What You Need to Know Right Now About Legionnaires’ Disease in New York City

Aug 5, 2025 | Featured, Infectious Diseases, Your Health

You have probably heard about an outbreak of Legionnaires’ disease in New York City.  Legionnaires’ disease is a type of pneumonia (lung infection) caused by Legionella bacteria. The outbreak is mostly affecting people in an area of Harlem. The disease is suspected to have been caused by a building’s cooling system.

Vani George, DO

A key takeaway for New Yorkers is that Legionnaires’ disease is not contagious, cannot be spread by person-to-person contact, and can be treated with antibiotics, according to Vani George, DO, Assistant Professor, Medicine (Infectious Diseases), Icahn School of Medicine at Mount Sinai.

In this Q&A, Dr. George discusses Legionnaires’ and how to protect yourself.

Can I catch Legionnaires’ from another person?

No, you cannot. Legionella bacteria thrive in warm water and people get infected and sick by breathing aerosolized water droplets in the air that are contaminated with Legionella.

What are early symptoms I should watch for, and how serious can it get?

Some of the early symptoms of Legionnaires’ disease are very similar to flu and can include fever, cough, headaches, shortness of breath, and muscle aches. As opposed to other types of pneumonia, Legionnaires’ disease can cause gastrointestinal disturbances, such as nausea, vomiting and diarrhea, as well as kidney injury.

How is Legionnaires’ disease treated?

Legionnaires’ disease can be effectively treated with antibiotics. Complications from the disease are less common if treatment is started early on. It’s important to contact your health care provider as soon as possible if you have flu-like symptoms.

How did the recent outbreak in New York City happen?

Currently, there is a cluster of Legionnaires’ disease in Harlem from the following zip codes: 10027, 10030, 10035, 10037, and 10039. The suspected source of the bacteria causing pneumonia in this community is a cooling tower in the affected area. Cooling towers are water systems on top of the buildings that control the temperature of cooling systems, such as central air conditioning or refrigeration. There is an ongoing investigation and all the cooling towers in this area are being tested by local health authorities. The New York City Department of Health & Mental Hygiene has reported that the current outbreak is unrelated to any building’s plumbing system. It is safe for you to drink water, bathe, shower, cook, and use your air conditioner.

Is this contamination likely to happen at other locations in the city, and how?

The contamination can happen at other locations in the summer months because the bacteria thrive in warm water between 77-113o F and in stagnant water. New York City’s cooling tower regulations have specific requirements of maintenance to prevent such outbreaks in the community.

Beside cooling towers, how else is the disease spread?

In addition to cooling towers, other sources of legionella have been decorative fountains, hot tubs, humidifiers, hot water tanks, and whirlpool spas.

Am I at higher risk because of my age or any health issues I have?

Most healthy people exposed to Legionella generally don’t get sick. Individuals at higher risk of developing Legionnaires’ disease after exposure are:

  • Adults 50 years or older
  • Current or former smokers
  • People with weakened immune systems
  • People with a chronic disease

How can I avoid Legionnaires’ disease?

If you own any of the following devices, you should follow the manufacturer’s instructions regarding cleaning, disinfecting, and maintenance:

  • Cooling towers
  • Decorative fountains
  • Hot tubs
  • Centrally installed mister, atomizers, air washers or humidifiers

The Centers for Disease Control and Prevention has developed a useful toolkit in controlling Legionella in common sources of exposure.

For more information, read Cooling Towers: Learning from Legionnaires’ Disease Outbreak Investigations from NYC Health.

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Three Nutrition Tips for a Stronger Immune System

Updated on Sep 12, 2025 | Diet and Nutrition, Your Health

Viruses are in the air and all around us, from the common cold to COVID-19. Eating a healthy, balanced diet primes and activates your immune system to fight these pathogens, even before you get sick.

In this Q&A, Taylor Stein, Associate Researcher and Registered Dietitian at The Department of Environmental Medicine, Icahn School of Medicine at Mount Sinai, discusses what foods you should eat to support your immune system this cold and flu season.

How does nutrition affect my immune system?

If your diet contains a lot of saturated fatty acids, sugar, and refined carbohydrates, you will not have as strong of an immune response compared to someone consuming diets rich in micronutrients, antioxidants, and fiber. Certain nutrients—specifically vitamins A, D, E, and K—are fat-soluble, meaning they are stored in your fat and take time to accumulate, especially vitamin D. These vitamins support different functions of the immune system and are readily available to fight disease in advance.

