According to the CDC Legionnaires disease is a serious pneumonia caused by Legionella bacteria.
Hot tubs can be a source of Legionella growth and transmission when they are inadequately maintained and operated.
According to the 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. These devices are subject to less stringent operating requirements than are public hot tubs, and operating protocols were insufficient to prevent Legionella growth. Hot tubs offer favorable conditions for Legionella growth and transmission when maintained and operated inadequately, regardless of location.
Private hot tubs on cruise ships are not subject to the same maintenance requirements as are public hot tubs in common areas. Given the range of hot tub–type devices offered as amenities across the cruise industry, to reduce risk for Legionella growth and transmission, it is important for cruise ship water management program 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.
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