An outbreak of Legionnaires’ disease linked to a state fair this month in North Carolina has grown to 79 confirmed cases, including 55 hospitalizations and one death, according to the state division of public health.
Authorities haven’t pinpointed the source of the outbreak, but the division of public health said in an online post that many of the people reported attending the NC Mountain State Fair in Fletcher, outside Asheville, 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 34 confirmed cases, including the death, were reported in Buncombe County, where the fair occurred. Adjacent Henderson County reported 21 cases. Eleven other North Carolina counties reported one to five cases, and five cases were from out of state.
Four cases of Pontiac fever, a milder flu-lilke condition, have also been reported, the division of public health said.
“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.
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.
The Asheville Citizen-Times, citing fair officials, reported that the 10-day fair at the WNC Agricultural Center in Fletcher attracted more than 170,000 people.
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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.