Does this mean I need to consume these nutrients before I get sick?

Yes. When you are sick, your immune system is scavenging the body for nutrients, and if you don’t have enough fat-soluble vitamins stored, it can take you longer to get better. Additionally, being sick can affect your ability to eat and drink, so it is very important to have a balanced diet at all times to keep up your stores of these vitamins. Alternatively, vitamins that are water soluble, such as vitamin C and those in the B-complex group, cannot be stored, so you should strive to eat lots of these while you are sick. You also need to eat plenty of macronutrients—carbohydrates, proteins, fiber, and fats.

Follow these easy tips for a healthier immune system:

  1. Buy colorful produce (the brighter, the better).
  2. Snack on nutritious, high-fiber foods such as fruits, veggies, cheese, nuts, seeds, whole grains, bean dips, guacamole, etc.
  3. At meal time, fill one quarter of your plate with protein, one quarter with a whole grain or starchy vegetable, and the other half with brightly colored vegetables.

Taylor Stein, RD

What foods are good for my immune system, and why?

Immune system health largely depends on five food groups:

  • Animal meats, fish, dairy products, legumes, nuts, and whole grains. Proteins are the building blocks of cytokines, small proteins that send signals to the immune system telling it where to send white blood cells to fight infections. Since cytokines require different amino acids, you need to eat a variety of protein both from animal and plant-based products. High protein foods contain B-complex vitamins, which are necessary for cell proliferation, which plays an important role in immunity.
  • Brightly colored fruits and vegetables. Apricots, kiwi, blueberries, avocados, carrots, strawberries, Swiss chard, bell peppers, raspberries, red onions and other brightly colored produce are filled with both fat-soluble and water-soluble vitamins and are also a great source of fiber.
  • Fortified dairy products, eggs, and salmon. These are a great source of vitamin D, which helps activate T cells and has other important functions that affect your immune system. You can also get vitamin D in smaller amounts from nuts and mushrooms. Sunlight is also a great source of vitamin D.
  • Nuts, seeds, eggs, legumes, and fish. These all contain disease-fighting minerals, such as zinc, magnesium, and selenium. Pumpkin seeds, almonds, cashews, shellfish, tuna, chickpeas, and lentils are all good sources of these minerals.
  • High-fiber, pre-and-probiotic, and fermented foods. These foods are good for your gut, where more than 70 percent of your immune cells live. High-fiber foods include legumes, fruits, and vegetables. Pre-and-probiotic and fermented foods include yogurt, kefir, and buttermilk. These gut-healthy foods are important in maintaining lymphoid tissue in the gastrointestinal tract that helps fight disease.

What are some easy ways to incorporate these foods into my daily diet?

A great way to get more of these foods is to eat them as snacks. For example, snacking on nuts and seeds, bean or guacamole dip, whole grain toast with avocado, and fruit and cheese are all easy ways to get more of the nutrients that prime the immune system. You also need to include them in your main meals. Each dish should include a good source of lean protein—meats, poultry, or fish—and plant-based proteins such as beans, as well as non-starchy vegetables. A simple rule is to fill one quarter of your plate with protein, one quarter with a whole grain or starchy vegetable, and the other half with brightly colored vegetables.

How do these foods compare to taking supplements?

When it comes to immune system health, it is good to have a food-first mentality. Whereas supplements typically provide only one nutrient, a balanced diet filled with whole foods contains all the micro and macronutrients you need. These nutrients work most optimally when they are paired together and are easier to digest than supplements. However, supplements can be a great tool for someone who struggles to eat a variety of foods or has a condition that reduces their ability to consume or prepare healthy food. Keep in mind that supplements are not regulated by the Food and Drug Administration, so it is important to get a doctor or dietitian’s advice on what supplements you should use.

What else is important for my immune system?

Getting plenty of sleep and exercise will also strengthen your immune system. Sleep plays a vital role in hormone production, regulation, and function, which strengthens the immune system, and plays a role in building cytokines. Exercise creates stress in your body and activates the same pathways that are triggered when you’re sick, and gets your body primed and ready for when it needs to fight a pathogen. Lastly, recent studies have found that mental health disorders are associated with decreased immune function, which leads back to sleep hygiene and physical activity. However, mental health can be the cause and effect of not getting enough sleep or exercise. In any case, physical activity, sleep hygiene, and managing mental health are all important to maintaining a healthy immune system.

