News 13 Investigates: Questions linger months after Legionnaires' outbreak
It's being called the largest Legionnaires' outbreak in the U.S. in recent history.
On Sept. 22, 2019, the Buncombe County Health Department noticed a spike in patients with the disease. Around the same time, the Henderson County Health Department was alerted to the same situation there, and the state was notified the next day.
From there, the number of cases just kept growing and fairly early on, health officials realized the common link -- the Mountain State Fair.
Five months later, the State Department of Public Health has confirmed 141 cases of Legionnaires' Disease or Pontiac Fever. Officials say 94 people were hospitalized and 4 people died.
The same officials have also determined that hot tub displays inside the Davis Event Center spread the dangerous bacteria.
But some Legionnaire's experts believe the blame stretches back farther and wonders if anyone else should be held accountable.
'Doctors told my family I was going to die'
Al Rioux is 83 years old.
He's from New Hampshire and retired in 2006.
Over the past few years, he's become a full-time RV'er, travelling across the country with his partner, Pat.
He says they spend several months in Florida, then the rest of the year in Hendersonville, North Carolina.
That's where they were staying when they made a trip to the Mountain State Fair in September.
Rioux says he remembers returning home that night, but doesn't remember much else since he slipped into a coma.
"Went to bed one night and that was it," said Rioux. "Well, the doctors told my family and friends that I was going to die."
He says his kidney failed, part of his heart shut down, and his healthy 83 year old body was suddenly gone.
"When I woke up just about all my muscles were gonzo," said Rioux.
Since then, he's been either in the hospital or a rehab facility, trying to recover.
He says the worst part is that he also lost his love.
"Every time I think about her I cry," said Rioux.
His partner for nearly four decades has her own medical needs and was forced to move away.
"Being here, she couldn’t be with me, but just the same it’s terrible, when you’ve never been separated, it’s hard, it’s the worst," said Rioux.
Rioux said he believes one walk through the WNC Ag Center on the last day of the fair stole his entire life.
The source
Although officials quickly realized the outbreak centered around the fair, finding the exact source was a much harder question.
So, News 13 went to Raleigh to ask the buildings' owners exactly what went wrong.
The State Department of Agriculture's Assistant Commissioner Sandy Stewart says the investigation ultimately found that hot tubs displayed inside the Davis Event Center were the source of the Legionella bacteria.
"We went through the building very closely and throughout that whole thing there was no significant sources of aerolsolized water found there," said Stewart.
Stewart is confident that the Ag Center is now safe. He told News 13 an entire system clean out was done and he's confident the water is fine.
The State Department of Public Health did not comment on whether there could have been another source.
News 13 did speak to someone by phone and was told an on camera interview would be possible when the final report was complete. That's expected by February 2020.
But, the fair ended a week before anyone got sick, so testing was difficult.
The Health Department said 27 samples taken from the Ag Center and hot tubs showed no signs of Legionella that matched the strain of the patients' sickness.
Instead, the investigation revolved around interviews with each of the 141 people who got sick, or family members, plus a secondary survey.
Health officials said that information pointed straight to the hot tubs, and the hot tubs only.
"What we know about the report, it seems like the source was most likely the aerolsolized water from those hot tubs," said Stewart. "We don't have any indication that it was anything wrong with the systems or anything like that ahead of time." Stewart.
News 13 also requested records for the HVAC and fire sprinklers systems at the Ag Center over the last year.
They show no major issues, water tests that passed inspection, and routine maintenance in the weeks surrounding the fair, including an AC tune up at the Davis Event Center on August 28, 2019.
Who's to blame?
But, the Alliance to Prevent Legionnaires' Disease says many times, contamination happens before it's transmitted into the air.
Daryn Cline told News 13 often it's the water source or a buildings' water system that helps the bacteria to grow.
"I can only speculate and assume that there is a probability without having science and details I couldn't confirm that," said Cline.
News 13 asked if the responsibility stretches farther back from the transmission source.
Cline admits, "That's a difficult question. I would say that it's a multiple responsibilities for many parties."
North Carolina, like most states, does not require Legionella testing, but the Alliance says what's in the water and what's happened to the water tells a lot.
The Ag Center gets its water from the City of Asheville, specifically the Mills River Treatment Plant.
A city spokesperson told News 13 samples taken at the building in the days following the outbreak showed acceptable levels of chlorine and the absence of coliform.
Water quality results online in the weeks leading up to the fair show a boil water advisory and some missing data, but no indication of contamination.
The City of Asheville wouldn't do an interview but maintains the water was clean.
Dr. Janet Stout with Special Pathogens Laboratory has been researching Legionnaires' disease for more than 30 years.
"I think the things that might be frustrating to you and your viewers we can't say for sure this is exactly what happened at this point in time," said Dr. Stout.
She says without a positive DNA match between a water sample and an infected patient, the exact source is difficult to pinpoint.
Attorney Jory Lange specializes in Legionnaires' cases and believes the blame stretches beyond the hot tub companies.
Lange elaborated on who typically pays in these cases.
"Anyone who was responsible for treating the water and keeping the water in a safe supply, and anyone who was responsible for transmitting the water vapor containing that deadly bacteria into the air," said Lange.
Rioux has also hired an attorney and still has questions about how the outbreak unfolded.
"Say it was from the building water, at least now that they know it could happen, now at least they could test it," said Rioux.
He told News 13 he doesn't want to get angry, he just wants to get better.
"Just have to live with it, I can’t change it, but I can work like the dickens to try to improve my situation the best I can," said Rioux.
Neither of the hot tub vendors would comment for this story.
But because of this outbreak, the CDC announced a new set of regulations when it comes to hot tub displays.
Other states have passed stricter guidelines for testing and prevention of Legionnaires' as well.
However, right now there are no discussions to do any of that here in North Carolina.
