American Cruise Lines notifies guests of Legionella bacteria during cruise

American Cruise Lines found Legionella on its American Splendor vessel, the company said earlier this month.

The cruise line notified guests on a Lower Mississippi River sailing that a routine water sampling indicated the bacteria “was present in limited locations on board,” according to a copy of a letter provided to passengers and obtained by USA TODAY.

“In an abundance of caution, we are notifying you of the water sampling results,” Hotel General Manager Jay Hasan said in the letter dated Sept. 18, one day before the end of the week-long itinerary. He added that no confirmed cases of Legionnaires’ disease – a serious type of pneumonia caused by the bacteria – had been reported since the completion of the water sampling, and that the line has “a comprehensive water management plan to prevent and mitigate waterborne pathogens.”

American Cruise Lines “immediately took steps to remediate the issue” and services continued without interruption, according to spokesperson Alexa Paolella. “We are confident in the safety of our water systems and the health of our guests is of utmost importance,” she said in an emailed statement.

A Food and Drug Administration spokesperson said the agency “is aware of the situation on the American Splendor; however, generally, the FDA, by policy, does not discuss possible or ongoing investigations.”

‘I could hardly get out of bed’

Cairenn and Paul Spooner spent much of the cruise in their cabin.

The upstate New York couple, both 66, got sick during the sailing with symptoms like congestion, sore throats, fever, body aches and diarrhea. “I could hardly get out of bed, I was so depleted,” said Cairenn. “And I was afraid I wasn't going to get out of the ship to go home.”

At one point, Paul, whose symptoms were milder, said he spent about $100 and over an hour taking a Lyft to a pharmacy in Tunica to get Imodium that the ship did not have on board.

The couple said the line did not offer them a refund or compensation after notifying them of the Legionella. The cruise cost the pair around $12,000, including flights and a hotel stay prior to embarkation.

There was not a doctor on board, but Cairenn went to see her primary care physician when she got home, who tested her for Legionnaires’ disease. She later learned her sample was mishandled and she has to be retested, but she and Paul also tested positive for COVID which has delayed the process.

“We’re so upset,” she said. “We haven’t taken a real vacation in 10 years and we were really looking forward to this.” The spokesperson did not address specifics of the Spooners’ experience.

What is Legionnaires’ disease?

The symptoms of the disease include cough, shortness of breath, fever, muscle aches and headaches, according to the Centers for Disease Control and Prevention. The illness can also be associated with diarrhea, nausea and confusion, and symptoms typically start between two and 14 days after exposure.

Legionella is often present in small quantities in the water cruise lines pick up in port for drinking, use in showers and amenities like whirlpool spas, but not high enough to make people sick, according to Richard Miller, founder and president of Environmental Safety Technologies, Inc. and a Legionella expert.

But once on board, if the legionella is in a hospitable environment like warm water, it can grow. “They just have to manage that and keep it from replicating,” said Miller.

If the bacteria grows in a ship’s holding tank, it can be distributed throughout the vessel and begin growing elsewhere, such as a showerhead in a cabin.

Man-made water sources “become a health problem when small droplets of water that contain the bacteria get into the air and people breathe them in,” the CDC said in a fact-sheet. The majority of healthy people do not get the illness after being exposed, and the disease can be treated with antibiotics. Most people diagnosed have to seek medical care in a hospital, but fully recover.

Legionella can also cause Pontiac Fever, a milder infection.

In the letter to guests, Hasan urged guests to seek medical attention “in the unlikely event” they developed respiratory or pneumonia symptoms within two weeks.

Legionella previously found on American Cruise Lines vessels

The discovery on American Splendor comes after the FDA said earlier this year that the cruise line had not provided sufficient proof of procedure changes after multiple guests contracted Legionnaires’ disease. The agency found evidence of Legionella in the potable water systems of its American Star and American Heritage vessels following periodic inspections between December 2021 and and August 2022.

"Although we are not aware of a case of Legionnaires’ disease being associated with any (other vessels in your fleet), based on your practices on the American Star and American Heritage, we have concerns about the potable water on your other vessels," the FDA said in a January warning letter to the line.

At the time, Paolella said the line had immediately shared the requested documentation. "More importantly, American took the matter very seriously in 2021, and implemented new water management policies and equipment on its ships," she said.

Miller said there are established procedures for preventing legionella growth on board, though some scenarios are more challenging than others. While previous instances of illness do not necessarily mean future passengers will get sick, he recommended travelers make informed decisions when booking cruises.

“It’s one of those things that, consumer beware” he said.

Nathan Diller is a consumer travel reporter for USA TODAY based in Nashville. You can reach him at ndiller@usatoday.com.

This article originally appeared on USA TODAY: American Cruise Lines finds Legionella bacteria on board ship