FLETCHER, N.C. (AP) - Confirmed cases in a Legionnaires’ disease outbreak in western North Carolina have grown to over 50, but health officials still aren’t sure whether the illness originated from this month’s Mountain State Fair.

The Department of Health and Human Services says 53 laboratory-confirmed cases of the disease have been reported as of Thursday. One death was previously reported this week, and most of the patients have required hospitalization.

Legionnaires’ disease is a bacterial pneumonia that develops when someone breathes in mist or water that contains the bacteria into their lungs.

Many patients attended the fair. DHHS said on Friday that health officials visiting the Western North Carolina Agricultural Center - where the annual fair ended Sept. 15 - couldn’t locate any mist or water vapor source to pose a bacteria risk.

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