There’s been an outbreak of Legionnaires’ disease in New Hampshire. Here’s what you need to know.

Legionnaires’ has left one person dead and 15 others ill in recent weeks.

Hampton, NH.  September 3, 2018.  A hotel in Hampton, N.H., has been ordered to take action after the bacteria that causes Legionnaires’ disease was detected in the hot tub, water heater, and shower and sink heads of three rooms, state health officials said Sunday.  Nine people who have stayed at The Sands Resort since July have contracted the disease.  Jeremy Fox/Globe Staff
A hotel in Hampton, N.H., has been ordered to take action after the bacteria that causes Legionnaires’ disease was detected. –Jeremy Fox / The Boston Globe

An outbreak of Legionnaires’ disease in a New Hampshire seaside town has left one person dead and 15 others ill in recent weeks.

The people who contracted the disease likely picked it up at the end of July or early August in Hampton, in the area of Ashworth Avenue, between Island Path and M Street, according to the New Hampshire Department of Health and Human Services. 

“Federal, state, and local authorities are working cooperatively and diligently to address this situation and help mitigate any additional health risks,” Gov. Chris Sununu said in a statement last week. “Through regular communication and transparency, we will ensure members of the public have the most up-to-date information so that they can make the best decisions for themselves and their families.”

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Here’s what we know about the outbreak and what a health expert says you should know about Legionnaires’ disease.

What’s going on with the New Hampshire outbreak?

The majority of those diagnosed with the illness “stayed or resided” near Ashworth Avenue, leading the state’s  to close hot tub spas at the Sands Hotel and the Harris Sea Ranch Motel last week.

“Symptoms will usually begin within two to 10 days after exposure to the bacteria,” officials said in a statement. “However, people should watch for symptoms for about two weeks after exposure. People who visited the area more than two weeks ago and have not developed symptoms are not at risk for disease. If an individual visited this area and developed symptoms within 14 days of their stay, they should contact their health care provider and seek medical attention.”

Officials have said the overall health risk to the community is “low” but urged those who might be at a higher risk for the disease, such as those with chronic lung diseases or weakened immune systems, to talk to their health care providers and consider postponing visits to the area.

Early testing by the state and Centers for Disease Control and Prevention identified the presence of Legionella bacteria in the water system at the Sands Resort, health officials said on Sunday. The hotel was ordered to “take immediate steps to remediate the Legionella bacteria identified at the facility and notify guests of the bacteria’s presence.”

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Testing is still underway for samples taken at other locations, according to the department.

“We are working hard to identify the exact source of these infections,” Lisa Morris, director of the state’s division of public health services, said in a statement. “Even though the information is preliminary, we want to allow the public to make informed decisions about visiting the area and their activities in the area.”

According to WMUR, the person who died was an elderly adult from out of state.

Separate from the Hampton outbreak, two cases of Legionnaires’ have been confirmed in Nashua, according to the station. One of the cases was confirmed to be contracted out of state, while the origin of the other remains under investigation.

“In Nashua, we’ve seen two cases this month of August, and we went through the process of interviewing both cases, and they are not related to the ones in Hampton,” Flavia Martin, public health nurse for Nashua, told WMUR.

What you need to know about the illness:

Paul Sax, clinical director of the division of infectious disease at Brigham and Women’s Hospital, said Legionnaires’ disease is a form of pneumonia caused by Legionella bacteria. The disease was first discovered in the 1970s.

“People contract Legionnaires’ by inhaling aerosols of contaminated water,” he said. “It would be sprays or mists. If the water supply is contaminated by Legionella, the bacteria, then people can inhale it into their lungs and catch it that way. It’s not typically acquired from human-to-human spread. That’s not how people get it.”

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Once you get it, he said, you’re not contagious to others.

But the bacteria can cause a very severe form of pneumonia. Sax said that like typical pneumonia, the symptoms of Legionnaires’ disease include cough, fever, and shortness of breath.

“Sometimes people will have symptoms that are outside of the respiratory tract, including headache, abdominal pain, diarrhea, just generally feeling very, very sick,” he said. “But the primary symptoms are respiratory.”

Symptoms like that should prompt a medical evaluation, particularly for people with compromised immune systems, lung disease, or cardiac disease.

The disease is treated with antibiotics, but Sax said it is important for Legionnaires’ to be diagnosed by a medical professional before starting medication because not all antibiotics treat the disease.

While Legionnaires’ isn’t the “most common” form of pneumonia, Sax said it is a disease that would be on the mind of doctors whenever someone is admitted to the hospital with severe pneumonia.

“The good news is that most people who come into contact with this bacteria do not get sick. Their immune systems just take care of it and they’re fine,” he said. “But if they start to develop symptoms like the ones I described … then they should be evaluated by a clinician and mention the fact that they’ve potentially been exposed to Legionnaires’.”