FLETCHER - Legionnaires' disease has been confirmed in a patient who attended not the Mountain State Fair, but the Asheville Quilt Show at the WNC Agricultural Center, the North Carolina Department of Health and Human Services announced in a release Oct. 17.

Public health officials were aware that the Mountain State Fair, held at the WNC Ag Center Sept. 6-15, was the epicenter of the deadly Legionnaires' outbreak by the time the Asheville Quilt Show was to be held Sept. 27-29.

About 3,000 people were expected to attend the Quilt Show.

Ag Center was declared safe

Legionnaires' disease is a life-threatening respiratory infection contracted when tiny droplets of water contaminated with the Legionella bacteria are inhaled. As of Oct. 17, there were 141 confirmed cases of Legionnaires' and three deaths associated with the Mountain State Fair.

The day before the Quilt Show was to be held, Ag Center director Matt Buchanan told the Citizen Times that the facility had been declared safe.

"I would not have my staff in this building, I would not be in this building and I definitely would not have the quilt ladies out there" if he weren't certain the building was safe for occupancy, Buchanan added.

Also on Sept. 26, NCDHHS confirmed to the Citizen Times that scientists "did not identify any significant sources of aerosolized water currently at the WNC Agricultural Center."

Tests hadn't been completed before Quilt Show

On Oct. 2, the Ag Center canceled a gun and knife show slated to occur at the Davis Event Center Oct. 5-6.

Matt Buchanan, the director of the WNC Ag Center, said the Department of Agriculture has "voluntarily decided not to rent the Davis Event Center" while it undergoes "an aggressive and comprehensive mitigation plan."

"This is being done out of an abundance of caution and to reassure event attendees, fairgoers and Ag Center employees that the center is safe for occupancy," Buchanan said.

More:Legionnaires': WNC Ag Center cancels Gun & Knife show

But in an Oct. 3 question and answer session with the media, Buchanan and state epidemiologist Zach Moore said that samples from the Davis Event Center taken to test for Legionella bacteria hadn't been processed before the Quilt Show.

After the Oct. 3 DHHS press conference, Buchanan acknowledged the closure was in direct response to the sample that tested positive for Legionella in the Davis Center's women's bathroom.

According to the NCDHHS, that sample — from the sink of a "low-traffic" women's room in the Davis Event Center — was the only one to test positive for Legionella as of Oct. 3.

Other parts of the Davis Event Center water system were tested and did not test positive, but those results were not "final," Moore reiterated. A bathroom sink alone couldn't have been the source of the outbreak, he said, because sinks don't produce significant aerosolized water and a slight majority of the patients are men.

What about the hot tubs?

Public health officials have since pointed to hot tub displays in the Davis Center as the most likely source of the outbreak.

More:DHHS: Davis Center connected to Legionnaires' outbreak; authorities suspect hot tub

As of Oct. 17, NCDHHS has not announced the results of any samples taken from the hot tubs at the Davis Event Center during the fair. It wasn't until Sept. 23 that DHHS realized a possible connection between the Mountain State Fair and the Legionnaires' outbreak and it took time to make contact with the two hot tub vendors present, officials say.

Furthermore, Legionella needs water to survive, so if the hot tubs were drained and/or cleaned, it's possible that samples would come back negative for Legionella even if it were the source of the outbreak, Moore said.

Other common sources of Legionella bacteria

The Legionella bacteria is present in many natural waterways, but can grow to problematic levels in man-made systems without strict adherence to maintenance protocols.

Hot tubs, cooling towers (the large, industrial-sized air conditioning systems often located on the roofs of buildings like hotels, hospitals and conference centers) and misting stations are frequent vectors for water contaminated with Legionella bacteria.

In the Oct. 3 call with the media, officials stated that there is no such cooling tower at the Davis Event Center, where both the hot tubs and the Quilt Show were located.

Other possible sources of aerosolized water have not been publicly identified by NCDHHS or the Department of Agriculture.

This story is breaking and will be updated as more information becomes available.