KNOXVILLE, Tenn. — A rare pneumonia claimed the lives of two people in North Carolina and sent 88 others to the hospital. Medical experts in the state said they were exposed to Legionnaires' Disease at a fair.
North Carolina state investigators said a hot tub display at the N.C. Mountain State Fair in September was responsible for a total of 134 cases of the disease.
The CDC said that the legionella bacteria spreads through small airborne water droplets.
Experts said while a Legionnaires' outbreak like the one in North Carolina isn't very common, the bacteria can be transmitted through the air in mist from things like air conditioners, fountains and hot tubs that haven't properly been cleaned.
Tony Campbell, the president of Campbell's Pool and Spa in Knoxville, said he's seen isolated cases of diseases from hot tubs, but never anything of this magnitude.
"Most people do things right when it comes to a hot tub," Campbell explained.
Campbell has been in the hot tub business for 35 years, and was shocked when he heard the news of the North Carolina outbreak, especially because the people effected weren't even inside the hot tubs on display.
He said at a fair or trade show, the water in the display tubs should be drained at the end of the day every day because you never know who might have come in contact with that water.
"It's hot water, it's warm, it's where all that stuff likes to grow, and then you put it up, you fill it up and you've got the cover off, you're basically diffusing some type of bacteria," Campbell noted.
He said the best way to prevent the growth in a personal hot tub is to take the proper sanitizing steps.
"You've got to clean the surface and you've got to clean the jets, you've got to clean the filters, and if none of those things are being done then yeah you can get all kinds of weird bacteria growing in that because it's hot water," Campbell explained.
Dr. Mark Rasnake, an infectious disease physician at UT Medical Center, said people don't usually know they're breathing in the bacteria.
"So you can walk by and breathe them into your lungs and not really notice anything different and they can cause an infection," Rasnake listed.
He said anything you own that aerates fresh water, check and clean it regularly.
"If you have something bubbling, air conditioner units, or misters or hot tubs or different things like that, it just sprays these bacteria out into the air and kind of like a fog," Rasnake explained.
Rasnake said the disease can be treated with antibiotics and is not transmitted from person to person. Just like with many infectious diseases, he warns young children and older people are more at risk.
The Knox County Health Department reports it has seen 13 cases of Legionnaires' Disease so far in 2019. In 2018, there were 19 cases total. Between 2014 and 2018, the average number of cases was 15.