NEW YORK • The largest outbreak of Legionnaires' disease in New York City in at least three years has claimed its fourth victim, reinforcing concerns among some residents and elected leaders that the city had not prepared adequately to combat the airborne illness.
On Saturday, the number of cases increased to 65, from 57 on Friday, including 55 who had been hospitalised. Five cooling towers in South Bronx have been found to be contaminated with legionella bacteria, which can make people ill when water droplets are released into the air from the towers.
The mounting toll has provoked a sense of anxiety on sidewalks and in malls, and caused city health officials to consider how they might forestall a disease that has surged across the country in recent years.
Some New York residents, fearful that their tap water had been contaminated, have taken to drinking bottled water. Health investigators are tracing the steps of those who have been infected, in an effort to track the origins of the outbreak.
City officials assured New Yorkers that the rising number of casualties reflects the incubation period of the disease, which can be as long as 10 days, rather than any spread of contaminants. They said the four people who died were all older and had pre-existing medical conditions, and the tap water was safe.
"We expect the case count to rise over the next several days because it reflects what has happened in the past," said Dr Jay Varma, deputy commissioner for disease control at the New York City Department of Health and Mental Hygiene. "But we are also confident we have done the most intensive, immediate work to cut off any risk, so we anticipate the number of cases will first rise, then fall again."
For residents and local leaders, the outbreak has raised questions about New York's ability to defend itself against a disease whose prevalence in the city has more than tripled in the past 10 years. The number of cases of Legionnaires' disease citywide rose to 225 last year, from 73 in 2004.
Most of the cases last year were in the Bronx and Brooklyn, the boroughs with the highest percentages of people living below the poverty level citywide, reflecting a tendency for the disease to be concentrated in poor areas.
That has fed a sense in New York that the city had not acted aggressively enough to address the risks of the disease. Last Saturday, at Concourse Plaza, a strip mall east of Yankee Stadium, residents criticised the city for not regularly inspecting cooling towers and for not moving quickly enough to publicise cases of the disease.
Four of the affected buildings had been decontaminated as of last Saturday, while decontamination of the last building was ongoing, city officials said.
Why the cases of the disease have steadily increased is unclear. The illness cannot be spread from person to person and most often infects older people who suffer from pulmonary disease.
"We are confident the investigation we've done has identified all the potential sources of the infection," Dr Varma said.
But, he added, "to be honest, we don't know what it is about the cooling towers or the bacteria or the environment that led to this specific outbreak".
NEW YORK TIMES