Email from X re Legionella.

[Julma]

We boarded the Ascent on the 14th of January for three weeks and haven't received an email.  

[chengkp75]

1 hour ago, hcat said:

thanks....would vinegar work?

Nope.  Maybe peroxide or betadine, but would want to test it on something first.

[MCC retired]

Unusual that the original outbreak of this disease on a cruise ship was aboard Celebrity also.

Celebrity Horizon back in the 90's . Identified source were the hot tubs which were promptly removed.

[chengkp75]

6 minutes ago, MCC retired said:

Unusual that the original outbreak of this disease on a cruise ship was aboard Celebrity also.

Celebrity Horizon back in the 90's . Identified source were the hot tubs which were promptly removed.

Which is why many cruise lines don't keep the hot tubs "hot enough" for people (105*F is the optimum breeding temperature for legionella) or have disabled the air jets (source of aerosolizing).  Also led to the CDC/USPH requirement to superchlorinate the hot tubs daily.

[mahdnc]

1 hour ago, MCC retired said:

Unusual that the original outbreak of this disease on a cruise ship was aboard Celebrity also.

Celebrity Horizon back in the 90's . Identified source were the hot tubs which were promptly removed.

 

Here is a New York Times article about the event aboard Horizon in 1994 when she was doing her NYC to Bermuda run:

 

New York Times: Ship Is Evacuated To Be Disinfected For Legionnaire's 

 

I believe there was one fatality.

[Pushka]

10 hours ago, chengkp75 said:

Legionella needs water to remain viable, and the air in the HVAC system on ships tends to be very dry, so the major spot where legionella grows is the condensate pans under the cooling coils.  These pans are required to have sanitizing pads placed in them for just this reason.  Therefore, the main source of possible legionella infection on cruise ships are the shower heads, where there is always just a little water in the shower head when turned off, and which then becomes aerosolized when the shower is turned on.  For this reason, the shower heads on cruise ships are scheduled to be taken off every 6 months and soaked in bleach.

 

So, while missed maintenance in either case (HVAC condensate pan or shower heads), the fact that there are only about 70 condensate pans on the ship, but a couple of thousand shower heads means that the odds on favorite for being missed is with the shower heads.  Also, the condensate pan pads are changed more frequently than the shower heads are sanitized.

Yes there are other sources. I guess my point was that it wasn't close contact with the actual confirmed case that was the issue but is something more systemic. Like airconditioning. 

[gold1953]

2 minutes ago, Pushka said:

Yes there are other sources. I guess my point was that it wasn't close contact with the actual confirmed case that was the issue but is something more systemic. Like airconditioning. 

and likely from a pre cruise hotel room

[hcat]

no way to tell...esp at this point for us

 

We drove to the port and did not use the shower at our pre- cruise hotel... looked grungy!

 

But we did shower daily on board....and then drove home .. west coast Fl..

[gold1953]

1 hour ago, hcat said:

no way to tell...esp at this point for us

 

We drove to the port and did not use the shower at our pre- cruise hotel... looked grungy!

 

But we did shower daily on board....and then drove home .. west coast Fl..

the air conditioner is more likely

[dock]

It seems like not everyone is getting an email so  assuming the affected cabins and those in the vicinity are being notified. 

Our pre cruise hotel hasn’t sent a memo so whoever it was, we don’t have a hotel in common. 

 

[Sheal]

We were on the 2/11 cruise and received the memo Sunday morning. When I first saw it I assumed it was just a reminder to fill out the survey.  Being nosy I opened it anyway, just in case it was a chance for a free cruise.😆

[omahabob]

On 3/4/2024 at 4:32 AM, Pushka said:

Legionella exists in the airconditioning system. Once detected it's not known how long prior that people might be infected. Once detected the ship airconditioning needs significant cleaning and testing. You don't need to have close contact with a person, but the airconditioning system. 

Legionella isn't spread by air conditioners. It's only spread by aerosolized water particles, which air conditioners don't produce. It's a common mistake, spread because Legionella has caused infection in hotels that use cooling towers. But that isn't air conditioning, unless they use swamp coolers. I've never seen a hotel that does, though it's not impossible. Cruise ships don't use swamp coolers or cooling towers. That's why every documented case of Legionella on a cruise ship was related to the water supply, and showers.

[omahabob]

On 3/4/2024 at 6:43 PM, dock said:

It seems like not everyone is getting an email so  assuming the affected cabins and those in the vicinity are being notified. 

