Buncombe and Haywood health officials working with state agency to investigate Legionnaires’ outbreak

Press release from Buncombe County Health and Human Services:

Buncombe County, N.C.- Numerous cases of Legionnaires’ disease have been reported to Buncombe County Health and Human Services by local medical providers over the past several days. The investigation of these cases is ongoing. The NC Communicable Disease Branch is working with Mountain State Fair organizers to investigate a possible connection of these cases with attendance at the fair earlier this month (Sept. 6-15th). As of Tuesday, September 24th, there are nine confirmed cases of Legionnaires’ disease in Buncombe County residents, including one fatality caused by the illness.

Legionnaires’ disease is caused by Legionella bacteria. It is spread through water droplets in the air that people can breathe in. Legionnaires’ disease is not typically spread person to person. State Health Officials, event organizers, and Local Health Departments are investigating reports and working to identify a source.

Legionnaires’ disease causes a severe lung infection or pneumonia. Symptoms may include cough, high fever, weakness, muscle aches, headaches, and shortness of breath. Legionnaires’ disease is treated with antibiotics. Most people who get sick with it need to be hospitalized, but recover fully. However, according to the Centers for Disease Control and Prevention, about 1 out of 10 people with Legionnaires’ disease will die from the infection.

Most healthy people exposed to Legionella do not become sick but certain people are at increased risk for getting Legionnaires’ Disease including:

  • Those age 50 or older
  • Current or former smokers
  • Those with chronic lung disease like emphysema or COPD
  • Those with weakened immune systems due to disease or medication

If you attended the Mountain State Fair and are sick with symptoms of Legionnaires’ disease, we recommend you see your health care provider and discuss Legionnaires’ disease with them. If you live in Buncombe County and have questions about Legionnaires’ disease, please call Buncombe County Communicable Disease at (828) 250 – 5109.

Earlier today, NCDHHS issued a press release about the investigation. For more information on Legionnaires’ disease, visit this link. You may also view the attached fact sheets from the CDC.

BCHHS will be providing updates daily at 3:30 p.m.


Press release from Haywood County Public Health:

Haywood County Public Health, in conjunction with the North Carolina Department of Health and Human Services, is investigating a case of Legionella, commonly known as Legionnaire’s disease. Additional cases are also being investigated in surrounding counties. The state issued the following information today: “The Buncombe and Henderson County Health Departments, in conjunction with the North Carolina Department of Health and Human Services, are investigating multiple cases of Legionnaires’ disease reported in individuals who attended the NC Mountain State Fair in Fletcher, NC, Sept. 6–15, 2019.

‘We don’t yet know whether people might have been exposed to Legionella bacteria at the NC Mountain State Fair,’ said State Epidemiologist Dr. Zack Moore. ‘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.’

Legionnaires’ disease is a form of bacterial pneumonia (lung infection). A person may develop Legionnaires’ disease when they breathe in mist or accidentally swallow water into the lungs that contains Legionella bacteria. In North Carolina, more than 150 cases of Legionnaires’ disease are reported each year. Symptoms typically begin two to 10 days after exposure and can include cough, shortness of breath, fever, muscle aches and headaches. Legionnaires’ disease is a serious illness but can be treated effectively with antibiotics. Legionella bacteria can also cause a milder flu-like illness called Pontiac fever, which resolves without treatment.”

Legionella bacteria are found naturally in the environment, usually in warm water, such as in hot tubs, cooling towers, hot water tanks, large plumbing systems and decorative fountains. They do not seem to grow in car or window air-conditioners. Legionella does not spread from person-to-person. Most people who are exposed to Legionella bacteria do not become ill.

People at a higher risk of getting sick are:

  • Older people (usually age 50 or over)
  • Current or former smokers
  • Those with chronic lung disease (like COPD or emphysema
  • Those with a weak immune system from diseases like cancer, diabetes, or kidney failure
  • People who take drugs that weaken the immune system (like after a transplant operation or chemotherapy)

Environmental testing for Legionella is not routinely done, as these bacteria are commonly found in the environment. However, environmental testing may be performed, under certain circumstances, as part of a Legionellosis outbreak investigation. Clinical isolates are necessary to interpret the investigational findings.Physicians and laboratories are required by law to report cases of Legionella infections to public health officials so they can rapidly assess risk and institute control measures to prevent additional cases from occurring.


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