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.