Legionnaires lawyer Elliot Olsen has extensive experience when it comes to filing a Legionnaires lawsuit. If you or a family member were sickened in this outbreak linked to the NC Mountain State Fair hot tubs at the Davis Event Center, please call Elliot at (612) 337-6126 for a free consultation.


Health officials with the North Carolina Department of Health and Human Services (NCDHHS) confirmed a second death in the NC Mountain State Fair legionellosis outbreak that has stricken 134 people.

 Of the 134 cases, 126 have been confirmed to be Legionnaires’ disease, with 88 victims hospitalized. (Legionellosis is the umbrella term for diseases caused by Legionella bacteria: Legionnaires’ disease and its milder sibling, Pontiac fever.)

The NCDHHS would not provide any information on the two fatalities, citing privacy laws.

“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, the state epidemiologist. “Legionnaires’ disease is a serious illness which can lead to complications and death, especially in older individuals or those with underlying conditions.”

The 10-day NC Mountain State Fair took place Sept. 6-15 at the WNC Agricultural Center in Fletcher.

NC Mountain State Fair outbreak: interim report

The NCDHHS released an interim report and FAQ about the outbreak, and preliminary findings suggest that exposure to Legionella occurred in the Davis Event Center at the WNC Ag Center, more specifically near the hot tubs and during the final five days of the fair.

According to the Centers for Disease Control and Prevention (CDC), Legionella are naturally found in water, especially warm water. Hot tubs (or spas) that are not cleaned and disinfected enough can become contaminated with the bacteria. A person can become infected when they breathe in steam or mist from a contaminated hot tub.

“Hot tubs are a well-established source of aerosolized water exposure, and have been associated with previous Legionnaires’ disease outbreaks nationally and internationally,” the interim report said. “No other significant sources of aerosolized water at the WNC Ag Center or other ongoing potential sources of exposure identified and continuing surveillance for Legionnaires’ disease cases indicates that the outbreak has ended.”

NC Mountain State Fair outbreak: reactions

In response to the outbreak, officials for the Dixie Classic Fair in Winston-Salem, NC, decided to implement several safety measures during the fair’s 10-day run, which concludes Sunday:

  • They banned the use of mist fans by vendors.
  • They told fairgoers that hand-held mist fans would not be allowed.
  • They announced that the fair’s lone water ride would be disinfected daily.
  • Drinking fountains will be available for fairgoers inside a building adjacent to the fairgrounds.

The Raleigh Home Show (Fall), which took place Oct. 4-6, also followed suit with extra precautions. Hot tub and whirlpool vendors were taking extra steps, including the addition of more chlorine and water tests because of the outbreak.

“We’ve been actually testing this hot tub about once an hour, every hour,” Rod Adams with Spa & Pool Outlet told Raleigh’s CBS 17 News. “We do have a lot of people coming in and out of the booth. We’ve never had an incident at this show, like they had in the mountains. We don’t anticipate having something like that.”

The Raleigh Home Show’s manager, Chiara Renella-Brooks, said the event always has taken precautionary measures, such as requiring hot tub companies to test their water a few times a day. Renella-Brooks also said state health officials provided guidelines.

“We do have guidance we have created,” Dr. Moore said, “especially in light of the outbreak at the Mountain State Fair that’s specifically for vendors of hot tubs and other whirlpools.”

NC Mountain State Fair outbreak: death in SC

According to WSPA 7 News, an obituary for Lorene Hall Williams, 83 of Campobello, SC, reported that she died from Legionnaires’ disease, and family members said she attended the NC Mountain State Fair.

Spartanburg County coroner Rusty Clevenger, however, told WSPA he could not confirm Williams’ cause of death, so it’s believed her death is not one of the two tied to this outbreak.

“I will also comment that this case was not reported to my office for investigation as it does not fit the requirements,” Clevenger said.

To be considered part of the NC Mountain State Fair outbreak, a patient must have displayed:

  • Legionnaires’ disease symptoms: pneumonia (clinical or radiologically confirmed; see symptoms below) in anyone who attended or worked at the NC Mountain State Fair, with symptom onset 2-14 days after attending the fair.
  • Pontiac fever: fever, myalgia (muscle pain), headaches, chills, nausea, vomiting, or diarrhea within three days of attending or working at the fair.
  • Diagnosis confirmed through laboratory testing, including cultures (respiratory secretions, lung tissue, pleural fluid, or other normally sterile sites) and urine analysis.

Clevenger did not clarify why Williams’ illness did not meet the criteria.

NC Mountain State Fair outbreak: symptoms

Legionnaires’ disease is a severe type of pneumonia or lung infection. According to the CDC, an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur in the United States every year. However, because of the disease’s nonspecific signs and symptoms, only 5,000 cases are reported.

The disease frequently begins with the following symptoms:

  • headache
  • muscle pain
  • chills
  • fever, which can be 104 degrees Fahrenheit or higher.

By the second or third day, other symptoms develop, including:

  • cough, which can bring up mucus and sometimes blood
  • shortness of breath
  • chest pain
  • gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
  • confusion and other mental changes.

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and other parts of the body, including the heart.

Legionnaires lawyer Elliot Olsen has extensive experience when it comes to filing a Legionnaires lawsuit. If you or a family member were sickened in this outbreak linked to McLaren Macomb Hospital, you might have reason to do just that. Call Elliot at (612) 337-6126 for a free consultation.


Michigan health officials are probing a Macomb County hospital after seven cases of Legionnaires’ disease were connected to the hospital since July.

The Macomb County Health Department (MCHD) and the Michigan Department of Health and Human Services (MDHHS) are investigating McLaren Macomb Hospital in Mount Clemens, attempting to find the source of the disease and whether more individuals have been infected.

