Five days ago, when we told the legiollosis in the Upper East Side, the budget was 63 cases, twelve people still admitted and no dead. Since then three people have died and the number of confirmed cases has risen to 74. According to the updated data at the evening of 19 July, eight people are still in the hospital, 51 were resigned and twelve did not need shelter. The budget is still provisional and can be updated.
The Department of Health of New York has communicated the three deaths, one per day, between Friday 17 and Sunday 19 July, without spreading names or clinical information. According to Ronald Katter, the second victim’s family lawyer, he was an 88-year-old man, former entrepreneur and veteran of the Air Force. He was admitted on July 2, after his wife had found him at home with a fever of about 40 °C.
The deaths were announced just as the new diagnosis slowed down. Between 2 and 8 July the department had confirmed on average more than eight cases a day; between 10 and 17 July the average fell under one case a day. The most recent people in the count had begun to get hurt over a week earlier. On Sunday, health commissioner Alister Martin said that for more than seven days no one has been identified with symptoms just appeared and that first aid data show no suspicious increases. According to the department, this data indicates that the source of exposure was probably eliminated.
The difference between the date of symptoms and the date of diagnosis is important to read the budget. Legionellosis can occur from two to fourteen days after exposure and confirmation of the case arrives even later. The total can therefore increase even when the dispersion of bacteria in the air is already over. It is on this timeline and the first aid data that the department bases its assessment.
The intervention focused on the cooling towers, the plants placed on the roofs of many large buildings that recirculate water to disperse the heat and release on the outside small drops. The city sampled 183 in the three postal codes involved, 10028, 10075 and 10128. In 76 buildings at least one plant gave a first positive result to the PCR and was empty, clean and disinfected; all the owners had communicated the completion of the work by July 16. This is the first time New York has ordered a complete remediation based on the only preliminary test, without waiting for crop results. Previously, only an increase in disinfectants was required during waiting.
These tests have not yet indicated which plant has caused the outbreak. The PCR detects Legionella’s genetic material even when the bacteria is dead and can no longer cause infections. The laboratory is performing crops on samples of all 183 towers to verify where live bacteria are present; a possible connection with patients will then require comparison with clinical samples. The probable end of the exhibition therefore comes from the failure to identify people who have begun to be ill after the simultaneous reclamation of the plants. The precise origin of the foliage remains to be established.
The foliage covers systems that release nebulizations on the outside, not the piping of buildings or the common domestic air conditioners. In the area concerned you can continue drinking tap water, showering, cooking and using air conditioning. The disease does not pass from one person to another: you get sick breathing water droplets containing live bacteria. The risk is greater for those who are over 50 years old, smoke or escape, have chronic diseases or a weakened immune system.
The survey will continue with the crops and with the inspections of the plants positive results to the first test. The department must also check whether the owners have complied with the maintenance rules, which from May impose a control of the Legionella every 31 days during the period of activity of the towers. The president of the municipal council Julie Menin announced an audition on the management of the outbreak and the application of these rules. In the meantime the indication remains valid for those who attended the area from the end of June: fever, cough or respiratory difficulties should be reported immediately to a doctor, especially for people most exposed to complications.
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