TORONTO -- Three more people have died from an outbreak of legionnaires' disease that investigators confirmed yesterday originated in the cooling tower of a Toronto nursing home.
 
Toronto health officials said droplets were distributed into the air by the cooling system on the roof of the Seven Oaks Home for the Aged in the city's east end and then sucked into the ventilation system's air intake.
 
"The bacteria causing the disease was spread through a very vulnerable population of elderly residents with tragic results," Dr. David McKeown, Toronto's medical officer of health, told a news conference.
 
"From what we know at this point, there's no evidence that the cooling tower was not properly maintained."
 
The latest three people to die were all elderly residents of the home with a median age of 90 and pre-existing health conditions, officials said.
 
Health officials ordered the cooling tower shut down Oct. 6 when the disease was detected, and McKeown said there's been no risk to the public since that time.
"This outbreak stands as one of the most significant events on record involving legionnaires' disease and we will be very diligent in reviewing our work and identifying important lessons learned."
 
A separate, independent review of the outbreak is also being conducted by Dr. David Walker, who also chaired an expert panel on Toronto's deadly SARS outbreak two years ago.
 
Walker will evaluate the city's response to the latest outbreak and determine whether lessons learned from the 2003 SARS outbreak were applied.
 
So far, 20 people - all of whom were elderly with underlying health conditions - have died as a result of the outbreak, which began late last month. The investigation is continuing, but there's no evidence the building's cooling tower was not properly maintained.
 
All told, there have been 127 cases of legionnaires' disease, including 67 residents, 30 staff and 26 visitors.
 
Another four people who live or work in close proximity to Seven Oaks Home for the Aged have also contracted the disease, likely infected by droplets that escaped the building through the cooling tower.
 

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