The N.C. Department of Health and Human Services has released preliminary findings regarding a Legionella outbreak tied to the N.C. Mountain State Fair held in Fletcher Sept. 6-15.

Legionella can cause Legionnaire’s Disease, a bacterial lung infection similar to pneumonia, as well as the less severe Pontiac fever, according to the NCDHHS. As of Oct. 7, there are 131 cases of Legionellosis confirmed in those who attended the N.C. Mountain State Fair, 11 of those being Haywood County residents, according to NCDHHS outbreak data.

“People who were diagnosed with Legionnaires’ disease were much more likely to have visited the Davis Event Center while at the fair and much more likely to report having walked by the hot tub displays compared to people who did not get sick,” said a press release from the NCDHHS. “People who were diagnosed with Legionnaires’ disease were also much more likely to have visited during the latter half of the fair compared to people who did not get sick.”

The Davis Event Center is a large building that housed many vendor displays during the fair, including hot tubs, the NCDHHS press release said. Testing has identified Legionella bacteria in one water sample taken from the Davis Event Center, with results still pending from other samples taken as part of the investigation, the NCDHHS said.

“Finding Legionella in one water sample is an important piece of the puzzle, but it does not tell us how so many people were exposed at this event,” said Dr. Zack Moore, State Epidemiologist, in the press release. “To get Legionnaires’ disease or Pontiac fever, you have to breathe in Legionella in aerosolized water, meaning small droplets like mists or vapors.”

Early findings suggest that low levels of Legionella were able to grow in hot tubs or possibly some other source in the Davis Event Center, leading to exposure by fair attendees breathing in aerosolized water containing the bacteria, but investigation is ongoing, the NCDHHS said.

“Health officials visited the Western North Carolina Agricultural Center on Sept. 25 and Sept. 27 — after the fair had ended — and did not identify any significant sources of aerosolized water on the site,” the NCDHHS said. “Very little aerosolized water is created from hand washing sinks, toilets and other currently operating water sources at the Agricultural Center, meaning the risk of exposure to Legionella is low.”

Nonetheless, rental of the Davis Event Center has been postponed until more definitive answers are formed, according to a statement from The North Carolina Department of Agriculture and Consumer Services in the press release.

“Although Legionnaires’ disease is a rare infection, this is a reminder that the bacteria that cause it are common in nature and can be found in man-made water systems,” Moore said. “This means it’s very important for owners and managers of water systems that can create aerosols to take steps to prevent Legionella from growing and spreading in water systems.”

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