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Legionnaires’ disease outbreak linked to cruise ship hot tubs, CDC says

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Legionnaires’ disease outbreak linked to cruise ship hot tubs, CDC says

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Recent outbreaks of Legionnaires’ disease have been linked to U.S. cruise ship hot tubs, according to reports.

Private outdoor hot tubs on the balconies of two cruise ships were pinpointed as the source of multiple infections between November 2022 and June 2024, as stated in a report last month from the Centers for Disease Control and Prevention (CDC).

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“Epidemiologic, environmental and laboratory evidence suggests that private balcony hot tubs were the likely source of exposure in two outbreaks of Legionnaires’ disease among cruise ship passengers,” the CDC said in the report.  

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Hot tubs can foster Legionella bacteria due to their warm temperatures, which are ideal for bacterial growth, according to Waleed Javaid, MD, epidemiologist and director of infection prevention and control at Mount Sinai Downtown in New York. 

Recent outbreaks of Legionnaires’ disease have been linked to U.S. cruise ship hot tubs, according to reports. (iStock)

“The bubbling and aerosolization make it easy for bacteria to be inhaled, which is the primary way people get infected,” Javaid, who was not affiliated with the CDC report, told Fox News Digital.

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What to know about Legionnaires’ disease

Legionnaires’ disease is a type of pneumonia caused by Legionella bacteria. 

The bacteria can grow in any area where water sits for a long time, according to Dr. Andrew Handel, a pediatric infectious diseases expert at Stony Brook Children’s Hospital on Long Island, New York.

When people swallow or breathe in droplets of water that contain Legionella, they can potentially become ill.

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Although human transmission is possible in rare cases, the disease is not typically spread from person to person, per the CDC.

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Infections can lead to severe pneumonia in older people and those with compromised immune systems, Handel warned.

Hot tub pool cruise ship

Private outdoor hot tubs on the balconies of two cruise ships were pinpointed as the source of multiple infections between November 2022 and June 2024. (iStock)

“Legionella infections cause symptoms that are similar to other forms of pneumonia — fever, coughing, difficulty breathing, shortness of breath and chest pain,” said Handel, who also was not involved in the CDC report.

Some patients may also experience nausea, diarrhea and confusion, the CDC noted. 

A medical professional can diagnose the infection with laboratory tests and chest X-rays.

Hot tub maintenance

To reduce the risk of bacterial growth and transmission, the CDC recommends that cruise ship staff members apply the stricter public hot tub maintenance and operations protocols when using private outdoor hot tubs. (iStock)

The condition is typically treated with antibiotics. In cases of severe infection, hospitalization may be required for breathing support and IV hydration.

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Around 10% of people who contract Legionnaires’ disease will die from those complications — and the mortality risk rises to 25% for those who get Legionnaires’ while staying in a health care facility, according to the CDC.

Around 10% of people who contract Legionnaires’ disease will die from complications, according to the CDC.

If someone suspects they were exposed to Legionella bacteria, it is important to see a health care professional right away, as early intervention may increase the chances of a full recovery, infectious disease experts told Fox News Digital.

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“If you’ve recently used a hot tub and are worried about Legionnaires’ disease, watch for symptoms like cough, shortness of breath, fever, muscle aches and headaches,” which can appear anywhere from two to 14 days after exposure, Javaid advised.

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“Act quickly if you notice these signs, especially if you fall into a vulnerable category,” he added.

The CDC’s findings

Twelve cases of Legionnaires’ disease were reported among cruise ship passengers on two different vessels, according to the CDC report. 

Out of the dozen sickened individuals, 10 were hospitalized. No deaths were reported. 

The cruise ship companies were not identified in the report, and were only named as cruise ships A and B.

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The CDC determined that the private hot tubs were operating in ways that fostered Legionella growth. 

These conditions included water running at temperature ranges of 77 to 113 degrees Fahrenheit for several days, “without draining and operating with no residual disinfectant,” according to the report.

The report also noted that individuals could have been exposed without using the hot tubs, which were located near outdoor areas where aerosols could be disseminated.

