Thursday, October 10, 2019

NCDHHS Releases New Information on the Legionnaires' Disease Outbreak in WNC

<p><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:black">Officials with the North Carolina Department of Health and Human Services&rsquo; Division of Public Health today released an interim report and FAQ related to the investigation into the Legionnaire&rsquo;s disease outbreak associated with the NC Mountain State Fair.</span></span></span></p>
Oct 10, 2019

Officials with the North Carolina Department of Health and Human Services’ Division of Public Health today released an interim report and FAQ related to the investigation into the Legionnaire’s disease outbreak associated with the NC Mountain State Fair.

As of Oct. 9, the Division of Public Health has confirmed 134 cases of Legionnaires’ disease or Pontiac Fever in residents of multiple states and North Carolina counties who attended the 2019 NC Mountain State Fair, which took place Sept. 6–15, 2019 at the Western North Carolina Agricultural Center in Fletcher, NC. Eighty-eight people have been hospitalized and two deaths have been reported. To protect the privacy of the families, the decedents’ personal information including location of residence, ages and genders will not be released.

“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, 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 interim report outlines the timeline and process that the Division of Public Health, the North Carolina Department of Agriculture and Consumer Services, the Buncombe County Department of Health and Human Services, other local health departments and the Centers for Disease Control and Prevention (CDC) used throughout the investigation.   

The preliminary epidemiologic and environmental findings suggest that exposure to Legionella bacteria occurred in the Davis Event Center of the WNC Ag Center, particularly near the hot tubs and during the last five days of the fair. Hot tubs are a well-established source of aerosolized water exposure and have been associated with previous Legionnaires’ disease outbreaks nationally and internationally. These results highlight the importance of caring for and maintaining equipment that can aerosolize water.

There were no other significant sources of aerosolized water at the WNC Ag Center and no other ongoing potential sources of exposure identified. 

This report provides preliminary information from the investigation to date. Additional information will be provided when the environmental and epidemiologic investigations are complete.   

Legionella bacteria are found naturally in the environment. These bacteria can become a health concern when they grow and spread in human-made building water systems like hot water tanks, cooling towers of air conditioning systems, decorative fountains and hot tubs or spas that aren’t properly maintained. Approximately 200 cases are reported annually in North Carolina. If you experience symptoms consistent with pneumonia, please contact your health care provider.

Updated case counts and information about the outbreak are available online at The FAQ can be found at and the Interim Summary Report at

More information about Legionella bacteria and Legionnaires' disease can also be found on the CDC website at and on the DPH website at

For additional information or to report possible cases, please call your local health department or the NCDHHS Division of Public Health at (919) 733-3419. In Buncombe County, call BCHHS Communicable Disease at (828) 250-5109. In Henderson County, please call (828) 694-6019.