WNC Legionnaires outbreak grows; up to 15 confirmed cases

The North Carolina Department of Health and Human Services has confirmed 15 cases of Legionnaires’ disease in the western part of the state, including one death, all associated with the Mountain State Fair. That’s an increase of six cases in two days.

Nine cases have been confirmed in Buncombe County, and six more have been confirmed in Henderson County. Officials said all 15 patients spent time at the Mountain State Fair in Fletcher, although the fair has not been confirmed as the source of the outbreak.

Legionnaires’ disease – which is also called legionellosis or Legionella pneumonia – is a respiratory illness that is transmitted when people breathe in aerosolized water droplets, such as those from misting stations or large air conditioners.

The Mountain State Fair ran from Sept. 6-15 at the WNC Agricultural Center. Fair officials said more than 170,000 people attended the 10-day event.

WNC Legionnaires outbreak:
Symptoms? See your doctor

There were no misting stations or rides involving water at the fair, an Ag Center media representative told the Asheville Citizen Times. Multiple calls made by the Citizen Times to the contractor who supplied the rides and games at the fair have not been returned.

“We don’t yet know whether people might have been exposed to Legionella bacteria at the NC Mountain State Fair,” Dr. Zack Moore, the state epidemiologist, stated in news release distributed Tuesday. “As a precaution, we are recommending that anyone who went to the fair and has symptoms of pneumonia – like cough, fever or shortness of breath – see a doctor right away and talk with them about Legionnaires’ disease.”

The WNC Legionnaires outbreak linked to the Mountain State Fair has grown to 15 confirmed cases, North Carolina health officials announced.

WNC Legionnaires outbreak:
Flu-like symptoms as well

Legionnaires’ disease is a potentially deadly type of pneumonia. Symptoms, which also resemble those of flu, usually develop two to 10 days after exposure to Legionella, and generally begin with:

• headaches
• muscle aches
• chills and fever, which can be 104 degrees Fahrenheit or higher.

After the second or third day, symptoms usually worsen to include:

• coughing, which can produce mucus or blood
• shortness of breath (called dyspnea)
• chest pains (called pleurisy, pleuritis, or pleuritic chest pains)
• gastrointestinal problems, such as nausea, vomiting and diarrhea
• confusion and other mental changes.

If you attended the Mountain State Fair and have any of the above symptoms, you should see your health-care provider immediately.

Legionnaires’ disease cannot be passed from person to person, and it is treatable with antibiotics if diagnosed early. If that does not occur, however, it can lead to severe complications.

WNC Legionnaires outbreak:
High-risk demographics

People 50 years old and older – especially those who smoke or have a chronic lung condition, such as COPD (chronic obstructive pulmonary disorder, most commonly emphysema or bronchitis) – are at a much higher risk of contracting Legionnaires’ disease. Other groups more susceptible to infection include:

• people with a compromised immune system
• organ-transplant recipients
• people on a specific drug protocols, such as corticosteroids
• alcoholics.

After Legionnaires’ disease has been diagnosed, hospitalization is almost always required. In the most severe cases, complications can include respiratory failure, kidney failure, septic shock, or even death – and about 10 percent of those infected will die from the infection.

WNC Legionnaires outbreak:
Information hot lines

For more information or to report possible cases of Legionnaires’ disease, the public is being asked to call the Division of Public Health at (919) 733-3419 or contact your local health department:

• In Buncombe County, call (828) 250-5109.
• In Haywood County, call (828) 452-6675.
• In Henderson County, call (828) 694-6019.

In North Carolina, there were 83 cases of legionellosis reported through July of this year. In 2018, 175 cases were recorded, and between 2014 and 2018, there was an average of 198 cases per year, according to the NCDHHS communicable disease reports.