Legionella bacteria

Legionnaires’ disease is a type of pneumonia caused by Legionella bacteria, which can grow in any area where water sits for a long time. (iStock)

Private hot tubs on cruise ships are subject to “less stringent operating requirements than public hot tubs,” the agency noted.

Ships A and B did adhere to the current CDC requirements for operating and maintaining private hot tubs, but these steps were not sufficient to prevent Legionella growth.

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The cruise ships cooperated with the investigation and made efforts to mitigate Legionella growth, per the CDC report.

WHAT TO KNOW ABOUT LEGIONNAIRES’ DISEASE, THE LUNG INFECTION REPORTED IN NEW HAMPSHIRE

To reduce the risk of bacterial growth and transmission, the CDC recommends that owners and operators of hot tubs follow safe operation and maintenance procedures to prevent exposure to Legionella. 

“Additionally, an automatic disinfectant dosing system, rather than handfeeding disinfectant, is an important design feature to help prevent growth,” the CDC said in a statement sent to Fox News Digital.

Enjoying hot tubs safely

The experts shared steps people can take to minimize exposure to bacteria when using hot tubs.

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“I advise people who are worried to stay informed, but not alarmed,” Javaid said. 

      

“I also advise keeping an eye on the hygiene standards of hot tubs in public spaces, especially if you are someone at higher risk.”

It’s reasonable for cruise-goers to ask questions about how hot tubs are maintained and disinfected, Javaid said, and it’s best to avoid hot tubs that “smell strange or seem poorly kept.”

“The hot, stagnant water has the potential to transmit a number of harmful bacteria and viruses that can cause severe illness in high-risk individuals.” 

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“Certain populations should exercise extra caution, including individuals of advanced age, smokers, people with chronic lung conditions and immunocompromised people,” the expert added, noting that these groups are particularly vulnerable to Legionnaires’ disease.

Handel echoed that hot tub owners should follow health guidance on maintaining sterile water and machinery.

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“While properly maintained hot tubs can be safe, people who are older or are immunocompromised may want to speak with their medical providers before using one,” Handel cautioned. 

“The hot, stagnant water has the potential to transmit a number of harmful bacteria and viruses that can cause severe illness in high-risk individuals.” 

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Lung infection

Legionella infections can lead to severe pneumonia in older people and those with compromised immune systems. (iStock)

The CDC provided the following general recommendations to Fox News Digital.

“Some general practices to prevent Legionella as well as other waterborne germs at home include flushing faucets and showerheads after not using them or water pressure drops, cleaning and maintaining devices that use water (e.g. humidifiers, nasal rinses, showerhead and faucet aerators, water filters), and checking and flushing water heaters.”

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On a brighter note, Handel noted that there have been some improvements in water treatment and monitoring, which has resulted in Legionella infections becoming less common.

Currently, there are no vaccines for Legionnaires’ disease. 

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Senior man on oxygen

“Legionella infections cause symptoms that are similar to other forms of pneumonia — fever, coughing, difficulty breathing, shortness of breath and chest pain,” an expert said. (iStock)

Fox News Digital reached out to four popular cruise lines to discuss their hot tub maintenance protocol, but had not heard back as of publication.

Fox News’ Melissa Rudy contributed reporting.

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Mimic Ozempic’s Weight Loss Effects Naturally With a Keto-Based Diet

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Mimic Ozempic’s Weight Loss Effects Naturally With a Keto-Based Diet


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Breast cancer vaccine update from Cleveland Clinic: ‘A new era’

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Breast cancer vaccine update from Cleveland Clinic: ‘A new era’

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A breast cancer vaccine could be closer to reality, according to Cleveland Clinic, as its researchers have announced some encouraging results.

At the Society for Immunotherapy of Cancer earlier this month in Texas, researchers shared updated findings from a study of a new vaccine designed to target triple-negative breast cancer, a press release stated.

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Triple-negative breast cancer (TNBC) is a highly aggressive type of breast cancer, according to the American Cancer Society (ACS).

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TNBC grows and spreads faster than less aggressive types and is more difficult to treat.

