Five people died of Legionnaires' disease over the summer at a New York City nursing home that had been cited repeatedly for improper maintenance of cooling towers where Legionella bacteria can spread, The New York Times reported.
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 home has restricted water use since the outbreak that ended in September, spokesperson Jeff Jacomowitz said. “All further tests have been coming back negative, and the facility has provided bottled water for drinking and for all sanitary uses."
People can get Legionnaires’ disease when they breathe in water vapor containing the Legionella bacteria, which grows in wet environments including hot tubs, fountains and cooling towers. Deaths attributed to Legionnaires' are rare, but the risk is higher for older populations such as nursing home residents.
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.
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Dozens of other nursing homes 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.
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Jacomowitz said Amsterdam Nursing Home's cooling tower was cleaned prior to start-up in the spring and tested according to the city's rules. He said the facility “continues to work closely with the Department of Health on anything having to do with the water supply and with anything at all to clear up this matter.”
Jeffrey Hammond, a spokesperson for the state Department of Health, said the restrictions on water use at Amsterdam Nursing Home are recommended as a precautionary measure even though no additional Legionnaires' cases have been identified since September.
“The water restrictions will remain in place until additional water culture testing for Legionella has been completed and no additional cases are identified,” he said.
The exact source of the outbreak at the facility has not been determined, Jacomowitz said.