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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A popular class of weight-loss drugs may prevent life-threatening cardiac complications by opening microscopic blood vessels that often remain blocked after a heart attack, according to a study published this week in Nature Communications.
The research, led by the University of Bristol and University College London, identified a biological brain-gut-heart signaling pathway.
This discovery appears to explain how GLP-1 drugs — which mimic glucagon-like peptide-1, a hormone that helps regulate blood sugar and appetite — protect heart tissue from a condition known as “no-reflow.”
“In nearly half of all heart attack patients, tiny blood vessels within the heart muscle remain narrowed, even after the main artery is cleared during emergency medical treatment,” Dr. Svetlana Mastitskaya, the study’s lead author and a senior lecturer at Bristol Medical School, said in a press release.
“This results in a complication known as ‘no-reflow,’ where blood is unable to reach certain parts of the heart tissue.”
In nearly half of all heart attack patients, tiny capillaries (blood vessels) remain narrowed even after the main blocked artery is cleared. (iStock)
This lack of blood flow increases the risk of heart failure and death within a year. GLP-1 medications could prevent this, according to the researchers.
How it works
When the GLP-1 hormone is released in the gut or administered as a drug, it sends a signal to the brain, which then sends a signal to the heart that switches on special potassium channels in tiny cells called pericytes.
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When these channels open, the pericytes relax, which allows the small blood vessels (capillaries) to widen and improve blood flow to the heart muscle, the researchers noted.
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The new study used animal models and cellular imaging to track how GLP-1 interacts with heart tissue. When the researchers removed the potassium channels, the drugs no longer protected the heart — confirming they play a key role.
The findings suggest that existing GLP-1 medications, already used for type 2 diabetes and obesity, could be repurposed as emergency treatments. (iStock)
The findings suggest that existing GLP-1 medications, already used for type 2 diabetes and obesity, could be repurposed as emergency treatments during or immediately after a heart attack to reduce tissue damage.
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The researchers noted several limitations, including that the study relied on animal models.
Clinical trials are necessary to determine whether the brain-gut-heart pathway operates with the same timing and efficacy in humans.
While the study highlights the drug’s immediate benefits during a heart attack, it des not establish whether long-term use of these drugs provides a pre-existing level of protection. (iStock)
Additionally, while the study highlights the drug’s immediate benefits during a heart attack, it does not establish whether long-term use of the medication provides a pre-existing level of protection.
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The research was primarily funded by the British Heart Foundation.
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Collagen supplements have exploded in popularity, touted as everything from an anti-aging miracle to a muscle recovery booster.
But a sweeping new review conducted by U.K. researchers suggests that while collagen may help improve skin elasticity and ease arthritis pain, it does little for athletic performance or wrinkle reduction.
Researchers from Anglia Ruskin University analyzed 16 systematic reviews and 113 randomized controlled trials involving nearly 8,000 participants worldwide, which they say is the most extensive evaluation of collagen’s health effects to date.
The review found consistent evidence that collagen supplementation improves skin elasticity and hydration over time and provides significant relief from osteoarthritis-related joint pain and stiffness, according to findings published in Aesthetic Surgery Journal Open Forum.
A large U.K. review found that collagen supplements may improve skin elasticity and hydration over time. (iStock)
The researchers, however, did not find meaningful improvements in post-exercise muscle recovery, soreness or tendon mechanical properties (strength, springiness and stretch resistance).
“Collagen is not a cure-all, but it does have credible benefits when used consistently over time, particularly for skin and osteoarthritis,” co-author Lee Smith, professor of public health at Anglia Ruskin University, said in a statement.
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“Our findings show clear benefits in key areas of healthy aging, while also dispelling some of the myths surrounding its use,” Smith added.
Collagen, the most abundant protein in the body, supports skin, bones, tendons, cartilage and connective tissue, according to experts. Natural collagen production begins to drop in early adulthood and declines more sharply with age.
The study found that collagen supplements may help reduce joint pain and stiffness in people with osteoarthritis. (iStock)
The review found that long-term collagen supplementation was linked to improved skin firmness and hydration, but did not help skin roughness — a proxy for visible wrinkles.
Benefits appear to accumulate gradually, suggesting that collagen should not be viewed as an “anti-wrinkle ‘quick fix,’ but as a foundational dermal support for individuals seeking holistic skin maintenance,” the researchers said.
“If we define anti-aging as a product or technique designed to prevent the appearance of getting older, then I believe our findings do support this claim for some parameters,” Smith told the BBC. “For example, an improvement in skin tone and moisture is associated with a more youthful-looking appearance.”
Collagen supplementation was linked to reduced pain and stiffness in people with osteoarthritis, with stronger benefits seen over longer periods of use, and showed modest improvements in muscle mass and tendon structure that may support healthy aging.
Collagen did not significantly improve skin roughness, a marker of visible wrinkles. (iStock)
However, it did not show meaningful results when used as a fast-acting sports performance supplement, and evidence for benefits related to cholesterol, blood sugar, blood pressure and oral health was mixed or inconclusive.
Dr. Daniel Ghiyam, a California-based physician and longevity specialist, said the findings align with what he sees in clinical practice.
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“Collagen is a targeted support tool, not a foundation of health or performance,” Ghiyam, who was not involved in the study, told Fox News Digital. “When marketed that way, it makes sense. When marketed as a cure-all, it doesn’t hold up to the data.”
The authors noted that while many previous collagen studies have received financial support from the supplement industry, the current review did not receive industry funding.
Experts say collagen supplements may offer modest benefits for skin hydration and joint comfort, but they are not a cure-all. (iStock)
The team called for more high-quality clinical trials examining long-term outcomes, optimal dosages and differences between collagen sources, such as marine, bovine and plant-based alternatives.
Among its limitations, the review could not determine whether certain forms of collagen work better than others or what the optimal regimen should be.
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While the review included randomized controlled trials, the quality of the studies varied, with newer research generally showing stronger results.
Experts say more data and studies are needed to build on the findings. They also noted that diet plays a crucial role in skin health.
Collagen supplements, often sold as powders or pills, may improve skin elasticity and ease joint pain, experts say. (iStock)
Dr. Erum Ilyas, a Pennsylvania-based dermatologist and chair of dermatology at Drexel University College of Medicine, noted that the review analyzed previously published meta-analyses rather than generating new primary data.
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“At this time, I have not seen sufficiently strong independent evidence to routinely recommend collagen supplements to my patients,” Ilyas, who was not involved in the review, told Fox News Digital.
“Although some studies show modest improvements in markers such as hydration and elasticity, there remains limited independent, biopsy-confirmed evidence demonstrating sustained increases in dermal collagen content,” she added.
Fox News Digital has reached out to the researchers for comment.
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