A 53-year-old woman died early Thursday at the University Hospital in Cleveland, Ohio, after being diagnosed with Legionnaires’ disease, health officials said. The infectious bacterial disease, which killed six people in two separate outbreaks in 2013 in Ohio, has claimed 10 lives and infected at least 100 people in New York City in the past month.

University Hospital said that the woman, Elaine Stacer of Brunswick, was very ill when she was admitted to the facility. She was admitted to a different hospital on July 24 before being brought to the hospital she died in, officials said, according to a report from a local ABC News affiliate. Family members reportedly said that Stacer was a healthy woman before the infection but suffered a stroke after the diagnosis.

Officials said it was not clear how Stacer contracted the disease and, according to reports, added that local health officials will investigate her death. Between 8,000 to 18,000 people are reportedly infected with the disease in the U.S. annually.

Legionella, the bacteria that causes Legionnaires’ disease, breeds in warm water in places like hot tubs, cooling towers, hot water tanks, large plumbing systems and decorative fountains, and spreads through mist or vapor. The disease does not spread from person to person, according to the Centers for Disease Control and Prevention (CDC).

Symptoms include cough, shortness of breath, high fever, muscle aches and headaches, and can begin showing within two to 14 days after a person has been exposed to the bacteria, which also causes Pontiac fever, a milder form of Legionnaires’ disease, according to the CDC. While infected people recover on their own from Pontiac fever, antibiotics are required to cure Legionnaires’ disease, which may cause lung failure and prove fatal in some cases.

In New York City, the outbreak of the respiratory illness has been seen in the South Bronx and Dr. Mary T. Bassett, the city’s health commissioner, ordered Thursday that buildings with water-cooling towers must assess and disinfect units in the next two weeks. The outbreak in the city began last month and the death toll so far is the highest from the condition in the city’s history, the New York Times reported. Legionnaires’ disease is reported in an average of 539 people in New York state each year.

Mayor Bill de Blasio is expected to provide more details about a legislative plan, announced this week, on Friday to tighten the regulation of the cooling towers. “Everyone understands that the outbreak has been limited to one community in our city,” de Blasio said Thursday, according to the Times, adding: “But we are doing this out of an abundance of caution.”