Lee S, Edens C, Ritter T, Rodriguez LO, Tardivel K, Kozak-Muiznieks NA, Willby M, Ortiz N, Cohen AL, Smith JC. MMWR Morb Mortal Wkly Rep. 2024 Oct 24;73(42):950-954.
Highlights:
• During November 2022-June 2024, CDC was notified of 12 cases of Legionnaires’ disease among travellers on two cruise ships.
• Epidemiologic data identified private hot tubs on selected cabin balconies as the most likely exposure source.
• To minimise legionella growth, both cruise lines modified the operation and maintenance of these devices by removing the heating elements, draining water between uses, and increasing the frequency of hyperchlorination and cleaning.
• Private hot tubs on cruise ships are not subject to the same maintenance requirements as are public hot tubs in common areas.
• It is important for cruise ship water management programme staff members to inventory and assess private balcony hot tubs and adapt public hot tub maintenance and operations protocols for use on private outdoor hot tubs.






