Staff reports

Officials with the North Carolina Department of Health and Human Services’ Division of Public Health have confirmed a second death in the outbreak of Legionella bacteria, which has now infected dozens of Mountain State Fair attendees with the potentially life-threatening Legionnaires' disease.

On Oct. 10, NCDHHS officials confirmed 134 cases of Legionnaires’ disease or Pontiac fever among people who attended the 2019 NC Mountain State Fair, which took place Sept. 6-15 at the WNC Ag Center in Fletcher. Those diagnosed live in in multiple states and several North Carolina counties, according to a news release.

More on the Legionnaires' outbreak:

Two people have died and 88 people have been hospitalized in the outbreak. Personal information of those who have died is not being released, NCDHHS said, to protect privacy of the families.

“We send our sincerest condolences to the families of the two people who have died and to all those who have been affected by this outbreak,” said Dr. Zack Moore, state Epidemiologist. “Legionnaires’ disease is a serious illness which can lead to complications and death, especially in older individuals or those with underlying conditions.”

Seven of the confirmed cases are actually Pontiac Fever, a milder illness also caused by the bacteria Legionella. Symptoms are the eponymous fever, muscle aches, headache, chills, nausea, vomiting or diarrhea, according to NCDHHS.

Source of bacteria still unknown

While officials have not yet confirmed a source for the deadly bacteria, officials have pointed to a hot tub display as the most likely culprit.

"The preliminary epidemiologic and environmental findings suggest that exposure to Legionella bacteria occurred in the Davis Event Center of the WNC Ag Center, particularly near the hot tubs and during the last five days of the fair," the NCDHHS release stated.

Hot tubs are a well-established source of aerosolized water exposure and have been associated with previous Legionnaires’ disease outbreaks nationally and internationally.

"These results highlight the importance of caring for and maintaining equipment that can aerosolize water," according to the release. "There were no other significant sources of aerosolized water at the WNC Ag Center and no other ongoing potential sources of exposure identified."

The Legionella bacteria enters the body via contaminated water — but it has to reach the lungs to be dangerous.The culprit is usually aerosolized water, tiny water droplets suspended in the air by something like a misting station, an air conditioner or steam that people unknowingly breathe in.

To report possible cases, call the local health department or the NCDHHS Division of Public Health at (919) 733-3419. In Buncombe County, call BCHHS Communicable Disease at 828-250-5109. In Henderson County, call 828-694-6019.