Legionnaires' disease cases may be linked to cooling tower in Lincoln

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New Hampshire health officials are asking people to be aware of potential risks before going to an area of downtown Lincoln after an outbreak of Legionnaires' disease.

The Department of Health and Human Services said five people developed the illness in June and July, and they might have been exposed to contaminated water droplets from a cooling tower.

>> NH DHHS information about waterborne diseases | CDC information about Legionella bacteria

In the advisory issued Monday, HHS said the cooling tower behind the Riverwalk Resort in downtown Lincoln is still in operation while remediation efforts are underway.

"A cooling tower is something that is used for air conditioning to cool the air down, but it uses a water source and fans blowing water into the air," said Dr. Benjamin Chan, the state epidemiologist.

Legionnaires' disease is a form of pneumonia caused by inhaling water droplets contaminated with Legionella bacteria.

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Because the cooling tower is still in operation, HHS officials said there might be a continued risk of exposure to the public, especially for people within a half-mile radius of tower.

"So, we want the public to be aware that there is this area of contamination. It may still pose a risk to the public, and that people, particularly if they have health conditions that put them at higher risk, should take note and sort of assess their own health risk before traveling to this small area of Lincoln," Chan said. "Again, it's not all of Lincoln. It's about a half-mile radius around where this cooling tower is that poses the highest risk of exposure to Legionella bacteria."

Riverwalk vice president Renee Blood said that the cooling tower has been sanitized.

"Initial remediation started Friday morning and was completed by Barclay Water Management Services this morning, Monday, Aug. 12," Blood said in a written statement. "After complete sanitation, the cooling tower was put back into full operation as discussed with the State. Out of an abundance of caution, additional testing will be performed later this week."

Chan said it's important to have the cooling tower running again so that new tests can be done to confirm that the contamination has been cleared.

HHS said anyone visiting the Main Street area should assess their health risk. Most people who are exposed to Legionella don't get sick, but those who are older, are current or former smokers, have weakened immune systems or have certain medical conditions such as diabetes or chronic lung disease are at higher risk.

>> Related: What is Legionnaires' disease?

Symptoms usually begin two to 14 days after exposure and can include fever, cough and shortness of breath. Cases can be fatal if left untreated.

People can get sick from contaminated water systems, such as hot tubs or showers, but infections don't spread from person to person.

This isn't the first time New Hampshire has seen an outbreak of Legionnaires' disease. In 2023, a woman from Massachusetts died after contracting Legionnaires' while staying at Mountain View Grand Resort.

At least five people were sickened while staying at the Meredith Woods and Clearwater Campground between fall of 2021 and January 2023. That outbreak wasn't investigated until two years after the first case.

In 2018, 34 people contracted the disease in Hampton Beach. One person died. A report linked those cases to the hot tub or potable water system at The Sands resort.