- Cruise ships can treat a wide range of illnesses and injuries on board.
- Some onboard medical facilities look like urgent care centers, while others are more like doctor'soffices.
- Health insurance often does not cover medical care on cruises, but travel insurance might.
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When Jennifer Lautenschlager woke up with sniffles and a headache last month,she canceled her plans and went to see the doctor. The nurse took her temperature – she had abouta 102-degree fever –and ran some tests, and thedoctor examined her, before sending her on her way with severalprescriptions.
It was a largely normal sick visit,except the 51-year-old software engineer was on a cruise ship alongthe coast of Mexico.
Lautenschlagerhad been looking forward to going kayakingon astop in Cabo San Lucas during her 15-day Panama Canal sailing with Norwegian Cruise Line. Instead, she spent most of the day in her cabin before visiting the ship's medical facility, where she was diagnosed with an upper respiratory infection.
"(The facility was like) what I wouldthink a typical urgent care was," saidLautenschlager, who lives in the Atlanta area. "Like adecent, good urgent care."
"Each of our ships has a state-of-the-art onboard medical center staffed with highly qualified doctors and nurses, to provide care for both guests and crew while at sea," Norwegian said in its 2021 ESGreport."We follow guidelines for our medical facilities provided by CLIA in conjunction with the American College of Emergency Physicians (ACEP)."
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Cruise ships are perhaps best known for amenities like buffets and swimming pools, but their medical facilities also have the capability to treat a wide range ofillnesses and injuries, fromcommon colds to heart attacks.
Here's what to know about getting sick or hurt on a cruise ship.
What are cruise ship medical facilities like?
Dr. Joe Scott, seniordirector of fleet medical operations at cruise line operator Carnival Corporation, said some of its ships' facilities looklike urgent care centers passengers would find on land, while others on some of its larger vessels are bigger and more similar to doctor's offices.However, he noted thatthe facilities are generally set up like a typical emergency department.
Cruise line members of Cruise Lines International Association, the industry's leading trade group, worked with the ACEP"to develop and implement guidelines on cruise ship medical facilities," according to its website. Oceangoing CLIA memberlines must follow them.
Scott, who is currently chair of the ACEP'sCruise Ship Medicine Section,said the guidelines are updated every couple of years.
The facilities are staffed by doctors and nurses,and the company's biggerships may also have medical administrators, paramedics and health care assistants.
The ships also have alternatemedical sites, as directed by the guidelines."So, ifthe first medical center is compromised in any way, we have an alternative oneso wecan continue to provide treatment," said Scott, who oversees day-to-day operations for the company's North American brands, including Carnival Cruise Line, Princess Cruisesand Holland America Line.
What can cruise ship medical facilities treat?
Carnival Corp. medical facilities can treat a variety of ailments, from rashes and earaches to heart attacks. "There really isn't (anything)we can't treat, at least for the first few hours," said Scott.
Doctors on the ship can prescribe medications to be dispensed and taken while on board, and treat serious illness either until passengersimprove or as a stopgap measure until a passenger can be brought ashore, depending on the scenario.In the case of a heart attack, they can give patients thrombolytics – or "clot-busting drugs" – on board until they can get them to a cardiac catheterization lab, which the vessels do not have.
The cruise line operator hasaformulary – a list ofmedicationsneeded to treat most diagnoses made on the ships –and stocks the vesselswith those, though supplies are limited given the finite storage on board.
The cruise ship environment can limit the team's capabilities in other ways, too. For example,the vessels have X-ray machines(medical staff aretrainedto operate radiology and lab equipment).But Scott said, "No one has really yet figured out how to put a CT scan on a ship that is moving through the ocean and have it workwell."
And while all medical staffworking on board are credentialedin their home countries, sometimes they need outsideassistance.
Janice Mullin and her husband, Jeff,werewaiting to tour cavesas part of a shore excursioninGibraltarduring a 2012cruise when a Barbary ape jumped up on a bench beside her. The animalreached for the band of her Timex watch, attempting to takeit off her arm.
Asshe stood up, the ape bit her, leavingpuncture wounds on her arm. "I tend to make light of most everything, so I said,'It's no big deal,' " Mullin, now 77, said."My husband said, 'No, I think you need to tell the tour guide,' and she absolutely freaked out."
The cruise line, Holland America, rushed herto the ship's medical facility. The doctor told Mullin he had never seen a monkey bite before, andthe medical personnel called the Centers for Disease Control and Prevention for guidance. They gave her several injections and put her on antibiotic andantiviral medications.
Mullin, who livesin Enid, Oklahoma,said the cruise line coveredher medical expenses and she felt the care she received was "wonderful," though she picked up an undesirable souvenir. "I had this great big black spot on my arm ... it was probably about the size of a softball," she said. "I had my 15 minutes of fame, and people would say, 'Oh, there's the woman who got bit by the monkey.' "
Scott said situationslike that are "not that frequent." He alsonoted that the company developedHealth Operations Centersat the start of the pandemic, which are based in offices on shore and can provide support to those working onboard.
Carnival Corp.has agreements withmultiple university medical centersto conductconsultations with specialists.
How do cruise ships get sick or injured people to shore?
Scott said how cruise ships get sick or injured passengers to shore depends in large part on"the weather, the location and the assets available."
If the ship has a stopcoming up, they may wait until they can get to aport.If not, they consider what is nearby, or if the U.S. Coast Guard (or equivalent officials in other countries)areavailable to them, which can provide a helicopter evacuation, or by boat if they are closer to shore.
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Scott said they remove sick or injured passengers at ports the vast majority of the time, which is the "safest way to do it." Even if there are not medical facilities near a given port, there may be an airstrip, allowing the team to schedule a medevac aircraft to come meet the ship, Scott said.
Does insurance cover medical expenses on a cruise?
Many health insurance plans do not cover medical expenses incurred at sea or in foreign countries, Scott said. Carnival Corp. requires passengers to pay for those services, and they can then submit the receiptsto their insurance company.
He said he is "not aware" of any cruise line that accepts insurance in its medical facilities, and highly recommended passengers purchase travel insurance, which he said is more likely to cover those bills.
Scott said a medical evacuation can cost tens of thousands of dollars, though the amount varies depending on the circ*mstances.
Lautenschlager'smedical costson Norwegian totaled$371.96, including medication, according to a receipt she shared with USA TODAY. She plans to submit the expensesto her travel insurance provider.
While a medical issue can put a damper on vacation, even Mullin, who was bitten by the monkey,still loves cruising.Shesails two to three times a yearwith her husband.
"It hasn't deterred us any, the idea of being sick," she said. "Because that's life, people get sick."
