The hot tub exhibits at a state fair might be to blame for North Carolina’s recent outbreak of Legionnaires’ disease and Pontiac fever, which sickened more than 100 people and killed at least one, health officials said.
Visitors to the N.C. Mountain State Fair who developed the lung infections were more likely to have walked past the hot tub displays inside the Davis Event Center, where several vendor displays were housed, the North Carolina Department of Health and Human Services said in a news release on Thursday.
As part of the investigation into the outbreak, officials compared data compiled from fair attendees who got sick and those who did not. Those who got sick, according to officials, “were much more likely to have visited the Davis Event Center while at the fair and much more likely to report having walked by the hot tub displays compared to people who did not get sick.”
Officials said early testing found Legionella bacteria in at least one water sample taken from the center, but noted that results were pending from other samples.
“Legionella in one water sample is an important piece of the puzzle, but it does not tell us how so many people were exposed at this event,” Dr. Zack Moore, the state epidemiologist, said in the release.
To get Legionnaires’ disease or Pontiac fever, “you have to breathe in Legionella in aerosolized water, meaning small droplets like mists or vapors,” he said.
The state said that people who did get sick were more likely to have visited the fair, which took place from Sept. 6 to 15, during the latter half of its run. This was the 26th year for the fair, which features livestock shows, giant pumpkins and carnival rides and is held in Fletcher, N.C., about 110 miles west of Charlotte. In 2018, more than 100,000 people attended.
At least 124 cases of Legionnaires’ disease and Pontiac fever, a milder form of the infection without signs of pneumonia, have been reported. Coughing, muscle aches and headaches are among the symptoms for both.
After the initial findings, the North Carolina Department of Agriculture and Consumer Services said on Thursday that it “voluntarily decided to suspend rental of the Davis Event Center while it undergoes an aggressive and comprehensive mitigation plan.”
“This is being done out of an abundance of caution and to reassure event attendees, fairgoers and Ag Center employees that the center is safe for occupancy,” the agency said.
Legionella grows in fresh water environments, and can be found in a variety of places, such as shower heads and sink faucets, cooling towers, decorative fountains, and “hot tubs that aren’t drained after each use,” according to the Centers for Disease Control and Prevention.
While it is uncommon for these infections to be spread from one person to another, the agency warned that it may be possible under rare circumstances.
Current and former smokers, people over 50 and people with chronic lung disease or a weakened immune system are at risk of getting sick if they are exposed to Legionella bacteria, according to the C.D.C.