CDC Links Hot Tubs to Legionnaires’ Disease Outbreaks on Cruises

A recent report from the Centers for Disease Control and Prevention (CDC) has identified private balcony hot tubs as the likely source of two Legionnaires’ disease outbreaks aboard cruise ships. The report reveals that between November 2022 and June 2024, approximately a dozen cases of the illness were reported among passengers, although the specific ships and cruise lines were not disclosed.

Legionnaires’ disease is a severe form of pneumonia characterized by symptoms such as cough, fever, headaches, muscle aches, and shortness of breath. The CDC report indicates that eight individuals were infected on the first vessel, referred to as cruise ship A, while four passengers fell ill on the second vessel, cruise ship B. Out of the 12 affected passengers, 10 required hospitalization, but fortunately, there were no fatalities.

The CDC’s investigation, based on patient interviews and environmental assessments, pinpointed private hot tubs on selected cabin balconies as the primary exposure source for the infections. Legionella bacteria were found in six of the ten private balcony hot tubs on the first ship. Following these findings, the hot tubs remained closed until their operation and maintenance protocols were revised to ensure safety and eliminate the presence of Legionella.

In response to the outbreak, the cruise lines involved implemented new operational measures. Both companies modified their hot tub protocols by removing heating elements, ensuring that the tubs were only filled upon guest request, draining them between uses, and increasing the frequency of cleaning and disinfection.

Experts note that while small amounts of Legionella can exist in the water used for drinking and showers on cruise ships, the bacteria typically do not reach levels sufficient to cause illness. Hot tubs, however, provide a warmer environment where the bacteria can thrive, increasing the risk of infection.

It’s important to recognize that Legionnaires’ disease is not confined to cruise ships. Recently, Caesars Palace in Las Vegas also experienced issues related to the illness, highlighting the broader implications of waterborne pathogens in various settings.

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