Report Highlights Legionella Risks from Hot Tubs at Rental Properties
A hot tub at a short-term vacation rental property was the likely source of exposure to Legionella that resulted in two cases of Legionnaires’ disease in New York in 2024, according to a recent issue of CDC’s Morbidity and Mortality Weekly Report (MMWR). The two patients were family members who had stayed together at the property and whose symptom onset dates were similar. The CDC report details an investigation of the property by the New York State Department of Health (NYSDOH) that focused on identifying any additional cases of Legionnaires’ disease and potential sources of exposures. The department did not find any other cases potentially related to the rental property, but it did conduct a separate cluster investigation for three other patients in the same city who had also received positive urine antigen test results that indicated recent exposure to Legionella pneumophila serogroup 1. NYSDOH did not find common exposures among the three patients, nor could it identify or confirm the sources of their exposures.
The rental property where the two related patients stayed was located 40 miles south of the city. Whole-genome sequencing was used to determine that a sputum sample from one of the patients was “closely related to the environmental samples collected from the hot tub,” and NYSDOH recommended that the property owner close the hot tub, have it professionally cleaned, and implement a chemical treatment program before allowing future guests to use it. The owner ignored the department’s recommendations and instead “personally cleaned the hot tub (i.e., did not hire professionals), tested a sample using an unapproved method, and reopened the hot tub for guest use without consulting NYSDOH,” the report states. Weeks later, department staff learned that the listing for the rental property continued to advertise the hot tub and that new reviews from guests mentioned using the hot tub.
NYSDOH was ultimately able to use a public nuisance law to get the owner to close and properly remediate the hot tub, but the situation highlights issues stemming from the fact that “residential spa pools, including those at homes rented for overnight occupancy, are exempt from” New York regulations related to Legionella contamination in cooling towers and healthcare facilities, the report notes.
“Activities to raise awareness among short-term rental and vacation rental property owners regarding the risks associated with an improperly managed hot tub are needed to decrease the likelihood that rental property hot tubs are in a condition that is conducive to Legionella growth and reduce the risk for Legionnaires’ disease associated with vacation rental stays,” the report’s authors urge.
The full report is available in CDC’s MMWR.
Related: Read “Legionella Regulations in New York: How Much Progress Have We Made?” and “Why Legionnaires’ Disease Outbreaks Continue” in the digital Synergist.