Did you know?

  • Orange-colored fruits and vegetables are high in beta-carotene, which the body converts into vitamin A, a fat-soluble vitamin
  • Avocados and kiwis provide vitamin E, an essential micronutrient for building T cells, which play a vital role in fighting disease
  • Green leafy vegetables and cruciferous vegetables, including broccoli, cauliflower, and cabbage, contain vitamin K, another essential fat-soluble vitamin
  • Leafy greens, bell peppers, and oranges contain Vitamin C, a powerful antioxidant that supports immune system function

Read more about Your Health.

Could My Snoring Be Obstructive Sleep Apnea?

Jul 24, 2025 | Ear Nose Throat, Sleep, Your Health

Does your bed partner complain that you snore loudly or gasp for air in the middle of the night? Have you been nudged awake or kicked to the couch because your loved one can’t sleep? These are telltale symptoms of obstructive sleep apnea, and if you suspect you may have the condition, the person lying beside you may be your best ally.

Fred Lin, MD

Fred Lin, MD, a sleep surgeon and Division Chief of Sleep Surgery of the Mount Sinai Health System, recommends people to take this feedback seriously.

“Bed partners are often the first to see an important quality of life and possible health issue,” says Dr. Lin. “People with sleep apnea are generally unaware of nighttime symptoms like snoring or interruptions in their breathing. It is very possible to not experience daytime symptoms, like drowsiness and difficulty concentrating, and may even blame factors like young children or work stress.”

 
What is obstructive sleep apnea?

Affecting as many as 22 million people in the United States, obstructive sleep apnea (OSA) is a serious sleep disorder that causes your breathing to repeatedly start and stop throughout the night. The condition occurs when the muscles of the upper airway relax and block the flow of air, which prevents your body from getting the oxygen it needs and causes you to wake up repeatedly during the night.

These nighttime disruptions can negatively affect the sleep of the OSA sufferer and can put a significant strain on relationships. In fact, frustrated companions are often the reason patients eventually visit a doctor.

“Bed partners end up suffering significantly,” he adds. “They may struggle to fall asleep or stay asleep. Some couples end up sleeping in separate rooms.”

 
How do I know if my snoring is obstructive sleep apnea?

Consistent snoring, pauses in breathing, or gasping for air in the middle of the night are common symptoms of the condition and should be evaluated by a physician. If left untreated, sleep apnea can lead to serious complications. For instance, individuals with OSA are more likely to have high blood pressure, stroke, heart disease, and diabetes.

That being said, it is hard to make a diagnosis from symptoms alone. To know for sure, Dr. Lin explains, you need a sleep study. In the past, patients had to stay overnight at a sleep center for testing. But today, for most patients, a sleep study is performed at home using minimally invasive equipment, sometimes requiring only a special finger and wristband gadget that is connected to a smartphone. Home sleep tests record the number of times your breathing is interrupted throughout the night, revealing if you have OSA and, if so, how severe it is.

“Home studies are unbelievably easy to do with the current technology,” explains Dr. Lin. “Most insurances cover the studies and the devices are generally mailed directly to the patient’s home. I don’t think anyone should be nervous about having a sleep study.”

 
How is obstructive sleep apnea treated?

If you are diagnosed with sleep apnea, there are three types of treatments that can help. Dr. Lin likes to start with the least invasive treatment.

  • CPAP (continuous positive airway pressure) therapy has long been the gold standard treatment for OSA. This is a machine that uses air pressure to keep the airway open throughout the night. Patients wear a mask while sleeping—placed over the nose or both the nose and mouth—that connects to this device. Although several options and models are available, research shows that only half of patients can tolerate sleeping with the mask.
  • Oral appliances are an alternative to CPAP machines or are sometimes used in conjunction with a CPAP device. Oral appliances are worn in the mouth to reposition your lower jaw while you sleep. These appliances are made by a dentist and molded specifically to fit your teeth.
  • Surgery is recommended when noninvasive therapies fail to provide relief or patients struggle to successfully use CPAP, oral appliances, or both. There are numerous options that open, reshape, enhance, or stimulate the upper airway and eliminate symptoms like snoring and breathing interruptions.
 
What are the surgical options to treat sleep apnea?

The type of surgery required depends on the severity of your symptoms, the severity of the condition, and your unique anatomy. Dr. Lin works closely with patients to decide what procedure is right for them.

