Health authorities in New York City are continuing to track a Legionnaires’ disease outbreak that has led to multiple deaths and dozens of confirmed cases. Doctors say residents can take steps to minimize their risk of exposure while the investigation continues.

As of July 21, five people have died and 82 have been diagnosed with the illness connected to the Upper East Side cluster, according to the New York City Department of Health and Mental Hygiene. Eight remain hospitalized, though officials report that no new cases have emerged in the past six days.

That pause in new infections suggests the likely source of exposure has been contained, though the department emphasized that the probe has not yet concluded.

Legionnaires’ disease is a severe form of pneumonia caused by Legionella bacteria, typically spread through inhalation of contaminated water droplets. The Centers for Disease Control and Prevention states that the disease is not commonly transmitted from person to person.

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Outbreaks are frequently tied to contaminated water systems, such as cooling towers, hot tubs or complex plumbing in large buildings. Cases have also been documented on cruise ships and in spas, according to the CDC.

“We get infected when it gets aerosolized in the water droplets, usually, and we breathe those droplets in,” said Dr. Dana Mordue, associate professor of pathology, microbiology and immunology at New York Medical College.

She added that infection may also occur if contaminated water is inhaled directly into the lungs, but most cases develop from exposure to mist generated by affected water systems.

While it is possible to contract the infection at home, Mordue noted that the vast majority of outbreaks are traced to commercial or public building systems rather than household cooling equipment.

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“The good news is you usually don't get it from the types of cooling systems that we have in our cars or our homes,” she said. “But if you don’t clean your humidifiers, technically any water source can get contaminated with Legionella.”

Symptoms often appear within two to fourteen days of exposure and can include cough, fever, shortness of breath, muscle aches and headaches. Some patients may also experience gastrointestinal distress or confusion.

The illness generally requires treatment with antibiotics. Mordue explained that its mortality rate is relatively low among healthy, immune-competent individuals but higher for those with weakened immune systems, older adults or smokers.

“These are a lot of the same risk factors you might see for COVID,” Mordue said.

Public health experts emphasized that early medical evaluation is important. Anyone who might have been exposed and develops symptoms should seek immediate care.

“If you have certain risk factors, particularly advanced age, get help as quickly as you can,” Mordue advised.

The CDC outlines strategies that can prevent bacterial growth in water systems and lower the risk of outbreaks. Regular maintenance, cleaning, and water management programs can reduce the likelihood of Legionella contamination.

Cooling towers, in particular, should be monitored and disinfected routinely to prevent bacteria from thriving. Preventing stagnant water and maintaining proper flow through pipes can also help.

Since Legionella grows best in warm water—typically between 77°F and 113°F—the CDC advises building operators to maintain safe water temperatures and adequate disinfectant levels.

By combining these preventive steps, experts estimate that nearly nine in ten Legionnaires’ disease outbreaks could be avoided through effective water management alone.

New York City officials continue to monitor the situation closely as the community watches for lingering cases and awaits confirmation that the source of the deadly outbreak has been fully eradicated.