Six of the seven cases were diagnosed since mid-September, prompting the investigation.

“Though the investigation is ongoing and a definite source has not been identified, we are responding with an abundance of caution and partnering with the Macomb County Health Department to identify targeted areas in the hospital to implement additional precautions to our water management efforts,” according to a statement released by McLaren Macomb Hospital officials.

The precautions include increased water testing at the facility, installing filters, removing aerators, and providing bottled water options. Recent testing has not indicated any presence of Legionella, the bacteria that causes Legionnaires.

McLaren Macomb Hospital: warning issued

“We are urging anyone who has been a recent patient at McLaren Macomb, or been at the hospital, and is experiencing any of the symptoms to contact their primary doctor,” MCHD director William Ridella told the Macomb Daily.

Legionnaires’ disease generally develops two to 10 days after exposure to Legionella bacteria. It frequently begins with the following symptoms:

  • headache
  • muscle pain
  • chills
  • fever, which can be 104 degrees Fahrenheit or higher.

By the second or third day, other symptoms develop, such as:

  • cough, which can bring up mucus and sometimes blood
  • shortness of breath
  • chest pain
  • gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
  • confusion and other mental changes.

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and other parts of the body, including the heart.

McLaren Macomb Hospital: disease on rise

Macomb County has recorded 45 legionellosis cases in 2019 and 96 in the past 12 months. (Legionellosis is the umbrella term for Legionnaires’ disease and its milder sibling, Pontiac fever.)

The county also reported an increase in legionellosis cases in each of the previous four years, with a record 102 cases in 2018, according to the MCHD’s Reportable Diseases Summary:

  • 2019: 45
  • 2018: 102
  • 2017: 56
  • 2016: 34
  • 2015: 25

The MCHD reminds us that Legionnaires’ disease is a respiratory infection with radiologic findings consistent with pneumonia. It is most common in the summer and early fall, when temperatures are higher, and stagnant waters present the best environment for bacterial growth in water systems.

McLaren Macomb Hospital: difficult diagnosis

Legionnaires’ disease, or Legionella pneumonia, is a respiratory illness that is contracted when people inhale microscopic aerosolized water droplets (vapor or mist).

Because many symptoms of legionellosis are similar to those of the common flu or pneumonia, the illness it causes is often overlooked or undiagnosed, leading to the disease being underreported, according to the Centers for Disease Control and Prevention (CDC).

For the disease to be classified correctly, specific testing and diagnosis must be done from a Legionnaires’ disease standpoint, and those tests are often not ordered. It’s not required for physicians to order Legionella-specific testing when a patient presents with pneumonia.

McLaren Macomb Hospital: most at risk

A 2015 study by the CDC stated that “75 percent of (Legionnaires’ disease) acquired in health-care settings could be prevented with better water management.”

Most people exposed to Legionella do not get sick, but people 50 years old and older – especially those who smoke or have chronic lung conditions – are at a higher risk.

Others more susceptible to infection include:

  • recipients of organ transplants
  • individuals who are on specific drug protocols (corticosteroids, to name one)
  • heavy drinkers of alcoholic beverages.

The list also includes anyone with an immune system weakened by:

  • frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis or skin infections
  • organ inflammation and infection
  • blood disorders, such as low platelet counts or anemia
  • digestive problems, such as cramping, appetite loss, diarrhea, and nausea
  • delayed growth and development.

After Legionnaires’ disease has been diagnosed, hospitalization is often necessary. In the most severe Legionnaires cases, complications can include respiratory failure, kidney failure, septic shock, or even death.

McLaren Macomb Hospital: serious consequences

The severity of the illness is illustrated in an Epidemiology & Infection study from the University of Minnesota. Based on data from the CDC and the Centers for Medicaid and Medicare Services (CMS), “approximately 9 percent of legionellosis cases, caused by waterborne Legionella bacteria, are fatal, and 40 percent require intensive care.”

Legionnaires lawyer Elliot Olsen has extensive experience when it comes to filing a Legionnaires lawsuit. If you or a family member were sickened in this outbreak linked to Mountain State Fair hot tubs at the Davis Events Center, you might have reason to do just that. Call Elliot at (612) 337-6126 for a free consultation.


Health officials in North Carolina said they have a leading suspect for the Legionella bacteria that infected at least 116 Mountain State Fair attendees with Legionnaires’ disease: hot tubs on display at the Davis Events Center.

“We do have indication from our epidemiological study … that having walked by the hot tubs is linked to Legionnaires’ disease,” said state epidemiologist Dr. Zack Moore, referring to a space at the WNC Agricultural Center in Fletcher.

Moore also said that patients who have developed Legionnaires’ disease are more likely to have visited the fair during the “latter half” of its run from Sept. 6-15.

State Fair hot tubs: two vendors

There were two vendors with hot tub displays at the Davis Events Center, and samples from one hot tub are being processed. The North Carolina Department of Health and Human Services (NCDHHS) hasn’t been able to sample other hot tubs that were on display.

“If the hot tubs had been drained, or drained and disinfected, it’s possible that we would not pick up any Legionella, even if it had been present during the fair,” Moore said. “Legionella has to be in water to survive.”

Moore said samples were taken from several spots in the space, but only one was positive for Legionella – a sample from a “low-traffic” women’s bathroom. One sink could not have been the source of the outbreak, Moore said, because sinks don’t produce significant aerosolized water, and a majority of the patients are men.

Ronnie Goode said he wanted to make some extra cash, so he got a job at the Mountain State Fair. Unfortunately for him, he also picked up a potentially serious illness.

Goode, who lives in Canton, didn’t even enter the Davis Events Center.

“We rode around and picked up trash,” he told WLOS-TV. “Kept (the fair) nice and clean.”

About five days after his final shift at the fair, he said experienced severe chest pains.

“The best description was it felt like a heart attack,” Goode said.

Days later, he became one of the 116 confirmed cases of Legionnaires’ disease.

State Fair hot tubs: 80 hospitalized

The statistics on the outbreak, as compiled by the NCDHHS:

  • Eight victims developed Pontiac fever, a milder form of legionellosis that does not affect the lungs. Putting that total together with the number of Legionnaires’ disease illnesses makes the total number of legionellosis cases 124. (Legionellosis is the umbrella term for diseases caused by Legionella.)
  • Seventy-two victims are male (58 percent); 50 are female (40 percent). (The NCDHHS said some cases were reported without a gender.)
  • The age range of those infected is 24 to 91; the median age is 61. (People older than 50 are particularly susceptible to Legionella.)
  • Eighty people (65 percent) have been hospitalized.
  • One victim passed away.
  • There are seven out-of-state cases, all residents of South Carolina.

State Fair hot tubs: high risk

Legionnaires’ disease (also: Legionella pneumonia) is contracted by inhaling microscopic aerosolized water droplets (vapor or mist). Because many symptoms are similar to those of flu or pneumonia, the illness often is overlooked or undiagnosed, leading to it being underreported, according to the Centers for Disease Control and Prevention (CDC).

People 50 years old and older – especially smokers or those with a chronic lung condition, such as COPD (chronic obstructive pulmonary disorder, most commonly bronchitis and emphysema) – are more susceptible to developing Legionnaires’ disease. Other high-risk people include:

  • anyone with a compromised immune system
  • organ-transplant recipients
  • anyone on a specific drug protocol (for example, corticosteroids)
  • alcoholics.
State Fair hot tubs: symptoms

Legionnaires’ disease symptoms generally develop within 10 days after one has been exposed to Legionella. Symptoms generally begin with:

  • headaches
  • muscle aches
  • fever, which can top 104 degrees Fahrenheit, and chills.

After the second or third day, symptoms usually worsen to include:

  • coughing, which can produce mucus and blood
  • dyspnea (shortness of breath)
  • chest pains (pleuritic chest pains, pleurisy, or pleuritis)
  • gastrointestinal problems (diarrhea, nausea, vomiting)
  • confusion and other mental changes.

Legionnaires’ disease cannot be caught from someone else, and it is treatable with antibiotics if diagnosed early. If that doesn’t happen, however, the disease can lead to severe complications, including respiratory failure, kidney failure, and septic shock.

North Carolina outbreak: Legionnaires lawyer Elliot Olsen has vast experience when it comes to filing a Legionnaires lawsuit. If you or a family member were sickened in this outbreak, you might have reason to do just that. Please call Elliot at (612) 337-6126 for a free consultation.


The North Carolina outbreak of legionellosis is up to 116 cases, making it the largest such outbreak in state history, the NC Department of Health and Human Services (NCDHHS) confirmed. One victim has died, 75 have been hospitalized, and 109 have developed Legionnaires’ disease.

(Note: There are two types of legionellosis: Legionnaires’ disease, the most severe form of the illness, and Pontiac fever.)

The NCDHHS first announced the outbreak on Sept. 23, detailing nine Legionnaires cases and one fatality. Updates have been almost daily since then, and the NCDHHS website says that the “case finding is ongoing, and additional cases have been reported.”

The source of the Legionella bacteria that caused the illnesses is still unknown, and officials are concerned that additional cases will be identified.

The focus of their investigation remains on the Mountain State Fair, which was Sept. 6-15 at the WNC Agricultural Center in Fletcher, about 12 miles south of Asheville in the western part of the state. Fair officials said the 10-day event was attended by more than 170,000 people.

North Carolina outbreak:
Public asked for help

The North Carolina Division of Public Health (DPH) has requested that all attendees of the Mountain State Fair, even if they did not become ill, complete an online survey. Officials said participation will help investigators understand the outbreak, and it could help prevent future outbreaks.

Answers will be confidential, the DPH said, and the information will be used only for public health purposes. The survey takes about five minutes; if multiple people in a household attended the fair, the DPH asks that each person complete a survey.

If someone is not able to answer the questions, another person can answer on their behalf. Start a new survey for each person at  https://www.surveymonkey.com/r/dhhs_survey.

To report possible cases, or to ask questions about the survey or the investigation, call the DPH hotline at (828) 694-4040, or contact the NCDHHS at (919) 733-3419.

North Carolina outbreak:
Criteria considered

To be considered as part of the North Carolina outbreak, a patient must have displayed:

  • Legionnaires’ disease symptoms: pneumonia (clinical or radiologically confirmed; see symptoms below) in anyone who attended or worked at the Mountain State Fair, with symptom onset 2-14 days after attending the fair.
  • Pontiac fever: fever, myalgia (muscle pain), headaches, chills, nausea, vomiting or diarrhea within three days of attending or working at the fair.
  • A diagnosis confirmed through laboratory testing, including cultures (respiratory secretions, lung tissue, pleural fluid, or other normally sterile sites) and urine analysis.

For the disease to be classified correctly, specific testing and diagnosis must be done from a Legionnaires’ disease standpoint, and those tests often go unordered. (Doctors are not required to order Legionella-specific testing when a patient presents with pneumonia.) That’s why officials are urging anyone who attended the Mountain State Fair and has since become ill to see their health-care provider; tell them that you attended the fair; and provide the date for the onset of symptoms.

North Carolina outbreak:
75 have been hospitalized

The case characteristics compiled by the NCDHHS are as follows:

  • Seven victims have contracted Pontiac fever, a milder form of Legionnaires’ disease that does not affect the lungs.
  • Sixty-eight victims (59 percent) are male, and 47 are female.
  • The victims’ ages are between 24 and 90, with a median age of 61. (Note: People over the age of 50 are particularly susceptible to Legionella.)
  • Seventy-five people (65 percent) have been hospitalized.
  • One victim has died.
  • Residents of 17 North Carolina counties have been infected.
  • There are six out-of-state cases, all in South Carolina.

North Carolina outbreak:
Symptoms are numerous

Symptoms usually develop two to 10 days after exposure to Legionella, and they usually begin with:

  • headaches
  • muscle aches
  • fever, which can be 104 degrees Fahrenheit or higher, and chills.

After the second or third day, symptoms often worsen to include:

  • coughing, which can produce mucus or blood
  • shortness of breath (dyspnea)
  • chest pains (also: pleurisy, pleuritis, or pleuritic chest pains)
  • gastrointestinal problems (nausea, vomiting, diarrhea)
  • confusion and other mental changes.

Legionnaires’ disease cannot be contracted from someone else. If it is diagnosed early enough, it is treatable with antibiotics. If that does not occur, however, it can lead to severe complications, such as respiratory failure, kidney failure, and septic shock.

North Carolina outbreak:
More on the disease

The disease is contracted by inhaling microscopic, aerosolized water droplets (vapor or mist), such as those formed by misting stations or large air conditioners.

Other groups of people more likely to develop Legionnaires’ disease include:

  • smokers, current or former
  • those with chronic lung conditions, such as chronic obstructive pulmonary disorder (COPD, most commonly bronchitis or emphysema)
  • anyone with a compromised immune system
  • organ-transplant recipients
  • anyone on a specific drug protocol, such as corticosteroids
  • alcoholics.

Elliot Olsen is one of the few lawyers in the country who can call himself a “Legionnaires lawyer.” If you or a family member were sickened in this WNC outbreak, you might have reason to file a Legionnaires lawsuit. Please call Elliot at (612) 337-6126 for a free consultation.


The case count in the North Carolina Legionnaires’ disease outbreak is changing daily as the North Carolina Department of Health and Human Services (NCDHHS) confirmed an updated count of 32 cases – including one death – in the western part of the state, all associated with the Mountain State Fair.

The NCDHHS first announced the outbreak Tuesday, at which point there were nine cases and one fatality. The department increased the total to 25 on Wednesday, and then it confirmed seven more on Thursday.

Initially, the outbreak infected individuals from three counties, but a fourth county was added Wednesday, as two cases were identified in Transylvania County. It’s not unrealistic to think that residents of other counties or even other states will join the roll in the coming days.

The Mountain State Fair was held from Sept. 6-15 at the WNC Agricultural Center in Fletcher, which is about 12 miles south of Asheville. Fair officials said more than 170,000 people attended the 10-day event.

The number of confirmed cases per county is:

  • Buncombe – 15
  • Henderson – 13
  • Haywood – 2
  • Transylvania – 2
WNC outbreak: About the disease

Legionnaires’ disease – which is also known as legionellosis or Legionella pneumonia – is a respiratory illness that is contracted when people inhale microscopic aerosolized water droplets (vapor or mist), such as those formed by misting stations or large air conditioners.

Legionellosis is the collective term for diseases caused by Legionella bacteria, including Legionnaires’ disease (most serious) and Pontiac fever. Because many symptoms of legionellosis are similar to those of the common flu or pneumonia (see below), the illness it causes is often overlooked or undiagnosed, leading to the disease being underreported, according to the Centers for Disease Control and Prevention (CDC).

For the disease to be classified correctly, specific testing and diagnosis must be done from a Legionnaires’ disease standpoint, and those tests are often not ordered. It’s not required for physicians to order Legionella-specific testing when a patient presents with pneumonia.

That’s why health officials urge anyone who attended the Mountain State Fair and has since become ill to see their health-care provider. Let them know that you attended the fair and when symptoms started.

WNC outbreak: Multiple symptoms

Legionnaires’ disease is a potentially deadly type of pneumonia. Symptoms usually develop two to 10 days after exposure to Legionella and generally begin with:

  • headaches
  • muscle aches
  • chills and fever, which can be 104 degrees Fahrenheit or higher.

After the second or third day, symptoms usually worsen to include:

  • coughing, which can produce mucus or blood
  • shortness of breath (called dyspnea)
  • chest pains (called pleurisy, pleuritis, or pleuritic chest pains)
  • gastrointestinal problems, such as nausea, vomiting, and diarrhea
  • confusion and other mental changes.

Legionnaires’ disease cannot be passed from person to person. It is treatable with antibiotics if diagnosed early. If that does not occur, however, it can lead to severe complications.

WNC outbreak: High-risk demographics

People 50 years old and older – especially those who smoke or have a chronic lung condition, such as COPD (chronic obstructive pulmonary disorder, most commonly emphysema or bronchitis) – are at a much higher risk of contracting Legionnaires’ disease.

Other groups more susceptible include:

  • people with a compromised immune system
  • organ-transplant recipients
  • people on a specific drug protocol, such as corticosteroids
  • alcoholics.

After Legionnaires’ disease has been diagnosed, hospitalization is almost always required. In the most severe cases, complications can include respiratory failure, kidney failure, septic shock, or death (about 10 percent of those infected will die).

WNC outbreak: 22 victims hospitalized

The NCDHHS has examined 25 of the 32 patients confirmed with Legionnaires in this outbreak. Their ages range from 37 to 90, with a median age of 67. Twenty-two victims have been hospitalized, and 60 percent are male.

To be considered part of the outbreak, a patient must have displayed:

  • Legionnaires symptoms within 2-14 days of attending or working at the Mountain State Fair, or Pontiac Fever symptoms within three days of attending or working at the fair.
  • The diagnosis must be confirmed through laboratory testing, including – but not limited to – cultures (i.e., respiratory secretions, lung tissue, pleural fluid, or other normally sterile sites) and urine analysis.
WNC outbreak: Ag Center visitors at risk?

State and local health officials, along with WNC Agricultural Center and Mountain State Fair representatives, continue to work together to locate the source of the Legionella bacteria causing the infections.

The Ag Center is host to the Asheville Quilt Show, which begins today (Sept. 27) and runs through Sunday. Matt Buchanan, general manager of the Ag Center and the Mountain State Fair, said he believes attendees will be safe.

“Two of our engineers from solar and water here locally inspected all the buildings, all the grounds, and they found nothing that would be a risk,” Buchanan told the Asheville Citizen Times. “We had two environmentalists out of the Raleigh office come in, inspecting the buildings and everything, and they did not find anything.”

NCDHHS confirmed to the Citizen Times that scientists “did not identify any significant sources of aerosolized water currently at the WNC Agricultural Center.”

According to WHKP Radio, state officials are looking into three possible sources:

  • A water-spraying fan the Skyland Fire Department had at the fair to cool visitors.
  • Hot tubs that were emitting water into the air.
  • The cooling system of three buildings.
WNC outbreak: Information hotlines

For more information or to report possible cases of Legionnaires’ disease, the public is being asked to call the Division of Public Health at (919) 733-3419 or contact your local health department:

  • In Buncombe County, call (828) 250-5109.
  • In Haywood County, call (828) 452-6675.
  • In Henderson County, call (828) 694-6019.
  • In Transylvania County, call (828) 884-3135.

Elliot Olsen is one of the few lawyers in the country who can call himself a “Legionnaires lawyer.” If you or a family member were sickened after attending the Mountain State Fair, you might have reason to file a Legionnaires lawsuit. Please call Elliot at (612) 337-6126 for a free consultation.


North Carolina health officials confirmed a fatal Legionnaires’ disease outbreak in the western part of the state after nine people were diagnosed with the serious respiratory illness – and one of them died – in the past week.

Officials have identified the Mountain State Fair as the probable source for the outbreak, which has sickened residents of Buncombe, Haywood, and Henderson counties. The one commonality between those infected is that they all attended the fair, which is held at the WNC Ag Center in Fletcher.

The North Carolina Department of Health and Human Services (NCDHHS), Buncombe Health and Human Services (HHS) and Henderson County Health Departments are investigating the outbreak. No additional information was released on those infected.

Mountain State Fair: 170,000-plus attendees

More than 170,000 people attended the 10-day event, which ran from Sept. 6-15. Given the size of the event, health officials are concerned additional cases will be reported.

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

Mountain State Fair: numerous symptoms

Along with cough, fever, or shortness of breath (dyspnea), other symptoms to be concerned about include:

  • headaches
  • muscle pains
  • chills
  • chest pains (called pleurisy or pleuritis)
  • gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
  • confusion and other mental changes.

If you attended the Mountain State Fair and are exhibiting any of the above symptoms, seek care from your health-care provider immediately. Symptoms usually develop two to 10 days after exposure to Legionella.

Legionnaires’ disease is not contagious – that is, it cannot be passed from person to person. The condition is treatable with antibiotics, but it must be diagnosed early enough. If that does not occur, it can lead to severe complications.

Mountain State Fair: focus on water

Legionnaires’ disease is a severe form of pneumonia (lung disease) that is also called legionellosis or Legionella pneumonia. It can be contracted by breathing in small droplets of water (mist or vapor) containing Legionella bacteria.

“Features, exhibits, and rides that incorporated some type of water exposure that created droplets which came in contact with visitors will be our focus,” Steven Smith, Henderson County’s director of health, wrote in an email to the Henderson County Board of Health. “Limiting any future exposures for individuals is an important objective right now.”

Even a water-coiled cooling fan provided by the Skyland Fire Department is being considered a possible culprit. The fan was used as a mister to help cool fairgoers.

Skyland fire chief Ryan Cole said he and his staff are more than willing to turn over the fan for testing, although he said he expects the fan to be ruled out as a source.

“We had many of our staff near the station during the time it ran, and none of them have been sick or shown any symptoms,” Cole told WLOS-TV news. “The health department said they’re looking for an environmental specialist to test the fan and that they would be back in touch.”

Mountain State Fair: high-risk groups

The reason the fire department staff wasn’t sickened or exhibiting symptoms could be that staff members don’t meet the criteria for infection. People 50 years old and older – especially those who smoke or have a chronic lung condition – are at a much higher risk.

Other people more susceptible to infection include:

  • recipients of organ transplants
  • individuals who are on specific drug protocols (corticosteroids, to name one)
  • heavy drinkers of alcoholic beverages
  • people with suppressed immune systems.

After Legionnaires’ disease has been diagnosed, hospitalization is almost always necessary. In the most severe cases, complications can include respiratory failure, kidney failure, septic shock, or even death – and about 10 percent of those infected will die from the infection.

Mountain State Fair: call for more info

For more information or to report possible cases of Legionnaires’ disease, the public is asked to call the Division of Public Health at (919) 733-3419 or contact your local health department:

  • In Buncombe County, call (828) 250-5109.
  • In Haywood County, call (828) 452-6675.
  • In Henderson County, call (828) 694-6019.

In North Carolina, there were 83 cases of legionellosis reported through July of this year. In 2018, 175 cases were recorded, and between 2014 and 2018, there was an average of 198 cases per year, according to the NCDHHS communicable disease reports.

Elliot Olsen is one of the few lawyers in the country who can call himself a “Legionnaires lawyer.” If you or a family member were sickened in this Tracey Towers outbreak, you might have reason to file a Legionnaires lawsuit. Please call Elliot at (612) 337-6126 for a free consultation.


The New York City Department of Health and Mental Hygiene (NYC Health) returned to the Tracey Towers in the Bronx and informed residents that two more tenants had been diagnosed with Legionnaires’ disease, according to the Norwood News. That doubled the number of cases at the housing complex to four in the past year.

All four tenants who have been confirmed with the respiratory illness live in the tower at 20 West Mosholu Parkway North. The adjacent tower at 40 West Mosholu Parkway South has been illness-free.

Tracey Towers is among the tallest buildings in the Bronx, at 38 and 41 stories. It’s the second-largest cooperative housing development in the Bronx, behind Co-Op City, which is the largest of its kind in the world. (Co-Op City dealt with a Legionnaires outbreak in 2018 in which one resident was killed and two others sickened.)

Tracey Towers outbreak: shower heads switched

Jean Hill, president of the Tracey Towers Tenants Association, said shower heads were being changed at 20 West Mosholu as an extra precaution, and the same will occur at 40 West Mosholu. “People were concerned last week; now they’re angry,” Hill told the Norwood News.

The source of the Legionella bacteria, which causes Legionnaires’ disease, has yet to be found. Water testing continues throughout the complex, as do interviews of those sickened to try to pinpoint where they have been, on or off the property.

Tracey Towers outbreak: no cooling towers

Cooling towers have been frequent culprits in Legionnaires outbreaks in New York City over the years, including the biggest outbreak in city history in 2015. Tracey Towers, however, does not have cooling towers, which is why the complex’s water system is suspected.

The largest outbreak in New York City history occurred in the Bronx in 2015. Contaminated cooling towers were blamed for producing Legionnaires’ disease that killed 12 people and sickened more than 120 others in the south Bronx.

Tracey Towers outbreak: residents warned

Ricky Wong, NYC Health’s executive director of community affairs, told residents to take precautions to minimize their risk of exposure to Legionella.

Since Legionella bacteria are contracted by inhaling microscopic water droplets in the form of mist or vapor, tenants have been reminded that even fast-running water in someone’s sink – warm or cool – can create vapor that can be inhaled.

The following preventative measures should be followed by anyone at a higher risk for Legionnaires’ disease:

  • Don’t shower – instead, take a bath, filling the tub slowly, and minimizing your time in the bathroom while the water is running.
  • Wash dishes but fill the sink slowly to avoid creating a mist.
  • Drink cold water from the tap and start with cold water when heating water for coffee, tea, or cooking.
  • Continue to wash your hands.
  • Do not wear a mask – it’s unnecessary.
Tracey Towers outbreak: higher risk

The majority of people exposed to Legionella do not get sick, but people 50 years old and older – especially those who smoke or have a chronic lung condition – are at a higher risk.

Other people more susceptible to infection include:

  • recipients of organ transplants
  • individuals who are on specific drug protocols (corticosteroids, to name one)
  • heavy drinkers of alcoholic beverages
  • people with suppressed immune systems

After Legionnaires’ disease has been diagnosed, hospitalization is almost always necessary. In the most severe cases, complications can include respiratory failure, kidney failure, septic shock, or even death – and about 10 percent of those infected will die from the infection.

Tracey Towers outbreak: be wary

Seek care from your health-care provider if you are a resident, employee or have visited the Tracey Towers recently and are feeling flu- or pneumonia-like symptoms, which usually develop two to 10 days after exposure to Legionella.

Initial symptoms include:

  • headaches
  • muscle pains
  • chills
  • fever, which can be 104 degrees Fahrenheit or higher.

By the second or third day, symptoms can worsen to include:

  • cough, which can bring up mucus or blood
  • shortness of breath also called dyspnea
  • chest pains also called pleurisy
  • gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
  • confusion and other mental changes.

Tracey Towers outbreak: all too familiar

The Tracey Towers outbreak is the latest Legionnaires’ disease outbreak to affect the Bronx:

  • In February, NYC Health confirmed two cases at the Bronx River Houses, which occurred within the previous 12 months.
  • In September 2018, two residents were diagnosed with Legionnaires at Fort Independence Houses in the Kingsbridge Heights neighborhood.
  • In October 2017, five residents of the Hebrew Home at Riverdale were diagnosed with the disease.

Also, in the summer of 2018, Legionella bacteria were found in the water supply of the borough’s Jacobi Medical Center, but no illnesses were reported.

Tracey Towers outbreak: an NYC problem

On average, New York City records up to 500 cases of Legionnaires’ disease every year. In 2017, New York State set a record with 1,009 confirmed cases, a record that was projected to be broken in 2018. (Note: Final totals for 2018 have yet to be released, but by Sept. 27 of that year, 875 confirmed cases had been recorded, and 1,180 were projected by year’s end.)

Legionnaires lawyer Elliot Olsen has won millions for his clients. If you or a family member became ill in this Batavia Legionnaires outbreak, you might have cause to file a Legionnaires lawsuit. Please call Elliot at (612) 337-6126 for a free consultation.


The Illinois Department of Public Health (IDPH) has identified a construction site as a possible cause of a Legionnaires’ disease outbreak in Batavia.

The construction site is a short walk from the Covenant Living at Holmstad retirement home at 700 West Fabyan Parkway. Twelve residents of the facility have been confirmed with Legionnaires’ disease, which is contracted by inhaling Legionella bacteria-infected water droplets in the form of mist or vapor.

Just this week, two additional illnesses were diagnosed in people who live nearby Covenant Living but have no connection to the retirement home.

According to the IDPH, construction workers have been using pressure washers, which could aerosolize infected water and subsequently spread the Legionella.

A seven-month construction project began June 10 on the Fabyan Parkway bridge over the Fox River. (Fabyan Parkway is also known as County Highway 8.)

