Nearly 50 people from a Utah chapel of the Church of Jesus Christ of Latter-Day Saints were hospitalized for carbon monoxide poisoning on New Year's Eve, law enforcement officials said.

The Sevier County Sheriff's Office said it received two calls on Sunday from the Monroe East chapel, about 170 miles south of Salt Lake City. The first was for a four-year-old girl who was experiencing breathing problems, and the second call came about an hour later for a man feeling ill who initially thought it was due to low blood sugar.

After another family said they suffered from headaches after returning home from church, the Monroe City Fire Department was called to the building to check for carbon monoxide poisoning, the sheriff’s office said. Crews found elevated levels of the gas and evacuated everyone. 

The church told NBC News the incident was due to a malfunction with the heating system, and it had closed the building until all safety concerns were lifted.

Sevier County Sheriff Nathan Curtis told USA TODAY on Tuesday 49 people were hospitalized for carbon monoxide poisoning, but no fatalities had been reported.

Curtis said he had never seen carbon monoxide poisoning on such a large scale before Sunday. He noted the incidents were more likely to occur in winter when heating systems are running constantly and encouraged people to get checked early if they feel ill.

Deaths from carbon monoxide are relatively rare in the United States. The Lancet Public Health tracked 28,900 deaths across the globe from unintentional carbon monoxide poisoning in 2021, while the Centers for Disease Control and Prevention estimates 420 people in the U.S. die each year from the poisonous gas.

Multiple counties transport injured to hospitals

In a town of about 2,500 people, emergencies like Sunday's poisoning require all hands-on deck in Monroe, Curtis said. Law enforcement from neighboring counties were called in to help get some people to hospitals more than 100 miles away, where the poisoning treatment, hyperbaric chambers, was available.

Curtis said ambulances started transporting people to hospitals at 8:30 p.m. Sunday and the last one returned at 10 a.m. Monday.

Hyperbaric chambers contain pure oxygen in high air pressure levels and are aimed at filling the blood with oxygen to repair tissues and restore the body.

Carbon monoxide poisoning can be difficult to catch since it has no smell or odor and causes some flu-like symptoms.

“On this scale, I've never seen it before,” Curtis said of carbon monoxide poisonings, noting he has witnessed multiple smaller cases throughout his law enforcement career, including some resulting in death.

Last month, officials suspected carbon monoxide poisoning in the deaths of three Missouri men. In May 2022, three U.S. tourists at a resort in the Bahamas died from the same gas. 

Carbon monoxide safety tips

The CDC warns people the risk of carbon monoxide poisoning increases in winter as temperatures plummet and heating systems are running continuously.

Carbon monoxide is found in fumes produced by vehicles warmed up in garages, stoves, lanterns, portable generators, furnaces and other appliances, according to the CDC. The gas can build up in enclosed spaces, which can be fatal to people and animals.

Carbon monoxide poisoning can cause headaches, dizziness, weakness, nausea, vomiting, chest pain and confusion, the CDC said. People who are sleeping or those who have been drinking alcohol can die from poisoning before feeling any symptoms.

The CDC recommends the following safety tips to prevent carbon monoxide poisoning:

• Get a carbon monoxide detector and regularly check its batteries
• Clears vents and flues of debris
• Get your heating system and water heater checked every year
• Don’t run any gas-powered engine like a car or generator in an enclosed space
• Don’t use a grill, lantern or portable camping stove inside a home, tent or camper