Twelve passengers on two cruise ships contracted Legionnaires’ disease from hot tubs over a 20-month period, according to a new study from the Centers for Disease Control and Prevention (CDC). Legioannaires’ disease is a severe form of pneumonia people get when they inhale water vapor contaminated with Legionella bacteria.
To reduce the risk of transmission, cruise ship water management staff should adapt public hot tub maintenance and operations protocols on all onboard hot tubs including those on private balconies, researchers said.
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Cruise Ship A Legionnaires’ Disease Outbreak (November 2022–April 2024)
A total of eight passengers contracted Legionnaires’ disease during their voyages on Cruise Ship A that took place between November 2022 and April 2024
- Five passengers were on the same November 2022 voyage. Four cases were laboratory-confirmed, one case was probable.
- Between August 2023 and September 2023 two additional laboratory-confirmed cases were reported.
- Another case was reported in April 2024
To track the source of contamination for the first five passengers, 150 water samples were tested for Legionella between August 2022 and February 2023. “A single non-pneumophila Legionella detection was identified in the potable water system during that time (August 2022),” according to the report. All potable water samples were within control limits. No Legionella was detected in water samples from the cabins of infected patients, heat exchangers, potable water tanks, decorative fountains, recreational areas and public hot tubs in common areas.
The sixth patient became ill In August 2023 after using a private balcony hot tub. The CDC requested the closure of all 10 private balcony hot tubs on the ship. Water from these hot tubs was then collected and tested. Legionella was detected in six of 10 hot tubs.
In March 2024, when the eighth patient became ill, 300 water samples were collected, and no Legionella was detected.
Cruise Ship B Legionnaires’ Disease Outbreak (January–June 2024)
Between February 2024 and July 2024, four passengers aboard Cruise Ship B contacted Legionnaires’ disease. Two cases occurred during the same voyage in January 2024. The other passengers sailed on February and May voyages. All four patients were hospitalized.
In response to reports of illness, the CDC requested the closure of all hot tubs on the ship. Water tests found L. pneumophila serogroup 1 (Lp1) and Lp2–14 species in all eight private balcony hot tubs on the ship, and Lp2–14 in a single location in the potable water system.
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