A recent report from the Centers for Disease Control and Prevention (CDC) identifies private balcony hot tubs as the likely culprit behind two Legionnaires' disease outbreaks aboard a pair of cruise ships.
The CDC learned of about a dozen cases among passengers on two ships between November 2022 and June 2024. However, the report did not identify the ships or the cruise lines.
Legionnaires' disease is a serious type of pneumonia that often causes symptoms such as cough, fever, headaches, muscle aches and shortness of breath.
Eight people were infected on the first vessel—which the CDC referred to as cruise ship A—while four fell ill on the second ship, cruise ship B. Of the 12 ill passengers, 10 were hospitalized. No deaths were reported.
"Epidemiologic data collected from patient interviews and environmental assessment and sampling results identified private hot tubs on selected cabin balconies as the most likely exposure source," the CDC states in the report.
Officials discovered legionella in six of the first ship's 10 private balcony hot tubs. "The hot tubs remained closed until their operation and maintenance protocols were modified and nondetectable Legionella sampling results were obtained," the CDC said.
Fortunately, the cruise lines included in the report took steps to prevent further infection.
"Both cruise lines ultimately modified the operation and maintenance of the private hot tubs so that heating elements were removed; tubs were only filled upon guest request, drained between uses, and cleaned and disinfected more frequently," according to the report.
Experts point out that it's common for small amounts of legionella to be present in the water cruise ships use for drinking, showers and other amenities but that the quantity isn't enough to make passengers sick. The bacteria is more likely to thrive in hot tubs because of the warm water.
The disease is not limited to cruise ships, however, as Caesars Palace in Las Vegas was recently impacted.
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