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New York Legionnaires' Outbreak Source Still Unknown

NOV 30, 2016 | SARAH ANWAR
The New York State Department of Health is currently investigating an outbreak of Legionnaires’ disease in Saratoga Springs, New York.
 
According to an official statement from the DOH, “The New York State Department of Health continues to closely monitor cases of Legionellosis in the Saratoga Springs area. Multiple sources have been investigated, including construction on the municipal water system. As a precautionary step, state DOH recommended water restrictions for the facility, which it has implemented. ‎The Department will continue to work aggressively to identify an environmental source and protect against any additional cases in the Saratoga area.”
 
The DOH reports that it is currently investigating 12 cases of Legionnaires’ disease. These cases are believed to be associated with the Wesley Health Care Center (WHCC), a nursing home in the Saratoga Springs area. A timesunion article reports that two cases linked to the WHCC outbreak died of Legionnaires’ infections, and the family of one of the deceased is seeking legal action.
 
In investigating the outbreak, the DOH identified four cooling towers belonging to the nursing home. Samples from these towers had already been collected and tested in early September, and were found to be in compliance with the state’s updated maintenance regulations; nonetheless, the DOH retested the four cooling towers for the presence of Legionella in late October, and found them to have <10 CFU/ml. Following this, WHCC’s potable water systems were also tested for Legionella; however, the DOH reports that “results for representative samples were within the acceptable range as defined by the New York State regulations.”
 
Nonetheless, according to a DOH statement, seven previously diagnosed cases “did not identify any visits or stays at the WHCC or its campus.” Timesunion reports that no sources of Legionella have been identified outside of these four towers, although the DOH has expanded its investigation to include 15 towers as well as large conditioning systems within a one-mile radius of Wesley. However, the DOH notes that oftentimes, Legionnaires’ disease outbreaks are not always traced back to one “common environmental source for several reasons.”
 
According to the Centers for Disease Control and Prevention, to properly identify that the cause of a pneumonia infection is due to a Legionella infection, one must run either a urine or a sputum test. In addition, to identify the environmental source of the infection, a sputum sample is needed, according to the DOH. Unfortunately, “to date, the [DOH] has not been able to obtain sputum specimens from any of the cases of Legionnaires’ disease associated with WHCC.”
 
The DOH states that “WHCC is planning to install a monochloramine treatment for its potable water systems. [DOH] requested that samples be taken 7 to 10 days after the installation to validate efficacy and provided technical assistance to the facility on possible unintentional consequences of the chloramination system that should be considered.”
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