Health
Legionnaires’ disease outbreak linked to cruise ship hot tubs, CDC says
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).
“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.
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.
Infections can lead to severe pneumonia in older people and those with compromised immune systems, Handel warned.
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.
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.
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.
“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.
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.
The cruise ships cooperated with the investigation and made efforts to mitigate Legionella growth, per the CDC report.
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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.
“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.”
“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.”
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.
“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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The first oral GLP-1 medication for weight loss has been approved for use in the U.S.
The Wegovy pill, from drugmaker Novo Nordisk, was cleared by the Food and Drug Administration to reduce excess body weight, maintain long-term weight reduction and lower the risk of major cardiovascular events.
Approval of the once-daily 25mg semaglutide pill was based on the results of two clinical trials — the OASIS trial program and the SELECT trial.
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The Wegovy pill demonstrated a mean weight loss of 16.6% in the OASIS 4 trial among adults who were obese or overweight and had one or more comorbidities (other medical conditions), according to a press release. In the same trial, one in three participants experienced 20% or greater weight loss.
The first oral GLP-1 medication for weight loss has been approved for use in the U.S. (iStock)
Novo Nordisk reported that the weight loss achieved with the pill is similar to that of injectable Wegovy and has a similar safety profile.
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“With today’s approval of the Wegovy pill, patients will have a convenient, once-daily pill that can help them lose as much weight as the original Wegovy injection,” said Mike Doustdar, president and CEO of Novo Nordisk, in the press release.
Novo Nordisk reported that the weight loss achieved with the pill is similar to that of injectable Wegovy and has a similar safety profile. (James Manning/PA Images via Getty Images)
“As the first oral GLP-1 treatment for people living with overweight or obesity, the Wegovy pill provides patients with a new, convenient treatment option that can help patients start or continue their weight-loss journey.”
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The oral GLP-1 is expected to launch in the U.S. in early January 2026. Novo Nordisk has also submitted oral semaglutide for obesity to the European Medicines Agency (EMA) and other regulatory authorities.
“Most side effects will be GI-related and should be similar to the injectable, such as nausea, vomiting and constipation,” an expert said. (iStock)
Dr. Sue Decotiis, a medical weight-loss doctor in New York City, confirmed in an interview with Fox News Digital that studies show oral Wegovy is comparable to the weekly injectable, just without the needles.
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Although the pill may result in better compliance and ease of use, Decotiis warned that some patients may not absorb the medication through the gastrointestinal tract as well as with the injectable version due to individual idiosyncrasies in the body.
“Most side effects will be GI-related and should be similar to the injectable, such as nausea, vomiting and constipation,” she said.
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“In my practice, I have found tirzepatide (Mounjaro and Zepbound) to yield more weight loss and fat loss than semaglutide by about 20%,” the doctor added. “This has been shown in studies, often [with] fewer side effects.”
More oral GLP-1s may be coming in 2026, according to Decotiis, including an Orforglipron application by Lilly and a new combination Novo Nordisk drug, which is pending approval later next year.
One expert warned that some patients may not absorb the medication through the gastrointestinal tract as well as with the injectable version. (iStock)
“There will be more new drugs available in the future that will be more effective for patients who are more insulin-resistant and have not responded as well to semaglutide and/or tirzepatide,” the doctor said. “This is great news, as novel drugs affecting more receptors mean better long-term results in more patients.”
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As these medications become cheaper and easier to access, Decotiis emphasized that keeping up with healthy lifestyle habits — including proper nutrition with sufficient protein and fiber, as well as increased hydration — is essential to ensuring lasting results.
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“If not, patients will regain weight and could lose muscle and not enough body fat,” she said.
Fox News Digital reached out to Novo Nordisk for comment.
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A study from Sweden’s Uppsala University discovered a link between microplastics and multiple sclerosis (MS).
The research, published in the journal Environmental International, discovered that exposure to two common environmental contaminants, PFAS and PCBs, could increase the risk of the autoimmune disease.
