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What happens if you become ill or injured (or are bitten by a monkey) while on a cruise ship?

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When Jennifer Lautenschlager awoke last month with sniffles and a headache, she cancelled her plans and went to the doctor. The nurse took her temperature (she had a 102-degree fever) and ran some tests on her, and the doctor examined her before sending her home with several prescriptions.

Except the 51-year-old software engineer was on a cruise ship off the coast of Mexico, it was a largely routine sick visit.

Lautenschlager had been looking forward to going kayaking during her 15-day Panama Canal cruise with Norwegian Cruise Line. Instead, she stayed in her cabin for the majority of the day before visiting the ship’s medical facility, where she was diagnosed with an upper respiratory infection.

“(The facility was) similar to what I would expect from a typical urgent care,” said Lautenschlager, who lives in the Atlanta area. “Like a decent, good emergency room.”

“Each of our ships has a state-of-the-art onboard medical centre staffed by highly qualified doctors and nurses to provide care for both guests and crew while at sea,” Norwegian stated in its ESG report for 2021. “We adhere to CLIA guidelines for our medical facilities in collaboration with the American College of Emergency Physicians (ACEP).”

Cruise ships are best known for their amenities such as buffets and swimming pools, but their medical facilities can treat a wide range of illnesses and injuries, from common colds to heart attacks.

Here’s what you should know if you get sick or hurt on a cruise ship.

What are the medical facilities on cruise ships like?

According to Dr. Joe Scott, senior director of fleet medical operations at cruise line operator Carnival Corporation, some of its ships’ facilities resemble urgent care centres, while others on some of its larger vessels are larger and more akin to doctor’s offices. He did, however, observe that the facilities are generally set up in the manner of a typical emergency department.

The Cruise Lines International Association, the industry’s leading trade group, collaborated with the ACEP “to develop and implement guidelines on cruise ship medical facilities,” according to the organization’s website. They must be followed by all ocean-going CLIA member lines.

The guidelines are updated every couple of years, according to Scott, who is currently chair of the ACEP’s Cruise Ship Medicine Section.

Doctors and nurses staff the facilities, and larger ships may also have medical administrators, paramedics, and health care assistants.

As directed by the guidelines, the ships also have alternate medical sites. “So, if the first medical centre is compromised in any way, we have an alternative so we can continue to provide treatment,” said Scott, who oversees day-to-day operations for Carnival Cruise Line, Princess Cruises, and Holland America Line.

What are the medical services available on cruise ships?

From rashes and earaches to heart attacks, Carnival Corp. medical facilities can treat a wide range of ailments. “There’s really nothing we can’t treat, at least for the first few hours,” Scott said.

Doctors on board can prescribe medications to be dispensed and taken on board, as well as treat serious illnesses either until passengers improve or as a stopgap measure until a passenger can be brought ashore, depending on the scenario. In the event of a heart attack, they can administer thrombolytics – or “clot-busting drugs” – to patients on board until they can transport them to a cardiac catheterization lab, which the vessels lack. The cruise line operator maintains a formulary, which is a list of medications required to treat the majority of diagnoses made on board, and stocks the ships with them, though supplies are limited due to limited storage on board.

In addition, the cruise ship environment can limit the team’s capabilities in other ways. The vessels, for example, have X-ray machines (medical staff are trained to operate radiology and lab equipment). “No one has really yet figured out how to put a CT scan on a ship moving through the ocean and have it work well,” Scott said.

While all medical personnel on board are credentialed in their home countries, they occasionally require outside assistance.

During a 2012 cruise, Janice Mullin and her husband, Jeff, were waiting to tour caves as part of a shore excursion in Gibraltar when a Barbary ape jumped up on a bench beside her. The beast reached for the band of her Timex watch, attempting to remove it from her arm.

The ape bit her as she stood up, leaving puncture wounds on her arm. “Because I tend to make light of most things, I said, ‘It’s no big deal.'” Mullin, who is now 77, stated. “When my husband said, ‘No, I think you should tell the tour guide,’ she freaked out.”

Holland America, the cruise line, rushed her to the ship’s medical facility. The doctor informed Mullin that he had never seen a monkey bite before, and medical personnel contacted the Centers for Disease Control and Prevention for assistance. They administered several injections and prescribed antibiotics and antiviral medications to her.

Mullin, who lives in Enid, Oklahoma, said the cruise line covered her medical expenses and she received “wonderful” care, despite picking up an unfavourable souvenir. “I had this huge black spot on my arm… it was probably the size of a softball,” she explained. “I had my 15 minutes of fame, and people would say, ‘Oh, there’s the woman who got bitten by the monkey,'” she says.

Such incidents, according to Scott, are “not that common.” He also mentioned that at the start of the pandemic, the company established Health Operations Centers, which are based in offices on shore and can provide assistance to those working onboard.

Carnival Corp. has agreements with several university medical centres to conduct specialist consultations.

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