www.elitecme.com | 2019 | INFECTIOUS DISEASE, DISASTER PLANNING & WOUND CARE 5 O n January 11th , 2019, a Royal Caribbean cruise ship glided into port one day early, loaded with dis- appointed and frustrated passengers. Many were acutely ill, sickened with a highly conta- gious food-borne illness known as Norovirus. At least 277 passengers were ill, while the remainder were upset that they were in Florida on a Saturday, as opposed to disembarking in Jamaica on a planned seven-day cruise via the luxurious Oasis of the Seas, at one point the largest cruise ship in the world. They couldn’t know how lucky they were to be both on land, and away from the food- borne virus that would have run rampant through the remainder of the ship in due time. It is hardly coincidence that we see these epi- sodes occurring in the news again and again, for as every cruise ship nurse recognizes, an isolated vessel at sea is a perfect opportunity for infectious disease of nearly every type to be transmitted if protocols are not specifically followed. Yes, a cruise ship job might sound fabulous, until one must think of a closed vessel with more than 200 vomiting passengers with con- current diarrhea, many potentially young or elderly. Worse, imagine clinical subtypes with chronic disease, pregnant or lactating women with special needs of their own. Would you be ready? Are your Disaster preparedness skills up to the challenge?5 Nurses in the United States have gained basic knowledge of Disaster readiness fol- lowing two historic events: the tragedy of September 11, 2001, and the horrible after- math of Hurricane Katrina in 2005. Both events led to unexpected loss of lives and a change in the way Americans respond to Disaster. The Federal Department of Homeland Security was established in 2002, which combined 22 different federal agencies into a coordinated, integrated, “cabinet-level agency” to respond to emergencies. Since that time, the CDC manages the Strategic National Stockpile, which is the national repository of vaccines, antidotes, antibiotics, and critical medical equipment and supplies.4 Emergency responsiveness to any situation is generally categorized as the “5 R’s” frame- work, which is referred to as exposure sci- ence. The 5 R’s are defined as: rescue, re-entry, recovery, restoration, and rehabilitation. 4 To return to our passengers on that ill-fated cruise ship, personnel did what they could to rescue those who were exposed, minimize further contamination to the remainder of the ship, dock early to release the passengers where they could return home (or receive fur- ther treatment), and allow the passengers to be restored and/or rehabilitated near home. It was a wise decision. Although Norovirus is the number-one food-borne illness, an outbreak of Salmonella could prove just as troublesome. Over one million people in the United States contract Salmonella each year, which is commonly associated with eggs, meat, or poultry. “Foods that are likely to contain Salmonella include |  COVER STORY