  • Soft tissue procedures—Dr. Lin likes to compare the upper airway to a house. With soft tissue surgeries, the goal is to make more room internally renovating the space. This may involve nasal, palate, or tonsil surgery, which creates more room in the passageways for air to flow.
  • Skeletal surgeries—With skeletal surgeries, the goal is to make the house bigger by building it out as you would by adding a new room. These more extensive operations include widening or forward movement of the jaws and chin advancement. The goal of these surgeries is to improve the position, balance, and movement of the upper airway.
  • Neurostimulation/Hypoglossal Nerve Stimulator—Inspire ™ therapy is a newer therapy that has been approved by the United States Food and Drug Administration. It stimulates the base of the tongue to expand the airway. Like a pacemaker, the device is surgically implanted into your chest and connected by a wire to the upper airway. You can control the device using a remote device. Mount Sinai’s Division of Sleep Surgery was one of the early adopters of Inspire therapy.

 

Learn more about Sleep Services at Mount Sinai
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Expert Advice on Protecting Your Kids From Ticks

Updated on Jul 24, 2025 | Featured, Your Health

Being outside is wonderful for children’s development and health. However, if your plans include being in grassy or wooded areas, remember to try to protect your family from ticks and the risk of illnesses like Lyme disease.

The best protection is prevention. You can have children help in a way that also allows them to practice their developmental skills and understand the health benefits of avoiding ticks. Blair Hammond, MD, a pediatrician and Co-Founding Director for the Mount Sinai Parenting Center, explains how and offers four things to keep in mind and to discuss with your family.

Blair Hammond, MD

Choice and Independence

Encourage your child to pick out pants and long-sleeve shirts they’d like to wear to decrease the chance that a tick will get on the skin. You can treat outdoor clothing with permethrin, an insecticide, or buy already made tick-repellent clothing. Giving choices is great for fostering independence.

 Apply and Explain

You can apply insect repellent with DEET to your child’s exposed areas. You can make a game of it: “Where are your ankles? Let’s protect them with the insect repellent.”  Follow recommended safety tips from the American Academy of Pediatrics (AAP) on choosing the right product for your child’s needs. Remember that back and forth conversations and explaining things helps your child learn language and connect with you.

Routines

You can have a consistent routine of bathing after being outside (this removes non-attached ticks).  Also, try to incorporate tick checks into your nightly routines (a tick needs to be on a person for at least 24 to 48 hours to transmit Lyme disease). Pay special attention to hiding places like under the arms, in and around ears, behind legs, in the groin area, and along the scalp and in the hair. Having consistent routines helps with children’s self-regulation and behavior. Keeping pets free from ticks will also help. The AAP suggests checking your pets every day and using appropriate pet products.

No Need for Panic

If you do find a tick on you or your child, don’t panic. You can carefully remove the tick with tweezers by squeezing at the head and gently pulling back. If the tick has likely been on your child for more than 24 hours, or if you have any questions, call your health care provider. You can get additional guidance from the Centers for Disease Control and Prevention about what you should do about tick bites.

Get more information from the CDC

What Is Chronic Venous Insufficiency, and How Do You Treat It?

Updated on Jul 23, 2025 | Featured, Your Health

Chronic venous insufficiency (CVI) isn’t a medical condition you normally hear much about. But it was in the news recently after President Trump was diagnosed with the condition.

In this Q&A, Prakash Krishnan, MD, FACC, System Director of Endovascular Services, at the Mount Sinai Health System, explains what causes this condition, which causes swelling and pain in the legs and primarily affects older adults. He says it is important for people with CVI to seek treatment to prevent possible complications.

“This condition may cause discomfort. However, with early initiation of conservative therapy with compression stockings, lifestyle modifications, and surveillance with a vascular physician, you can continue to lead an active lifestyle without limitations,” says Dr. Krishnan, who is also Professor of Medicine (Cardiology), and Radiology at the Icahn School of Medicine at Mount Sinai and Director of Endovascular Services and the Endovascular Intervention Fellowship at The Mount Sinai Hospital.

Prakash Krishnan, MD, FACC

What is chronic venous insufficiency, what causes it, and who is primarily affected?

Chronic venous insufficiency  is a vascular condition in which the veins are unable to efficiently circulate blood back to the heart from the legs, causing blood to pool in the lower limbs. This is due to dilated or damaged valves that are in the veins found in the lower limbs. Common causes are aging, prolonged standing or sitting, obesity, pregnancy, or a history of blood clots. CVI primarily affects older adults and people with a family history of vein disorders.

