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Final Report Released on Legionnaires' Disease Outbreak

The Legionnaires’ disease outbreak linked to the Mountain State Fair impacted many people in our community and our thoughts are with all of those individuals and families who were affected.

On January 30, 2020, the Division of Public Health released a Final Outbreak Report (PDF) with findings from the investigation.

Legionnaires’ disease is a form of pneumonia (lung infection) caused by the Legionella bacteria. 

Most healthy people exposed to Legionella do not get Legionnaires’ disease. However, certain people are at higher risk of getting sick, including those 50 years of age and older, current or former smokers, and those with chronic lung disease or weak immune systems. Most people who get sick with Legionnaires’ disease recover with the use of antibiotics. However, the disease can be very serious and even cause death.

Legionnaires’ disease is spread through breathing in tiny water droplets containing the Legionella bacteria. According to the CDC, it is unlikely to be spread from person to person. Legionella bacteria can be found naturally in freshwater environments such as lakes and streams, and can become a health concern when it grows and spreads in manmade water systems such cooling towers, hot tubs, and decorative fountains. 

Work with Partners during Disease Outbreak Investigation:
Buncombe County Health and Human Services (BCHHS), like all local health departments in NC, investigates suspected cases of reportable communicable diseases in residents of our county. On September 23, 2019, BCHHS confirmed the first case of Legionnaires’ disease in a Buncombe County resident. Additional cases reported by medical providers and laboratories were confirmed throughout the day as Communicable Disease (CD) Nurses were interviewing ill patients and their families. The information gathered through those interviews was crucial to confirming the diagnosis and determining possible exposures. Due to the abrupt increase in cases of Legionnaires’ disease, CD Nurses immediately notified NC Division of Public Health (NCDPH). Experts at the NC Communicable Disease Branch reviewed reports from NC counties.  

BCHHS also alerts local medical providers when we are aware of increases in certain diseases or when we are aware of other public health threats to our community. On the morning of Tuesday, September 24, 2019, we alerted local medical providers of the increase in cases.

Legionnaires’ Outbreak Link to the Mountain State Fair:
On September 24, 2019, NCDPH notified the public of the possible link of Legionnaires’ disease at the Mountain State Fair and encouraged people who were sick and attended the fair to seek medical attention.

As NCDPH mentioned in their Interim Report, to reduce the risk of Legionnaires’ disease, it is important for individuals and businesses to properly maintain equipment that produces tiny water droplets, such as decorative fountains, hot tubs, and cooling towers.

We want to thank our local medical providers, hospitals and laboratories and ask that they remain vigilant in reporting communicable diseases to their local health departments. Without the help of medical providers who suspected, tested for, and reported Legionnaires’ disease appropriately, it would have taken longer to identify and address this outbreak. We also want to thank our county leadership, public health colleagues in Henderson and surrounding counties, as well as our state and federal partners for their support and hard work during this investigation.

Please reference recent updates from NCDHHS for information on the investigation: 


Table: News Item Documents
File NameSizeTypeDate & Time Added
Final Outbreak Report 2 MB 01/30/2020 10:19 AM
Public FAQ 339 KB 10/11/2019 9:22 AM
Fact Sheet: English 540 KB 09/24/2019 5:54 PM
Fact Sheet: Spanish 536 KB 09/24/2019 5:54 PM
Medical Provider Memo from NCDHHS 135 KB 10/10/2019 8:57 AM