G. Thomas Budd, M.D., lead study researcher, is pictured in the Cleveland Clinic lab. “The investigational vaccine represents a potential new way to combat breast cancer,” he said. (Courtesy of Cleveland Clinic)

The breast cancer vaccine that Cleveland Clinic is studying is the first that aims to prevent triple-negative breast cancer from developing, according to G. Thomas Budd, M.D., principal investigator of the phase 1 study at Cleveland Clinic’s Cancer Institute.

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The vaccine uses a protein found in breast tissue that is dedicated to lactation — called α-lactalbumin — which is no longer created after a woman is past childbearing age, Budd told Fox News Digital.

“Employing a retired lactation protein as a breast cancer vaccine autoantigen made sense because most breast cancers occur in women ages 40 and older, and the vast majority of those women no longer breastfeed,” he said.

Breast cancer vaccine lab

A researcher conducts a breast cancer vaccine-related experiment in a lab at Cleveland Clinic. The vaccine uses a protein found in breast tissue that is dedicated to lactation, called α-lactalbumin. (Courtesy of Cleveland Clinic)

This protein was selected because it is no longer found in detectable amounts in normal, aging breast tissues, but is expressed at high levels in more than 70% of triple-negative breast cancers, Budd shared.

“The investigational vaccine represents a potential new way to combat breast cancer,” he said.

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“It represents a paradigm shift in how we approach cancer care — focusing on prevention rather than treatment after the fact.”

In the Phase 1 trial, the researchers found that the investigational vaccine was “generally well-tolerated and produced an immune response in most patients,” according to a Cleveland Clinic press release. 

The team also presented the vaccine’s side effects, highest tolerated dose and immunologic effects, the release stated.

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The Phase 1 trial, funded by the U.S. Department of Defense, was conducted at Cleveland Clinic’s main campus in partnership with Anixa Biosciences, Inc., a California-based biotechnology company focused on treating and preventing cancer. 

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It included 26 patients in three separate groups.

Researcher in lab

A pharmacy research technican demonstrates a mock preparation of the new breast cancer vaccine. (Courtesy of Cleveland Clinic)

These findings come after nearly two decades of research by the late Vincent Tuohy, PhD, of Cleveland Clinic Lerner Research Institute, Budd noted.  

Next year, Anixa plans to launch a Phase 2 study to gauge the vaccine’s effectiveness.

“Our hope is that future studies will demonstrate that the antigen-specific T cell responses we observed translate to the prevention of triple-negative breast cancer recurrence,” Budd said.

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Fox News medical contributor Dr. Nicole Saphier called the development of breast cancer vaccines “groundbreaking and exciting.”

“It represents a paradigm shift in how we approach cancer care — focusing on prevention rather than treatment after the fact,” Saphier, who was not involved in the research, told Fox News Digital. 

Breast cancer vaccine

A vial of the breast cancer vaccine is pictured in the lab. “The entire cancer community eagerly awaits further advancements in this area, as it could usher in a new era of cancer prevention strategies,” a doctor said. (Courtesy of Cleveland Clinic)

“If successful, such vaccines could significantly reduce the incidence of breast cancer, saving countless lives and reducing the emotional, physical and financial burdens associated with cancer treatment.”

 

Breast cancer vaccine development is particularly important for high-risk individuals, the doctor noted — “but also presents a potential for broader public health benefits, helping to ease the societal and economic impact of cancer.”

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Added Saphier, “The entire cancer community eagerly awaits further advancements in this area, as it could usher in a new era of cancer prevention strategies.”

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What to know about actor Dave Coulier’s blood cancer: ‘Very aggressive’

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What to know about actor Dave Coulier’s blood cancer: ‘Very aggressive’

Dave Coulier, 65, announced on Tuesday that he has stage 3 non-Hodgkin lymphoma.

The actor and comedian, best known for his role as Joey Gladstone in “Full House” from 1987 to 1995, said he was diagnosed in October after experiencing an upper respiratory infection caused by major swelling in his lymph nodes. 