Our pre cruise hotel hasn’t sent a memo so whoever it was, we don’t have a hotel in common. 

 

The vicinity has no bearing, since it isn't contagious. But that does make it interesting, given that you'd assume they'd tell everyone. Everyone uses the same potable water supply as far as I know (it has nothing to do with air conditioning). I assume this is just an exercise to fend off the ambulance chasing lawyers. These people weren't diagnosed on the ship, and they have no clue where they contracted it. It may well have been from a pre or post cruise hotel stay, or somewhere else entirely. In the 1994 Horizon incident, they found Legionella monoclonal antibodies in the sand filter for one or more hot tubs. From all reports, Celebrity has taken the same measures now that they took then, and it had to pass inspection.

[omahabob]

No Legionella has been found on a cruise ship since that 1994 incident by the way, including this time on the Ascent. Lots of norovirus, some E. coli, and a smattering of other things, but no Legionella. The CDC documents all of them on their web site. It's interesting reading if you're into that sort of thing. You can look at the cruise ship listing at:

https://www.cdc.gov/nceh/vsp/surv/GIlist.htm

Edited March 6 by omahabob

[Pushka]

1 hour ago, omahabob said:

Legionella isn't spread by air conditioners. It's only spread by aerosolized water particles, which air conditioners don't produce. It's a common mistake, spread because Legionella has caused infection in hotels that use cooling towers. But that isn't air conditioning, unless they use swamp coolers. I've never seen a hotel that does, though it's not impossible. Cruise ships don't use swamp coolers or cooling towers. That's why every documented case of Legionella on a cruise ship was related to the water supply, and showers.

Opinions differ on that 

For example

 

https://www.gegroup.com.au/legionnaires-disease-air-conditioning/

[omahabob]

52 minutes ago, Pushka said:

Opinions differ on that 

For example

 

https://www.gegroup.com.au/legionnaires-disease-air-conditioning/

We don't differ. That link specifically addresses systems with cooling towers, which I covered. Cooling towers don't actually chill air for interior spaces. They cool a condenser in the chiller system, which is what does the air conditioning. The water circulated through the cooling tower is isolated from the air conditioning sent to interior spaces. The exception to that is swamp coolers, which do use that water to chill the air. Unfortunately, even though cooling towers aren't directly connected to the chilling of air, they do produce water vapor, and water vapor is what spreads Legionella. So the air conditioning in a hotel room can't infect you, but the cooling towers on the roof could if you're close enough to breathe in that vapor. But cruise ships have neither swamp coolers nor cooling towers, so there is no chance of getting Legionella from their air systems. The water system is another story.

[chengkp75]

5 hours ago, omahabob said:

No Legionella has been found on a cruise ship since that 1994 incident by the way, including this time on the Ascent.

Nope.  Both American Cruise Lines, and NCL have had confirmed outbreaks of Legionella in 2023, and Carnival Horizon in 2021.  The link you give is only for Gastro-Intestinal illnesses, which Legionella is not one.

 

5 hours ago, omahabob said:

Legionella isn't spread by air conditioners. It's only spread by aerosolized water particles, which air conditioners don't produce. It's a common mistake, spread because Legionella has caused infection in hotels that use cooling towers

 

2 hours ago, omahabob said:

Cooling towers don't actually chill air for interior spaces. They cool a condenser in the chiller system, which is what does the air conditioning. The water circulated through the cooling tower is isolated from the air conditioning sent to interior spaces.

So, while not an expert on cooling tower HVAC systems, you are saying that your exposure to water vapor created in a cooling tower located on the roof of a building, venting that vapor to the open atmosphere is more of a risk than the evaporator coils inside the HVAC ducts?  I believe that most of the cases of Legionella found in cooling tower systems are from older systems, that do, in fact, use direct cooling by the cooling tower water (i.e. the cooled water from the tower is sprayed over the HVAC air) (what I think you are calling a swamp cooler) as a supplement to the refrigerated cooling done by the HVAC chiller.

 

But, whether a land based system, or one on a cruise ship (and actually more prevalent on cruise ships due to their operating environment), you get condensation in the cooling coils of the HVAC system, where the warm, moist air from outside is cooled below the dew point.  If this condensate is allowed to collect in the drain pans, it can become a Legionella breeding ground, and then if the air filter for the cooling coil is partially blocked, increasing the air flow velocity across the cooling coil, the air can start to aerosolize the condensate in the drain pan and carry it along the ductwork.  This is why the CDC/USPH requires sanitizing pads in the condensate pans of all air coolers on cruise ships.

