A deadly outbreak of Legionnaires' disease at a North Carolina state fair is now responsible for killing two people, state health officials announced Thursday. Authorities are not publicly identifying the deceased.
Health officials have confirmed 134 cases of Legionnaires' disease, an airborne lung infection, or Pontiac Fever, a milder form of the disease, in residents of multiple states who attended last month's NC Mountain State Fair in Fletcher, North Carolina. Eighty-eight people have been hospitalized.
Health officials' interim report suggested that exposure to the Legionella bacteria occurred in one event center at the state fair, "particularly near the hot tubs and during the last five days of the fair," which went from September 6-15.
There were no other significant sources of aerosolized water -- small droplets of water or mist that can be inhaled -- at the event center, and no other ongoing potential sources of exposure identified, the health department said.
"Hot tubs are a well-established source of aerosolized water exposure and have been associated with previous Legionnaires' disease outbreaks nationally and internationally," according to the North Carolina Department of Health and Human Services.
Legionella bacteria are found naturally in the environment but can become a health concern when they "spread in human-made water systems like hot water tanks, cooling towers of air conditioning systems, decorative fountains and hot tubs or spas that are not properly maintained," North Carolina health officials have said.
Legionnaires' disease can be treated with antibiotics, but about 1 in 10 people who get sick from the disease die, according to the US Centers for Disease Control and Prevention.
"Legionnaires' disease is a serious illness which can lead to complications and death, especially in older individuals or those with underlying conditions," said NC State Epidemiologist Dr. Zack Moore. Symptoms are consistent with pneumonia.
There are approximately 200 cases reported annually in North Carolina, health officials say. About 7,500 US cases of Legionnaires' disease were reported in 2017, though it is known to be underdiagnosed, the CDC said. Its reported rate has risen by 550% since 2000.