Suspected Legionnaires' Outbreak on Fred. Olsen Cruise in Baltic

July 29, 2007

Six passengers on U.K.-based Fred. Olsen Cruise Lines' Black Watch have been afflicted with suspected Legionnaires' disease. The passengers, thought to hail from Britain, were debarked on a scheduled call to Stockholm, and have been taken to a hospital there, reports the U.K's Reuters.

The 798-passenger, 28,000-ton Black Watch, built in 1972, entered service with Fred. Olsen in 1996. As Legionnaires', a highly contagious pneumonia-like infection, is typically passed on via water, Swedish officials, Reuters says, have taken samples to determine whether it originated on the ship.

The 17-night cruise had already called at ports such as St. Petersburg, Estonia's Tallinn, Finland's Kemi and Turku, and Sweden's Lulea. The Reuters report quotes Fred. Olsen spokeswoman Wendy Hooper-Greenhill as saying that the ship has been disinfected as a precautionary measure and that it left Stockholm with the remaining passengers. Black Watch will return to Dover immediately, cutting its trip short; it will arrive on Monday afternoon.

As well, Fred. Olsen has issued a statement that says in part:

"Investigations are currently underway to determine exactly what the infection is, and where it may have been contracted as the vessel had previously visited five ports in northern Europe before arriving in Stockholm. However as a precaution, and for the welfare of all persons on board, all jacuzzis, swimming pool and swimmex machines have been closed until further notice.

"The passengers concerned will remain in hospital in Stockholm for the time being.

"The decision has now been taken to bring Black Watch direct to Dover where she will arrive on Monday 30th July, two days ahead of schedule. This will allow for a thorough cleansing of the vessel before she sets off on her next cruise on 1st August."

In its most severe form, Legionnaires', named after a group of American Legion convention attendees who contracted the illness while meeting in Philadelphia in 1976, appears as a pneumonia-like disease. It can be treated by antibiotics, but can affect elderly people in a particularly severe way. Legionnaires' bacteria, according to the United States' Centers for Disease Control and Prevention (CDC), "are found naturally in the environment, usually in water. The bacteria grow best in warm water, like the kind found in hot tubs, cooling towers, hot water tanks, large plumbing systems, or parts of the air-conditioning systems of large buildings."

Not Cruising's First Outbreak

Should the illnesses of Black Watch passengers be caused by Legionnaires', it wouldn't be the first time cruise ship travelers have been impacted. Over a decade ago, passengers on Celebrity's Horizon claimed they had gotten ill while onboard because of a defective water filter in a whirlpool spa that failed to stop the spread of bacteria.

Celebrity (or rather Royal Caribbean Cruises, Ltd., its parent company) was in fact recently awarded a multi- million judgment by a U.S. court, saying that Essef Corporation, a company that manufactures sump pumps and pool equipment, had not properly maintained its product on Horizon. The ship now sails as Island Star for the U.K.-based Island Cruises.

Legionnaires' Factoids

While Legionnaires' disease achieved its name in 1976, the illness, a lung infection caused by its bacteria, has been around for a long time. The disease can cause death in from 5 to 30 percent of cases though most can be treated successfully with antibiotics. Some other facts from the CDC:

People most at risk of getting sick from the bacteria are older (usually 65 years of age and up), as well as people who are smokers or those who have a chronic lung disease (like emphysema). Those who have weak immune systems from diseases like cancer, diabetes or kidney failure are also more likely to get sick from Legionella bacteria. People who take drugs to suppress (weaken) the immune system (like after a transplant operation or chemotherapy) are also at higher risk.

Each year, between 8,000 and 18,000 people are hospitalized with Legionnaires' disease in the U.S. However, many infections are not diagnosed or reported, so this number may be higher.

More illness is usually found in the summer and early fall, but it can happen any time of year.

Symptoms, like other forms of pneumonia, can be hard to diagnose. Signs include a high fever, chills and a cough. Some people may also suffer from muscle aches and headaches. Chest X-rays are needed to find the pneumonia caused by the bacteria, and other tests can be done on sputum (phlegm), as well as blood or urine to find evidence of the bacteria in the body. These symptoms usually begin 2 to 14 days after being exposed to the bacteria.

A milder infection caused by the same type of Legionella bacteria is called Pontiac Fever. The symptoms of Pontiac Fever usually last for 2 to 5 days and may also include fever, headaches and muscle aches; however, there is no pneumonia. Symptoms go away on their own without treatment and without causing further problems.

People get Legionnaires' disease when they breathe in a mist or vapor (small droplets of water in the air) that has been contaminated with the bacteria. One example might be from breathing in the steam from a whirlpool spa that has not been properly cleaned and disinfected. The bacteria are not, however, spread from person to person.

Outbreaks are when two or more people become ill in the same place at about the same time, such as patients in hospitals. Hospital buildings have complex water systems, and many people in hospitals already have illnesses that increase their risk for Legionella infection.

Most people exposed to the bacteria do not become ill; folks who believe they have been exposed to the bacteria should check with their doctors immediately (and be sure to mention if you have traveled in the last two weeks).

It's important to stress that Legionnaires' is only suspected -- not confirmed -- in the outbreak aboard Fred. Olsen's Black Watch. We expect an update on Monday and will keep you posted.

--by Carolyn Spencer Brown, Editor