Edited March 6 by chengkp75

[phoenix_dream]

For those wondering why everyone onboard  didn't get emails, this seems to be a common occurrence for all emails.  Some get advertising emails but never get a post cruise survey or a Move up activity email.  I wouldn't assume it didn't apply to you if you were on that sailing.

[omahabob]

19 hours ago, chengkp75 said:

Nope.  Both American Cruise Lines, and NCL have had confirmed outbreaks of Legionella in 2023, and Carnival Horizon in 2021.  The link you give is only for Gastro-Intestinal illnesses, which Legionella is not one.

 

 

So, while not an expert on cooling tower HVAC systems, you are saying that your exposure to water vapor created in a cooling tower located on the roof of a building, venting that vapor to the open atmosphere is more of a risk than the evaporator coils inside the HVAC ducts?  I believe that most of the cases of Legionella found in cooling tower systems are from older systems, that do, in fact, use direct cooling by the cooling tower water (i.e. the cooled water from the tower is sprayed over the HVAC air) (what I think you are calling a swamp cooler) as a supplement to the refrigerated cooling done by the HVAC chiller.

 

But, whether a land based system, or one on a cruise ship (and actually more prevalent on cruise ships due to their operating environment), you get condensation in the cooling coils of the HVAC system, where the warm, moist air from outside is cooled below the dew point.  If this condensate is allowed to collect in the drain pans, it can become a Legionella breeding ground, and then if the air filter for the cooling coil is partially blocked, increasing the air flow velocity across the cooling coil, the air can start to aerosolize the condensate in the drain pan and carry it along the ductwork.  This is why the CDC/USPH requires sanitizing pads in the condensate pans of all air coolers on cruise ships.

My mistake on the number of occurrences. Since they included one Legionella detection on that list, I assumed they'd be consistent.

 

Evaporator coils use refrigerant, not water.

 

Evaporators, compressors and condensers on cruise ships, with some possible outlying exceptions, are not located in the cabins. They're in a central location, outside or in the roof/ceiling. Only chilled air is distributed to the cabins, which typically have a fan to disperse that cool air. But that fan is nowhere near a condensate pan. And condensate pans are not located within ductwork anyway.

 

I find no CDC guidance on condensate pans for Legionella, though they do have recommendations for mold, fungus, algae, etc in them. The USPH inspection guidelines online say nothing about condensate pans. They only mention condensation in galley areas. But since condensate pans aren't in the cabins, it doesn't matter much, at least not in the context of Legionella.

 

I've found no documentation of anyone ever getting Legionella from a closed loop air conditioner, only from cooling towers. If you find something to the contrary, please post it. I'm always open to learning new things, and you always have really good sources. And feel free to simply disagree if you want. I have no problem with that. But we're getting deep into air conditioning, and farther from cruising. Maybe we should just give it a rest.

[chengkp75]

5 hours ago, omahabob said:

Evaporator coils use refrigerant, not water.

Never said they did, I said the water was condensation from the air.  But, actually, this is not the case, note below.

 

5 hours ago, omahabob said:

Evaporators, compressors and condensers on cruise ships, with some possible outlying exceptions, are not located in the cabins. They're in a central location, outside or in the roof/ceiling. Only chilled air is distributed to the cabins, which typically have a fan to disperse that cool air. But that fan is nowhere near a condensate pan. And condensate pans are not located within ductwork anyway.

On cruise ships, the evaporators, compressors, and condensers are all in the engine room.  The refrigerant system cools a closed loop fresh water system.  This system circulates chilled (40-45*F) water to the air cooling coils.  If you've ever wondered what those great big "white areas" that are on deck plans, that run down the center of passenger cabin decks are, they are the HVAC fan rooms.  Each of the 6-10 vertical fire zones the ship is divided into, will have separate ventilation systems, and each one or two decks within each fire zone will have a separate ventilation system for the cabins on one or two decks.  Also, virtually each separate public space will have a separate ventilation system.  Each of these myriad ventilation systems will have a fan (in those fan rooms, in close proximity to cabins and public spaces), and each of those fans has a cooling coil located within the same room (typically not more than 10-15 feet away), and that cooling coil has a condensate pan and an air filter.  That condensate pan is part of the ductwork that contains the cooling coil.  It is, in fact, directly below the air cooling coils, where 42*F water meets 75-80*F, high humidity, outside air.

