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Emergency measures have been taken as health officials warned more cases could still emerge because symptoms can take between two and 14 days to develop

Dozens of people have fallen ill in a growing Legionnaires' disease outbreak in New York City as health officials race to identify the source of the deadly bacteria.

At least 46 people have been diagnosed with the pneumonia-like illness in connection with an outbreak centred on Manhattan's Upper East Side.

Of those, 22 people remain in hospital, 19 have been discharged and are recovering at home, while five were treated without needing hospital care. There have been no deaths.

As part of the investigation, New York City officials have released a preliminary list of 31 buildings whose cooling towers tested positive for the presence of Legionella bacteria during initial screening.

Owners have been ordered to immediately clean and disinfect the cooling towers while further testing is carried out.

However, officials stressed that a positive PCR test does not confirm a building is the source of the outbreak, as the screening cannot determine whether the bacteria detected are alive. Culture testing, which takes up to two weeks, will establish whether live Legionella bacteria were present.

Health officials warned more cases could still emerge because symptoms can take between two and 14 days to develop after exposure.

The outbreak investigation began on July 2 after two linked cases were identified in the Upper East Side. Since then, more than 180 cooling towers have been sampled, with additional testing continuing over the weekend.

Authorities have sought to reassure residents that it remains safe to drink tap water, shower and use air conditioners in the affected neighbourhoods, adding there is no additional risk from simply being inside any of the buildings listed.

Legionnaires' disease is a serious form of pneumonia caused by Legionella bacteria, which spreads through tiny droplets of contaminated water. It is not transmitted from person to person. People aged over 50, smokers, those with chronic lung disease and people with weakened immune systems are considered most at risk.

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