
Why has no one, not even the press asked this question? The other locations can be sweot under the private ownership rug but not Lincoln Hospital.
Of those diagnosed, how many routinely receive outpatient care at Lincoln?
The fact that the disclosure lid is termed protecting privacy or is liability?
The Bronx remains the poorest and sickest.....or we also the most easily managed?
Why has no one, not even the press asked this question? The other locations can be sweot under the private ownership rug but not Lincoln Hospital.
Of those diagnosed, how many routinely receive outpatient care at Lincoln?
The fact that the disclosure lid is termed protecting privacy or is liability?
The Bronx remains the poorest and sickest.....or we also the most easily managed?
7
I do not believe the article states he contracted the disease at Lincoln. He got sick and first went to Lincoln, then St. Bananas and finally died at Montefiore, though he went home before going to Montefiore.
1
In my humble opinion: No one is alarmed because "It's only the Bronx, and the South (poorest section) Bronx at that". Where it in Chelsea, Tribeca or a trendy section of Brooklyn, the CDC would be involved. Doesn't mist travel through the air? I seriously doubt the outbreak will stay contained unless action is taken.
4
Do these people get infected from an open window inside the hotel? Or do they get infected by being outside the hotel downwind from the cooling towers? Is the outside air containing infected mist pumped into building? I'm confused as to how people inhale a mist that is on top of a building.
2
They get sick by opening their windows if they live next door to a hotel that spews water droplets from a contaminated cooling tower.
2
You raise some valid questions. It is my opinion that the most likely cause for being infected with Legionella bacteria is caused by the direct inhalation of the water mist which emanates from the cooling towers positioned on roof tops on the locations near the building which uses these towers to remove heat from a buildings central air conditioning system. Hence, an open window relatively close to the plume of a cooling tower would be a likely possibility for causing infection.
There is some published data to suggest that under some conditions a contaminated water plume from a cooling tower can cause disease a considerable distance from the contaminated tower. It would seem logical that this is dose related, meaning that heavily contaminated towers which emit high concentrations of Legionella in their mist can cause disease at a greater distance from the source than less contaminated sources.
Finally exposure within a building from the air handling system is possible in instances in which the fresh air intakes for the air handler system is located nearby the cooling tower.
Proper maintenance of the cooling tower water can minimize Legionella bacteria to levels at or below 1 organism per milliliter of water, which largely eliminates the risk of a cooling tower causing disease.
There is some published data to suggest that under some conditions a contaminated water plume from a cooling tower can cause disease a considerable distance from the contaminated tower. It would seem logical that this is dose related, meaning that heavily contaminated towers which emit high concentrations of Legionella in their mist can cause disease at a greater distance from the source than less contaminated sources.
Finally exposure within a building from the air handling system is possible in instances in which the fresh air intakes for the air handler system is located nearby the cooling tower.
Proper maintenance of the cooling tower water can minimize Legionella bacteria to levels at or below 1 organism per milliliter of water, which largely eliminates the risk of a cooling tower causing disease.
3
ramping up for more baseless lawsuits? The government and private owners cannot be responsible for illness and death for naturally occuring illness. Should this prompt a reasoned look at considering some new regulations-perhaps. maybe some future cases could be prevented maybe not. Not every death is some agencies' fault : people get sick and die from rare illnesses at times
Agreed; ren't hospital held to a greater standard of cleanliness? Isn't this germ eliminated by cleaniness?
Are the water towers in the public hospital outside their infection control protocols?
Are the water towers in the public hospital outside their infection control protocols?
Legionnaire's Disease is not rare. It is however under-diagnosed and the actual number of cases in the U.S. Annually could easily exceed 100,000 cases per year. Secondly, it is largely preventable. Proper maintenance of cooling towers with water testing to verify minimal growth of Legionella bacteria in these towers should greatly reduce the incidence of disease.
While persons with weakened immune systems may be more susceptible to contracting LD from the inhalation of water mists containing the bacteria, even relatively healthy individuals can develop the pneumonia if the concentrations of Legionella bacteria in the inhaled mist are sufficiently elevated.
I wouldn't challenge fate by inhaling the mist of cooling towers just to prove that I am strong and healthy!
While persons with weakened immune systems may be more susceptible to contracting LD from the inhalation of water mists containing the bacteria, even relatively healthy individuals can develop the pneumonia if the concentrations of Legionella bacteria in the inhaled mist are sufficiently elevated.
I wouldn't challenge fate by inhaling the mist of cooling towers just to prove that I am strong and healthy!
3
very sorry to hear this news.
Who are the others who died? Dont see their names anywhere. Coverup or privacy? If this is privacy, who is it benefiting?
Who are the others who died? Dont see their names anywhere. Coverup or privacy? If this is privacy, who is it benefiting?
5
Privacy--obviously names are only released when the family wants them released! Public health can't release names of disease cases
It is privacy. It is the law. The theory is that the patient and their loved ones benefit. HIPAA. Mr. Quiles is identified because in some way someone in or near the family made a connection with NY Times reporters and the family decided to tell his story. The other families could decide to do the same but I for one agree that should be their choice.
2
Can we blame REBNY for the outbreak? New York State has no certification process to become a managing agent of a residential building. NYCs HPD has no idea how they vet out their managing agents and you wonder why there are so many housing issues in NY and a break out of legionnaires disease. So, here we have a building that was mismanaged, heating system and ac not maintained. What happens to the managing agent of the building? Do they get fined? It's about time out state legislators who sit on housing committees require better oversight of managing agents in NY.
23
health commissioner out days into this crisis, to tell the citizens of New York that everything was under control, and that there was no need to test or identify the buildings whose mechanical systems were
swarming with bacteria.
Pressure from the real estate industry.
No matter that people were dying.
Suddenly a complete about face. They could no longer face the shame and outrage of a cave to real estate interests not to test widely and not to be transparent.
Just a bunch of old people in the Bronx.