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.