AUGUSTA — The Maine Center for Disease Control and Prevention (Maine CDC) reported Monday the number of cases associated with an August 7 wedding and reception in Millinocket has increased to a total of 53.

Maine CDC case investigators have identified secondary and tertiary transmission of the virus, which means that it has spread to people who did not attend the wedding or reception but had close contact with individuals who were present at the event (secondary cases) and close contacts of the secondary cases (tertiary cases).

Currently, 41 confirmed and 12 probable cases are included in the outbreak investigation.

Cases have been identified in individuals ranging from 4 to 98 years old. The median age of cases is 41 years, with 23 percent of cases being younger than 18 years and 28 percent being older than 60 years of age.

Of the confirmed and probable cases, 83 percent reported experiencing symptoms of COVID-19.

On Friday, Millinocket Regional Hospital announced that an individual who had been admitted for treatment of COVID-19 has died. Maine CDC expresses condolences to the individual's family and loved ones. While this case is reflected in Maine CDC's cumulative COVID-19 case data, because the notification process can sometimes take multiple days, the death is not currently reflected in the data.

Social gatherings such as weddings and receptions pose an elevated risk for virus transmission, the Maine CDC said in a news release.

The possibility of COVID-19 transmission increases as the number of attendees increases, even when some attendees are indoors and others are outdoors. This is because outdoor attendees may reasonably be expected to come indoors and interact with others, increasing the possibility of COVID-19 transmission. Indoor gatherings pose extra risk compared to outdoor gatherings, given the challenges of ensuring adequate physical distancing and ventilation. Individuals who do not feel well or who believe they might have come in contact with the virus should not attend social gatherings of any size. Attendees should wear face coverings at all times other than when eating or drinking.

Anyone who believes they may have been exposed to the virus and/or who has symptoms of COVID-19 should call their health care provider before seeking medical care. COVID-19 symptoms include cough, fever, shortness of breath, fatigue, or body aches among many others. A comprehensive list of symptoms can be found here.

Maine CDC's Health Inspection Program on Thursday issued an Imminent Health Hazard citation to Big Moose Inn in Millinocket after an investigation determined that the number of reception attendees exceeded what is allowed under the Governor's Executive Order.

Those who attend social gatherings should follow physical distancing guidelines including wearing cloth face coverings when not eating or drinking and maintaining a distance of at least 6 feet between individuals and six feet between household groups as much as possible. Social gatherings at which people comingle, such as wedding receptions, are considered single gatherings even if part of it is inside and part of it is outside.

The number of individuals who can gather in a shared space must not exceed the limit established by the Governor's Executive Order, currently set at 50 people indoors and 100 people outdoors and fewer if the space cannot accommodate 5 people per 1,000 feet

Further breaking a gathering up into smaller groups is encouraged to reduce potential exposure.

If a space cannot accommodate the gathering limit without complying with the 6-foot distancing requirement, occupancy must be limited to allow for such compliance.

Any entity that violates the current emergency gathering rules as outlined in the Executive Orders of the Governor may be charged with a Class E crime that includes punishment of a fine up to $10,000, and the payment of civil damages to the State for its cost in contact tracing, testing, and otherwise determining the extent of certain community transmission.

Face coverings should be worn in public settings when physical distancing is not possible.

For general information about COVID-19 in Maine, contact 211 Maine by calling 211, emailing info@211maine.org, or texting your ZIP code to 898-211. For questions specific to cases or potential cases, individuals may also call Maine CDC at 1-800-821-5821.