 

Additionally, each cabin has an air cooler and fan, typically located in either a vanity below the bathroom sink, or in the mechanical locker just outside each cabin.  This is the HVAC system that is controlled by the cabin thermostat, and takes the cabin air, circulates it over the cooling coil that is cooled by the chilled water, and returns that air to the same cabin.  Therefore, any condensation (though this is much less than the outside supply air system noted above, as the humidity is lower in the cabin already) drops to a condensate pan either in the cabin or just outside it.

 

I agree that there have not been any cases of Legionella reported on cruise ships from HVAC systems, but the possibility of it happening can not be dismissed.

[omahabob]

Condensate pans are below the coils, and the coils are in the ductwork. While not totally sealed (they can't be), condensate pans are not in the airflow going through the ducts, and are not considered to be part of the ductwork. Certainly they are not in an airflow path that might aerosolize water from the pan. If they were, that system wouldn't last long. Significant effort in design is made to keep them out of the airflow for that very reason.

 

I'm not dismissing the outright possibility. All manner of weird things are possible in this world. I'm saying it has never happened, at least that I can find, and the possibility of it is minimal, particularly when compared to other possibilities.

[Penny Robinson]

Received the email today indicating three passengers contracted it - not two.  We sail on Ascent March 17th.  

 

Dear Guest, Your health and safety are always our top priority, and in an abundance of caution, we are reaching out as the CDC has advised that while they are unsure where exposed, three guests who sailed on Celebrity Ascent were later diagnosed with a respiratory illness known as Legionella.  In response to this, before your sailing, we immediately implemented heightened sanitation protocols and followed all CDC remediation guidance, as precautionary measures. At this time, we are only contacting you for awareness.  It’s important to know that Legionella is not contagious from person to person. It is contracted by inhaling water droplets from a source containing the bacteria, which can be found throughout the world in any environment containing water – ponds, lakes, rivers, and streams, as well as municipal water systems, fountains, and whirlpools. Most healthy people exposed to Legionella do not get sick. Symptoms include cough, shortness of breath, fever, muscle aches and headaches. If you experience these symptoms before, during or after your sailing please reach out to your preferred medical professional or our medical team onboard.  Both Celebrity Cruises and the CDC work hard to protect the health of guests and crew. If you have questions about Legionella, contact your local or state health department or CDC at 1-800-CDC-INFO (1-800-232-4636) or visit cdc.gov/legionella. For questions about this situation or other questions related to travel on the Celebrity Ascent, please contact Celebrity Cruises at (888) 727-4907. We look forward to welcoming you onboard soon. Sincerely,  Celebrity Cruises

Edited March 8 by Penny Robinson
corrected sail date

[1Virgo]

Got the same email advising us. 3 people reportedly  

[Arizona Wildcat]

Let's remember that the people mentioned as getting sick had been on the ship.  Did they get the disease on board?  Nobody will ever know.   Could have contracted on shore or after disembarking. 

We certainly will  never understand how the email recipients were determined. 

[Heavy Roller]

I'm sailing on Ascent on Sunday 3/9. TODAY I got this email that says 3 guests, with no date information about when it happened.

 

Dear Guest,

Your health and safety are always our top priority, and in an abundance of caution, we are reaching out as the CDC has advised that while they are unsure where exposed, three guests who sailed on Celebrity Ascent were later diagnosed with a respiratory illness known as Legionella.

In response to this, before your sailing, we immediately implemented heightened sanitation protocols and followed all CDC remediation guidance, as precautionary measures.

At this time, we are only contacting you for awareness.

It’s important to know that Legionella is not contagious from person to person. It is contracted by inhaling water droplets from a source containing the bacteria, which can be found throughout the world in any environment containing water – ponds, lakes, rivers, and streams, as well as municipal water systems, fountains, and whirlpools. Most healthy people exposed to Legionella do not get sick. Symptoms include cough, shortness of breath, fever, muscle aches and headaches. If you experience these symptoms before, during or after your sailing please reach out to your preferred medical professional or our medical team onboard.

Both Celebrity Cruises and the CDC work hard to protect the health of guests and crew. If you have questions about Legionella, contact your local or state health department or CDC at 1-800-CDC-INFO (1-800-232-4636) or visit cdc.gov/legionella. For questions about this situation or other questions related to travel on the Celebrity Ascent, please contact Celebrity Cruises at (888) 727-4907.

We look forward to welcoming you onboard soon.

Sincerely, 

Celebrity Cruises