USA. Zika is primarily seen as a vector-borne disease prevalent in the Caribbean, Central America, South America, and Africa. Because Zika infection during pregnancy can cause birth defects, women are advised to check with their physician prior to traveling to any suspected areas.6 Another vector-borne illness well-known to nurses in the United States is Lyme disease, which is transmitted via tick bites. A very rarely seen vector-borne disease is bubonic plague, which has occasionally appeared in the news (transmitted from fleas to rats). Additionally, if you work in Primary Care (or the Emergency Department), you learn to ask patients if they have recently traveled out of the country, if they have suspicious fevers, or unusual lymph node swelling. We learn to assess for signs/symptoms of potential vector-borne disease, such as chiku- ngunya, dengue fever, yellow fever, or malaria. After all, it hasn’t been that long (2014) since we had Ebola on U.S. soil, and we are still learning exactly how that disease is transmitted, including how long the virus remains in the body once symptoms have begun to disappear. Disease transmission and disaster preparedness can be a compli- cated business, but especially for those on a vessel at sea. Imagine that you oversee those passengers, any one of whom could be transporting disease. Would you be ready? In review, what are the steps for disaster planning? REMEMBER THE 5 R’S. Rescue: know what process has occurred: is it food-borne, airborne, or vector-borne? Identify vulnerable populations. Rescue the most at risk groups first, isolate pregnant and lactating women and infants if possible. Re-entry: seek additional medical assistance or referral when able. Notify appropriate health authorities. Recovery: begin normalizing. Send people home, provide referral for those that require additional medical assistance. Restoration: cleaning, disinfection, containment. Rehabilitation: monetary support and continuing care. Finally, as the Oasis of the Seas departs to carry another group for a beautiful oceanic adventure, we wonder…will disaster strike a second time? We need to believe this was an isolated event, and thousands of cruising passengers will arrive at their expected ports unscathed. But we still find it comforting to know medical personnel will have pro- cedures to follow for potential food-borne, airborne, and vector-borne diseases to keep passengers safe from harm, just as they did on January 11th, 2019. That is disaster planning in action. Are you ready to board? n Diane Goodman, RN, MSN-C, CCRN, CNRN, is a semi-retired Acute Care Nurse Practitioner, with over 40 years of full-time nursing experi- ence.Althoughshenolongerworksfull-timeasaClinicalEducator,shehas maintained an active status as a Nursing Journalist & consultant during the last few years, writing and collaborating with nurses around the globe. REFERENCES 1. amp.usatoday.com., “People May Have Been Exposed to Measles on Christmas Eve at Newark Airport.” , Kanzler, K., North Jersey Record, December 28, 2018. 2. