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Health officials in North Carolina announced several new developments in the state’s recent legionellosis outbreak:
- A fourth person has died from Legionnaires’ disease linked to the outbreak connected to NC Mountain State Fair in Fletcher last month. The North Carolina Department of Health and Human Services (NCDHHS) did not provide any additional information on the victim.
- A new, unrelated case of Legionnaires’ disease was confirmed two weeks after the fair ended. This most recent victim is a person who attended the Asheville Quilt Show in the Davis Event Center – the same building that has been identified as the outbreak source.
- Due to the newest illness, the Davis Event Center in the WNC Ag Center has been closed until the air conditioning system can be checked by an “industrial hygienist,” according to WLOS.com.
Carolina outbreak: hot tubs
The outbreak has been traced to hot tubs on display in the Davis Event Center, specifically during the last five days of the 10-day fair, which was held Sept. 6-15.
No new cases had been linked to the outbreak with an onset date more than two weeks after the end of the fair, until the announcement that an attendee at the Asheville Quilt Show held Sept. 27-29 had been diagnosed with Legionnaires’ disease.
“We don’t know how or where this person might have been exposed to the Legionella bacteria,” Dr. Zack Moore, the state epidemiologist, told WLOS.com. “It is possible that they were exposed at the WNC Ag Center, but Legionella bacteria are very common in the environment. So, we can’t rule out exposure in another location.”
Because of this latest development, WNC Ag Center general manager Matt Buchanan said the Davis Event Center would be closed again until it has been given a new clean bill of health
“They have looked at it before – the CDC did – and saw nothing wrong with it,” Buchanan said. “But we’re going to actually run some really hard tests on it to make sure there is no evidence at all there.”
Carolina outbreak: 95 hospitalized
In addition to the four deaths, other case characteristics compiled by the NCDHHS, through Oct. 21, are as follows:
- A total of 142 people have been sickened, 134 with Legionnaires’ disease and eight with Pontiac fever, a milder form of legionellosis that does not affect the lungs.
- Eighty-two victims (58 percent) are male, and 59 are female.
- The victims’ ages are between 24 and 91, with a median age of 61. (Note: People over the age of 50 are particularly susceptible to Legionella.)
- Ninety-five people (69 percent) have been hospitalized.
- Four victims have died.
- There are 10 out-of-state cases.
Carolina outbreak: difficult diagnosis
Legionnaires’ disease, which is also called Legionella pneumonia, is contracted by inhaling microscopic aerosolized water droplets (vapor or mist) contaminated with Legionella bacteria (Legionella pneumophila).
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)
Carolina outbreak: symptoms
Legionnaires’ disease is a severe type of pneumonia or lung infection that – according to the CDC – sickens an estimated 25,000 Americans yearly. Because of the disease’s nonspecific symptoms, however, only 5,000 cases are reported.
The disease frequently begins with the following symptoms:
- muscle pain
- 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.