CDC Links Royal Caribbean Ship Hot Tubs to Recent Legionnaires’ Disease Outbreaks

In the past few years, awareness around health risks associated with cruise travel has heightened, especially concerning the spread of contagious diseases in enclosed environments like cruise ships. However, the dangers posed by hot tubs on private balconies—common features on newer vessels—are less discussed.

The Centers for Disease Control and Prevention (CDC) has been educating cruise lines about the risks of Legionella bacteria, which can thrive in poorly maintained hot tub systems. Unlike diseases transmitted through close contact, Legionella is spread by inhaling contaminated water droplets. When conditions are right, such as in inadequately maintained hot tubs, it can lead to Legionnaires’ disease, a serious type of pneumonia.

Though cases of Legionnaires’ disease among cruise passengers are rare, the emergence of private-balcony hot tubs raises concerns. These hot tubs tend to be used less frequently, resulting in less routine cleaning and maintenance compared to public hot tubs, thus creating an environment that may support bacterial growth.

Royal Caribbean International (RCI) has recently issued health notifications on its Symphony of the Seas following reports of passengers contracting Legionnaires’ disease after their cruise. Passengers were informed of one confirmed case associated with the ship, though the exact exposure site remains unclear. There had also been notices related to two other passengers who fell ill after sailing on the same vessel.

The Symphony of the Seas is not unique in this regard. In October 2024, the CDC reported a dozen cases of Legionnaires’ disease among travelers on two different cruise ships from separate lines between late 2022 and mid-2024, with private-balcony hot tubs identified as a common factor in those outbreaks.

Public hot tubs are typically subject to stricter cleaning measures, reducing bacterial growth risk. On the other hand, private hot tubs are often not maintained to the same standards, increasing contamination risks.

The CDC is collaborating with RCI to address design and operational factors that can heighten Legionella risk and to enhance maintenance procedures on board.

Royal Caribbean has confirmed that it is implementing additional sanitation protocols and following CDC guidelines, emphasizing its commitment to the health of passengers and crew. Although most individuals exposed to Legionella do not develop symptoms, certain high-risk groups—including older adults, smokers, and those with pre-existing health conditions—should be particularly vigilant.

Passengers are encouraged to watch for symptoms such as coughing, fever, muscle aches, headaches, and shortness of breath, and to seek medical advice if they experience any of these signs.

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