PFAS, or per- and polyfluoroalkyl substances, known as “forever chemicals,” are used in some common household products, such as non-stick cookware, textiles and cleaning products. They have also been found in drinking water throughout the U.S., according to the U.S. Environmental Protection Agency.
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PCBs, or polychlorinated biphenyls, are toxic industrial chemicals once widely used in electrical equipment before being banned decades ago, as stated by the National Institute of Environmental Health Sciences.
The new study findings were based on blood samples of 1,800 Swedish individuals, including about 900 who had recently been diagnosed with MS, according to a university press release.
PFAS, or per- and polyfluoroalkyl substances, known as “forever chemicals,” are used in some common household products, including non-stick cookware. (iStock)
The first phase of the trial studied 14 different PFAS contaminants and three substances that appear when PCBs are broken down in the body. These were then investigated for a link to the odds of diagnosis.
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“We saw that several individual substances, such as PFOS and two hydroxylated PCBs, were linked to increased odds for MS,” lead study author Kim Kultima said in a statement. “People with the highest concentrations of PFOS and PCBs had approximately twice the odds of being diagnosed with MS, compared to those with the lowest concentrations.”
The researchers then examined the combined effects of these substances and found that the mixture was also linked to increased risk.
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Fellow researcher Aina Vaivade noted that risk assessments should consider chemical mixtures, not just individual exposures, because people are typically exposed to multiple substances at the same time.
“We saw that several individual substances, such as PFOS and two hydroxylated PCBs, were linked to increased odds for MS,” the lead study author said. (iStock)
The final phase of the study investigated the relationship between inheritance, chemical exposure and the odds of MS diagnosis, revealing that those who carry a certain gene variant actually have a reduced MS risk.
However, individuals who carried the gene and had higher exposure to PFOS — a singular type of chemical in the PFAS family — had an “unexpected” increased risk of MS.
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“This indicates that there is a complex interaction between inheritance and environmental exposure linked to the odds of MS,” Kultima said.
“We therefore think it is important to understand how environmental contaminants interact with hereditary factors, as this can provide new knowledge about the genesis of MS and could also be relevant for other diseases.”
Multiple sclerosis is a disease that leads to the breakdown of the protective covering of the nerves, according to Mayo Clinic. (iStock)
Fox News senior medical analyst Dr. Marc Siegel commented on these findings in an interview with Fox News Digital.
“MS is a complex disease that is somewhat autoimmune and somewhat post-inflammatory,” said Siegel, who was not involved in the study. “Epstein-Barr virus infection greatly increases the risk of MS.”
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“There is every reason to believe that environmental triggers play a role, including microplastics, and this important study shows a correlation, but not causation — in other words, it doesn’t prove that the microplastics caused MS.”
The study had some limitations, the researchers acknowledged, including that the chemical exposure was measured only once, at the time of blood sampling. This means it may not accurately represent participants’ long-term or past exposure levels relevant to MS development.
“There is every reason to believe that environmental triggers play a role.”
Fox News Digital reached out to several industry groups and manufacturers requesting comment on the potential link between PFAS chemicals and multiple sclerosis.
Several have issued public statements, including the American Chemistry Council, which states on its website that “manufacturers and many users of today’s PFAS are implementing a variety of practices and technologies to help minimize environmental emissions.”
In April 2024, the EPA enacted a new federal rule that sets mandatory limits on certain PFAS chemicals in drinking water, aiming to reduce exposure. The agency also aims to fund testing and treatment efforts.
A woman working out outdoors takes a sip of water from a plastic bottle. (iStock)
Multiple sclerosis is a disease that leads to the breakdown of the protective coverings that surround nerve fibers, according to Mayo Clinic.
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The immune system’s attack on these nerve sheaths can cause numbness, weakness, trouble walking and moving, vision changes and other symptoms, and can lead to permanent damage.
There is currently no cure for MS, Mayo Clinic reports, but treatment is available to manage symptoms and modify the course of the disease.
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