Three confirmed cases of legionnaires’ disease, one of which was in a patient who has died, have been reported in people who travelled on a cruise ship from 6-23 August 2003. Approximately 354 passengers and a crew of 250 were on board. The passengers were mostly from Germany (213), France (84), and Switzerland (38), with small numbers (19) of nationals from the Czech Republic, Belgium, the Netherlands, Italy, Austria, Brazil, and Japan. The ship visited Iceland, Greenland, and northern parts of Great Britain before returning to Germany where all passengers disembarked.

The first case was confirmed by urinary antigen detection in a German male on 23 August. Two other passengers from the same cruise were admitted to hospital elsewhere in Germany and their cases have also been confirmed by urinary antigen detection. One of these patients, a man aged 69 years, has died. Two more German patients are suspected to have the disease. Information on the outbreak, passed on to all passengers by the shipping company, has resulted in several other European passengers seeking medical advice for symptoms compatible with legionella infection.

The ship is now in port in Harwich (England) where it is undergoing extensive environmental investigations and implementation of control measures. Further information about the cluster is available from Professor Adolf Windorfer at the State Health Authority of Lower Saxony, Germany, via email (Adolf.Windorfer@nlga.niedersachsen.de), telephone (+49 (0) 511 4505 500), or fax (+49 (0) 511 4505 502).