If construction equipment is the source of the problem, even people who have driven by or through the construction area could become infected.

Batavia Legionnaires outbreak: city water not source

City officials said the Legionella causing the 14 illnesses did not come from the local water supply.

Batavia city administrator Laura Newman told City Council members on Monday that chlorine tests of the water system returned levels higher than that required by the IDPH, meaning that Legionella could not survive.

“Our water system was never the culprit,” Mayor Jeff Schielke told the Kane County Chronicle.

Batavia Legionnaires outbreak: Sick? Seek treatment

Health officials are warning residents, employees, or individuals who have visited Covenant Living, as well as anyone living within a mile of the construction area, to watch for respiratory symptoms.

Seek care from your health-care provider if you are feeling flu- or pneumonia-like symptoms, which usually develop two to 10 days after exposure to Legionella. Initial symptoms include:

  • headaches
  • muscle pains
  • chills
  • fever, which can be 104 degrees Fahrenheit or higher.

By the second or third day, symptoms can worsen to include:

  • cough, which can bring up mucus or blood
  • shortness of breath, also called dyspnea
  • chest pains, also called pleurisy
  • gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
  • confusion and other mental changes.

Anyone can get the disease, but those at the most significant risk of infection include:

  • people 50 or older
  • smokers (current or former)
  • heavy drinkers of alcoholic beverages
  • people with chronic lung disease, such as COPD (most commonly, bronchitis or emphysema)
  • people with weakened immune systems.

Legionnaires’ disease is not contagious – that is, it cannot be passed from person to person. The condition is treatable with antibiotics when diagnosed early enough, although if that does not occur, it can lead to severe complications.

Batavia Legionnaires outbreak: disease complications

After a diagnosis of Legionnaires’ disease, hospitalization is almost always required. In the most severe cases, complications can occur, such as:

  • respiratory failure: caused by changes to the lung tissue, or oxygen loss in arteries supplying the lungs.
  • septic shock: this can occur when Legionella produce toxins that enter the bloodstream and cause a drop in blood pressure, leading to the loss of adequate blood supply to the organs.
  • kidney failure: those same Legionella toxins can damage the kidneys’ ability to eliminate waste from the blood, resulting in kidney failure.
  • endocarditis: an infection of the inner lining of the heart that can affect the ability of the heart to maintain adequate blood flow through the body.
  • pericarditis: swelling of the pericardium, which is the primary membrane around the heart. This can also affect the ability of the heart to circulate blood throughout the body.

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and other parts of the body, including the heart.

According to CDC statistics, about one out of every 10 people (10 percent) infected with Legionnaires will die due to complications from the illness.

More information about Legionnaires’ disease and updates on the outbreak can be found at KaneHealth.com/Pages/Menu-Disease.aspx.

A total of 285 cases of Legionnaires’ disease have been confirmed in Illinois thus far in 2019.

Legionnaires lawyer Elliot Olsen has won millions for his clients. If you or a family member got sick in this Covenant Living Legionnaires outbreak, you might have cause to file a Legionnaires lawsuit. Please call Elliot at (612) 337-6126 for a free consultation.


The Covenant Living Legionnaires outbreak in Batavia, Illinois, has spread beyond the senior living community, with two additional cases of Legionnaires’ disease confirmed in the surrounding area.

Public health officials are warning residents of Covenant Living at the Holmstad (700 West Fabyan Parkway), as well as anyone living within a mile of the facility, to be on the lookout for symptoms of respiratory illness that could stem from exposure to Legionella bacteria.

The outbreak, which is now up to 14 illnesses, first made headlines when it was announced August 31 that four residents were hospitalized. The most recent cases were confirmed Thursday, when the Illinois Department of Public Health (IDPH) announced that it had received reports of two community-based cases.

In 2018, Illinois reported 512 cases of Legionnaires’ disease statewide. This year, there have been 255 confirmed cases.

Covenant Living Legionnaires outbreak: Legionella search continues

Legionnaires’ disease is a serious form of pneumonia (lung disease) that is also called legionellosis or Legionella pneumonia. It can be contracted by breathing in small droplets of water (mist or vapor) containing Legionella bacteria.

At Covenant Living, officials said the two new cases prompted them to test additional samples at Covenant Living and within a 1-mile radius of the campus. The IDPH also has “recommended remediation steps of suspected sources,” agency leaders said.

For updates on the outbreak or for more information about Legionnaires’ disease, go to KaneHealth.com/Pages/Menu-Disease.aspx.

Covenant Living Legionnaires outbreak: neighbor sickened

Angela Prusinski, who lives about three blocks from Covenant Living, said she started feeling ill after a family picnic Sept. 1, but because she has underlying health conditions and underwent surgery in July, she told the Daily Herald that she thought, “Maybe I just overdid it today.”

When she awoke the next day, however, she said she had chills and muscle aches, and she “felt awful, worse than the flu.”

Prusinski said she went to the emergency room that night with stomach aches and cramping, although she had not yet experienced respiratory problems. After learning that her white blood cell count was elevated, doctors prescribed a broad-spectrum antibiotic and sent her home.

She returned to the hospital Sept. 7, and tests performed then revealed she had elevated blood pressure and a high resting heart rate – and doctors discovered she had bacterial pneumonia in her left lung.

Prusinski underwent more tests and was sent home Sept. 10. Two days later, she got a call from the Centers for Disease Control and Prevention (CDC) and the Kane County Health Department (KCHD) informing her that she had Legionnaires’ disease.

The identity of the second nearby resident has not been released.

Covenant Living Legionnaires outbreak: difficult diagnosis

Public health officials are advising that residents, employees, and visitors to Covenant Living who are feeling flu- or pneumonia-like symptoms see their doctor immediately.

Symptoms generally develop two to 10 days after exposure to Legionella, and they usually begin with severe headaches, muscle aches, fever (which can be 104 degrees or higher), and chills.

By Day 2 or 3, symptoms often worsen to include:

  • coughing, which can produce mucus or blood
  • dyspnea (shortness of breath)
  • chest pains (pleurisy or pleuritic chest pains)
  • gastrointestinal symptoms (nausea, vomiting, diarrhea)
  • confusion and other mental changes.

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and in other parts of the body, including the heart.

Covenant Living Legionnaires outbreak: seniors at risk

Most people exposed to Legionella do not get sick, but people older than 50 – especially those who smoke or have a chronic lung disease (such as COPD) – are at a much greater risk of becoming infected. Other people more susceptible to infection include:

  • organ-transplant recipients
  • anyone on a specific drug protocol, such as corticosteroids
  • alcoholics.

The list also includes anyone with an immune system that has been compromised because of:

  • frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis or skin infections
  • organ inflammation and infection
  • blood disorders, such as anemia or low platelet counts
  • digestive problems, such as cramping, appetite loss, diarrhea, and nausea.

After Legionnaires’ disease has been diagnosed, hospitalization is almost always necessary. In the most severe circumstances, complications can develop, such as respiratory failure, kidney failure, septic shock, or even death.

Legionnaires lawyer Elliot Olsen has won millions for his clients. If you or a family member got sick in this Covenant Living outbreak, you might have cause to file a Legionnaires lawsuit. Please call Elliot at (612) 337-6126 for a free consultation.


The Kane County Health Department (KCHD) announced that four more cases of Legionnaires’ disease have been diagnosed in residents at Covenant Living at the Holmstad in Batavia, Illinois, increasing the number of residents sickened to eight.

Four residents were hospitalized with Legionnaires’ disease last month at the senior living community, which is located at 700 West Fabyan Parkway.

“Two cases were reported to us this week, we received word of an early-onset case from mid-August, and an additional case reported this past Saturday,” KCHD’s news release quoted executive director Barbara Jeffers. “We are working closely with the Illinois Department of Public Health and Covenant Living to monitor this situation.”

Covenant Living outbreak: test results pending

Health officials have yet to locate the source of the Legionella bacteria, which causes Legionnaires’ disease.

“Water testing results are still pending with IDPH to determine if there is a source of Legionella bacteria on the Holmstad campus,” Amanda Gosnell, Covenant Living executive director, was quoted in the release. “However, because the safety of our residents, guests, and employees is our top priority, we have proactively and aggressively moved forward with several of the measures that could potentially be advised in the event of a positive result.

“We continue to collaborate closely with water management experts and state and the Kane County health departments and are following all recommendations; under their advisement, we continue to welcome visitors and maintain regular operations.”

Covenant Living outbreak: proactive measures taken

Since the initial report, Covenant Living officials have kept residents and employees informed of the situation and have been collaborating with both the state and county on proactive measures, the release stated.

More information about Legionnaires’ disease and updates on the outbreak can be found at KaneHealth.com/Pages/Menu-Disease.aspx.

In 2018, Illinois reported 512 cases of Legionnaires’ disease statewide. So far, 2019 has produced 251 confirmed illnesses.

Covenant Living outbreak: difficult diagnosis

Seek care from your health-care provider if you are a resident, employee or have visited Covenant Living recently and are feeling flu- or pneumonia-like symptoms, which usually develop two to 10 days after exposure to Legionella. Initial symptoms include:

  • headaches
  • muscle pains
  • chills
  • fever, which can be 104 degrees Fahrenheit or higher.

By the second or third day, symptoms can worsen to include:

  • cough, which can bring up mucus or blood
  • shortness of breath also called dyspnea
  • chest pains also called pleurisy
  • gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
  • confusion and other mental changes.

Anyone can get the disease, but those at the most significant risk of infection include:

  • people 50 or older
  • smokers (current or former)
  • heavy drinkers of alcoholic beverages
  • people with chronic lung disease, such as COPD (most commonly, bronchitis or emphysema)
  • people with weakened immune systems.
Covenant Living outbreak: warm water problematic

According to the Centers for Disease Control and Prevention (CDC), an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur in the United States every year. However, because of the disease’s vague symptoms, only 5,000 cases are reported.

A person contracts Legionella bacteria by Inhaling microscopic water droplets in the form of mist or vapor. The bacteria, which thrive in warm water, are found primarily in human-made environments, such as:

  • air-conditioning system cooling towers
  • large plumbing systems
  • water systems of large buildings (hospitals, nursing homes, hotels, etc.)
  • hot-water heaters and tanks
  • bathroom showers and faucets
  • swimming pools
  • whirlpools and hot tubs
  • physical-therapy equipment
  • mist machines and hand-held sprayers
  • decorative fountains.
Covenant Living outbreak: numerous complications

Hospitalization is almost always required after a diagnosis of Legionnaires’ disease. In the most severe cases, complications can occur, such as:

  • respiratory failure: caused by changes to the lung tissue, or oxygen loss in arteries supplying the lungs.
  • septic shock: this can occur when Legionella produce toxins that enter the bloodstream and cause a drop in blood pressure, leading to the loss of adequate blood supply to the organs.
  • kidney failure: those same Legionella toxins can damage the kidneys’ ability to eliminate waste from the blood, resulting in kidney failure.
  • endocarditis: an infection of the inner lining of the heart that can affect the ability of the heart to maintain adequate blood flow through the body.
  • pericarditis: swelling of the pericardium, which is the primary membrane around the heart. This can also affect the ability of the heart to circulate blood throughout the body.

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and other parts of the body, including the heart.

According to CDC statistics, about one out of every 10 people (10 percent) infected with Legionnaires will die due to complications from the illness.