Is CVI a serious health issue? What kind of symptoms or complications can it cause?

If left untreated, serious complications may arise. Patients usually have symptoms such as leg swelling, pain, heaviness, cramping, difficulty walking, varicose veins, and skin changes. Advanced untreated disease may cause painful wounds and skin ulcers that are difficult to heal. In severe cases, CVI increases the risk of infection and blood clots in the limbs, which is a potentially life-threatening condition. Early diagnosis and proper management are important to prevent the disease from progressing and to improve a patient’s quality of life.

Do you need to make lifestyle changes or take specific steps to manage the condition?

The primary goals of treatment for CVI focus on improving blood flow, relieving symptoms, and preventing complications. Initial treatments are less invasive, which includes wearing compression stockings to reduce swelling and support vein function, as well as elevating your legs regularly to help blood return to the heart. Lifestyle changes play a key role and may include maintaining a healthy weight, exercising regularly—especially walking—to boost circulation, and avoiding prolonged sitting or standing. In more advanced cases, minimally invasive procedures to treat the veins such as sclerotherapy, laser therapy, or ablations may be necessary. Consistent care and lifestyle adjustments can greatly improve symptoms and slow disease progression. For those who lead an active life that includes traveling and outdoor activities such as golf, compression stockings would be recommended as an initial step in treatment.

Does chronic venous insufficiency require ongoing monitoring?

Yes, CVI typically requires ongoing monitoring by physicians trained to manage and treat vascular disease. Consistent medical supervision ensures that the condition remains under control and that more serious complications, such as infections or deep vein thrombosis, are promptly addressed.

Learn more about Cardiology and Cardiovascular Surgery at Mount Sinai
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Why Pickleball Is a Win for Your Heart

Updated on Jul 22, 2025 | Featured, Your Health

Anu Lala, MD, recently met with pickleball players at CityPickle Wollman Rink to talk about heart health and the benefits of playing pickleball.

Pickleball is quickly becoming one of New York City’s favorite ways to stay active—and it’s doing more than just bringing people together. It’s also a fun, heart-healthy way to support your overall well-being.

Why Pickleball Is Good for Your Heart

You don’t have to be a lifelong athlete to enjoy the heart-healthy benefits of pickleball. The game involves light jogging, pivoting, and stretching, which are movements that increase heart rate up and improve your circulation. Depending on the intensity of your play, 30 to 60 minutes can count as a full cardio workout.

“Exercise doesn’t always need to be intense and exhausting to benefit your heart,” says Anu Lala, MD, a cardiologist at the Mount Sinai Fuster Heart Hospital. “Activities like pickleball offer a joyful, sustainable way to keep moving, and that consistency combined with weight-based activity is what protects and strengthens your heart over time.”

Benefits Go Beyond the Court

Playing pickleball a few times a week can help lower your blood pressure, support healthy cholesterol levels, and improve your endurance. Over time, this type of activity can help reduce the risk of heart disease, heart attacks, and other cardiovascular issues.

If you are living with a heart condition already, remaining active is important across a patient’s lifespan. Light-to-moderate exercise like pickleball is often a safe and effective way to stay strong—just be sure to talk to your doctor first.

It’s Also Good for Social and Mental Health

Beyond the physical benefits, pickleball is very social. Whether you’re playing a casual match or joining a local league, you’re likely to meet new people and feel part of a community. That social connection can improve mood, lower stress, and even benefit your heart health.

One thing to keep in mind: post-game celebrations. It’s tempting to reward a good game with indulgent snacks or drinks. But making heart-smart choices—such as fresh fruit, a handful of unsalted nuts, hummus with veggies, or whole grain crackers with avocado—can help keep all that movement working in your favor.

Bringing Heart Health to the Court

Caring for your health is an everyday practice, well beyond the walls of a doctor’s office. That’s why Mount Sinai has partnered with CityPickle to bring wellness, movement, and heart health education directly into the community in ways that are engaging, active, and fun.

“Whether you’re just picking up a paddle or you’re a regular on the courts, this partnership is about supporting your well-being—by encouraging healthy habits, building connections, and making expert guidance more accessible,” says Dr. Lala.

To book an appointment with Dr. Lala or for more information on Mount Sinai Fuster Heart Hospital, please visit our website.