Perhaps you are one of the many Americans who are planning a cruise this year. You have compared cruise lines, poured over the brochures, trimmed your diet in anticipation of the sumptuous cruise feasts, and even bought new vacation clothes. But have you called your doctor? Or your health insurance provider?
Although illness may not be on your vacation agenda, it is wise to do some medical planning. Onboard medical facilities are no substitute for a hospital. If you get sick while sailing the high seas, be prepared to shell out your own money. Most insurance policies and Medicare do not cover cruise ship medical treatment.
Because cruise ships originate from many countries and travel internationally, there are no common standards defining minimum credentials for doctors or equipment on cruise ships. Other variables, such as ship size, itinerary, and mix of passengers influence staffing, equipment, and facilities. The American College of Emergency Physicians (ACEP) developed recommendations for onboard medical facilities. These recommendations were adopted by the Cruise Lines International Association (CLIA). CLIA members voluntarily comply with these guidelines, which also include equipment standards.
The goal of medical personnel aboard cruise ships is to provide reasonable emergency medical care. This means stabilizing the ill or injured traveler until definitive treatment is available on shore. At minimum, most ship infirmaries will contain:
As cruise lines continue to grow and medical technology improves, some ships have become equipped with telemedicine capabilities. Doctors aboard the ship can use a digital system to connect with specialists on shore, sharing video links and data.
Whenever large numbers of people congregate in a confined area, disease outbreaks from an infected person or a tainted food supply become a real threat. The Vessel Sanitation Program run by the US Centers for Disease Control and Prevention (CDC) inspects all ships that carry more than 13 passengers, visit a US port or territory, and sail an international itinerary. The inspections focus on:
Each ship starts with a score of 100, and points are deducted for violations. A score of 86 and higher is acceptable. All scores are updated in the CDC's Vessel Sanitation Program website. It is a good idea to review these scores before making your choice of cruise lines.
People with medical restrictions may face difficulties during long journeys on land or sea. Fortunately, there are agencies that specialize in making arrangements for people who have important medical considerations. One company called Special Needs at Sea provides rental equipment that can be delivered right to your cabin. These include wheelchairs, lifts, oxygen equipment, and hearing impairment kits.
Follow these tips before getting on board:
Centers for Disease Control and Prevention
https://www.cdc.gov
Cruise Lines International Association
https://www.cruising.org
Health Canada
https://www.canada.ca
Tourism Industry Association of Canada
https://tiac-aitc.ca
Advanced cruise ship inspection search. Centers for Disease Control and Prevention website. Available at: https://wwwn.cdc.gov/InspectionQueryTool/InspectionSearch.aspx .Accessed October 13, 2018.
Green sheet report. Centers for Disease Control and Prevention website. Available at: https://wwwn.cdc.gov/InspectionQueryTool/InspectionGreenSheetRpt.aspx. Accessed October 13, 2018.
Health care guidelines for cruise ship medical facilities. American College of Emergency Physicians website. Available at: https://www.acep.org/content.aspx?id=29980#sm.0001fpfenu1dere2buhdwbfpp4x8i. Accessed October 13, 2018.
Vessel sanitation program. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/nceh/vsp/desc/about_inspections.htm. Accessed October 13, 2018.
Last reviewed October 2018 by EBSCO Medical Review Board Michael Woods, MD, FACP