A Bronx father who is among the more than 100 people sickened by Legionnaires' over the last month in what has become the largest outbreak of the disease in New York City history became the first of the victims to file a notice of claim against the city, the first step in a lawsuit, his attorney said Friday.
Marvin Montgomery, 36, has been hospitalized with Legionnaires' disease, a severe, often lethal, form of pneumonia spread through the air, in Harlem for the last three weeks. Attorney Adam Slater told NBC 4 New York his client is on dialysis and can barely walk.
"It's a step up from not living, but he's in very bad shape," Slater said after filing the notice of claim on Montgomery's behalf.
The hope, Slater said, is to prevent future outbreaks -- and he shamed the city for allowing what he called "a preventable catastrophe" by not requiring and conducting routine cooling tower testing earlier.
Q&A With Disease Expert on Legionnaires' Disease
The outbreak clustered in the Bronx is the largest ever in New York City that officials are "aware of," Health Commissioner Mary Bassett said earlier this week. On Friday, officials announced one more case linked to the current outbreak, bringing the total to 101 patients reported since July 10 -- an increase of 55 cases since health officials first discussed the outbreak. Ten people have died.
The death toll remain unchanged Friday, a day after authorities added another two deaths to the count. Health officials have said those who died were middle-aged and older adults with underlying medical issues. Ninety-four people with Legionnaires' have been hospitalized, and 65 of those patients have since been discharged, the city said.
Slater said his client "only smokes a little" and had no prior health concerns that would complicate the disease, so he's surprised Montgomery contracted it at all.
At a news briefing at Gov. Cuomo's Manhattan office Friday, representatives from the Centers for Disease Control and Prevention, whom the governor had asked to come assist with the outbreak, credited the city's response to the outbreak and called it "proactive." The agency said Legionnaires' is an underreported disease nationwide; it's hard to diagnose and even more difficult to trace.
Legionnaires' disease is caused by exposure to the bacteria Legionella; in most cases, people are exposed to the bacteria by inhaling contaminated aerosols from cooling towers, hot tubs, showers and faucets or drinking water.
The Health Department tested cooling towers at 17 buildings in the area near the cluster of cases -- five of those tested positive for Legionella, including one at Lincoln Hospital; one at Concourse Plaza; one at a shopping plaza; one at a Verizon office building and one at the Opera House Hotel. All have been decontaminated, and the mayor said earlier this week authorities believed those five sites were the only ones contributing to the outbreak.
All of those sites were required to submit long-term plans as to how they would maintain cooling towers to protect against any future growth of Legionella by Friday.
Slater said he believes Montgomery got Legionnaires' from the cooling tower at Lincoln Hospital. He said he was at the site several times for work prior to getting infected and lives in the area. The notice of claim is against Lincoln Hospital, but the city owns the hospital, so it's against technically against the city, he said. Slater said while his client is the only one to file a notice of claim so far, he's investigating whether others may have been exposed to the potentially deadly disease at any of the five contaminated sites and may file similar future notices depending on what he finds.
Bassett issued an emergency executive order Thursday requiring all owners of cooling towers to disinfect their towers within 14 days. The order applies to all people who manage or control water recirculating cooling towers in New York City, not just in the Bronx. According to the order, these individuals must clean their towers if they have not been disinfected in the last 30 days; they must also hire environmental consultants. Failure to comply is a misdemeanor.
"We now see the frequency of diagnoses decreasing, as well as the number of emergency department visits for pneumonia in the South Bronx," Bassett said Friday. "We have fewer new cases, people are seeking care promptly and getting treatment promptly. We’re optimistic that we’ve seen the worst of this outbreak, and that our remediation efforts are having an impact."
Cuomo said the state has been providing all of the testing for the city thus far and would extend its offer of free testing to all private building owners in the Bronx and across the state. He also said state teams, in cooperation with CDC and city health officials, would head to the Bronx beginning Saturday to start testing all cooling towers near the once-contaminated towers.
Slater said that while "it's great" the city is testing all the Bronx cooling centers now and mandating more extensive testing for individuals who own or manage them going forward, it should have been done in the past.
"They moved very slowly; they weren't proactive in the beginning and they weren't proactive before the outbreak," Slater said. "With proper monitoring this could have been prevented and they didn't live up to that standard."
Legionnaires' disease usually sets in two to 10 days after exposure to the bacteria and has symptoms similar to pneumonia, including shortness of breath, high fever, chills and chest pains. People with Legionnaires' also experience appetite loss, confusion, fatigue and muscle aches.
It cannot be spread person-to-person and those at highest risk for contracting the illness include the elderly, cigarette smokers, people with chronic lung or immune system disease and those receiving immunosuppressive drugs. Most cases can be treated successfully with antibiotics.
City officials plan to host a town hall Tuesday, Aug. 11 for area residents with council member Vanessa Gibson to answer questions and concerns about the outbreak.
The Health Department urges anyone with symptoms to seek immediate medical attention.
An outbreak last hit the Bronx in December. Between then and January, 12 people in Co-op City contracted the potentially deadly disease. Officials said a contaminated cooling tower was likely linked to at least 75 percent of those cases. No one died in that outbreak.
The CDC said outbreaks like the current one in the Bronx serve as a way to educate the public, and, in line with the city and state's new regulatory initiatives, said the conversation should turn now to teaching business owners how to maintain their towers and best test for bacteria.
According to Cuomo, the state sees about 539 cases per year on average. He said Friday state teams would be assessing the Bronx outbreak to determine if it should necessitate policy change.