“Three days later, my doctors called me back, and they said, ‘We wish we had better news for you, but you have non-Hodgkin lymphoma, and it’s called B cell, and it’s very aggressive,’” he told People.

‘FULL HOUSE’ STAR DAVE COULIER DIAGNOSED WITH ‘VERY AGGRESSIVE’ CANCER

What is non-Hodgkin lymphoma?

Non-Hodgkin lymphoma (also known as non-Hodgkin’s lymphoma, NHL or lymphoma) is a blood cancer that originates in the white blood cells (lymphocytes) that are part of the body’s immune system, according to the American Cancer Society (ACS).

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Dave Coulier, 65, announced on Tuesday that he has stage 3 non-Hodgkin lymphoma. (Getty Images)

Every year, more than 80,000 Americans are diagnosed with NHL.

“Non-Hodgkin lymphomas are a diverse group of white blood cell cancers that can vary greatly in terms of how aggressive or indolent they are,” Dr. Joshua Strauss, an attending hematologist and medical oncologist at Advanced Care Oncology and Hematology Associates of the Atlantic Medical Group in Morristown, New Jersey, told Fox News Digital.

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Patients with aggressive types of NHL may develop rapidly growing masses that they can feel, or they may experience more general symptoms, such as fevers, night sweats and unintentional weight loss, noted Strauss, who has not treated Coulier.

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An important part of diagnosis is determining what type of lymphoma the patient has, according to the ACS.

Non-Hodgkin lymphoma

Non-Hodgkin lymphoma (also known as non-Hodgkin’s lymphoma, NHL or lymphoma) is a blood cancer that originates in the white blood cells (lymphocytes) that are part of the body’s immune system. (iStock)

“The type of lymphoma depends on what type of lymphocyte is affected (B cells or T cells), how mature the cells are when they become cancerous and other factors,” the organization states on its website.

Stages and treatment

Like other cancers, lymphomas are assigned a stage, from 1 to 4. 

People with stages 1 and 2 have “limited disease,” according to Strauss, while patients with stages 3 and 4 have “advanced disease,” where the disease has spread to multiple areas of the body. 

Every year, more than 80,000 Americans are diagnosed with non-Hodgkin lymphoma.

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“However, as opposed to some other cancers, prognosis in NHL is more affected by histopathology, which is the particular subtype as determined by the appearance of the cancer under the microscope,” the doctor said.

Depending on the subtype, some patients with stage 3 disease can have an “excellent prognosis,” Strauss said, with recent advances in treatment improving outcomes.

      

Aggressive non-Hodgkin lymphoma is typically treated with intravenous chemo-immunotherapy. 

“This is a cocktail of various chemotherapy drugs combined with an immune treatment that attacks the cancer cells while trying to spare normal cells,” Strauss said. 

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Chemotherapy

Aggressive non-Hodgkin lymphoma is typically treated with intravenous chemo-immunotherapy.  (iStock)

After several months of treatment, doctors typically use imaging to determine whether any cancer remains.

Coulier revealed in the “Full House Rewind” podcast that he started chemotherapy two weeks after his diagnosis, and preemptively shaved his head.

Who is at greatest risk?

While anyone can be diagnosed with NHL, there are several known risk factors.

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“People with autoimmune diseases or those who take medications to suppress the immune system may be at higher risk of developing NHL over time,” Strauss said. 

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NHL cells

“The type of lymphoma depends on what type of lymphocyte is affected (B cells or T cells), how mature the cells are when they become cancerous and other factors,” according to the American Cancer Society. (iStock)

Certain infections, such as HIV and Epstein-Barr infection, as well as exposure to chemicals such as pesticides, may increase risk, the doctor warned.  

“While NHL can occur at any age, risk increases as we get older,” he said.

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The cancer type has also been associated with smoking and obesity, Strauss said — “so quitting smoking and maintaining a healthy weight may be protective.”

Dave Coulier split

Coulier (left) is best known for his role as Joey Gladstone in “Full House” from 1987 to 1995 (right). (Getty Images)

Stephanie Giang-Paunon contributed reporting.

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