The source of the outbreak is under investigation but the North Carolina Division of Public Health said in an online post that many of the cases reported attending the NC Mountain State Fair in Fletcher between September 6 and 15.
Authorities are looking at airborne droplets from water rides at the fair as a possible cause of the outbreak, Kelly Haight Connor, a spokeswoman for the state’s Department of Health and Human Services, told CNN Thursday.
Health officials said 15 confirmed cases were reported in Buncombe County, including one fatality; Haywood and Transylvania counties each reported two cases; and Henderson County reported six cases.
“As a precaution, anyone who attended the NC Mountain State Fair and is experiencing cough, fever or shortness of breath, is advised to call their health care provider right away and talk to them about Legionnaire’s disease,” the health division said.
State health officials were first notified about an increase in cases in Buncombe and Henderson counties on Monday.
There have been 22 hospitalizations from this outbreak. The cases range in age from 37 to 90, and more than half are male, according to health officials.
The state’s “Communicable Disease Branch is working with Mountain State Fair organizers to investigate a possible connection of these cases with attendance at the fair earlier this month,” Buncombe and Henderson county officials said in statements on Wednesday.
Atlanta outbreak killed 1
Legionnaires’ disease is a lung infection contracted when people breathe in the Legionella bacteria through a mist or by accidentally getting water into their lungs that contains the bacteria.
The disease is serious but can be treated with antibiotics, the department said. About 1 in 10 people who get sick from Legionnaires’ disease die, a recent government report found.
Legionella bacteria are found naturally in the environment but can become a health concern when they “spread in human-made water systems like hot water tanks, cooling towers of air conditioning systems, decorative fountains and hot tubs or spas that are not properly maintained,” the North Carolina health department said.
At least one person died of Legionnaires’ disease during a recent outbreak linked to an Atlanta hotel.
About 7,500 US cases of Legionnaires’ disease were reported to the US Centers for Disease Control and Prevention in 2017, but that’s likely an underestimate because the illness is underdiagnosed, according to the CDC. The reported rate of people who get Legionnaires’ disease has risen by 550% since 2000.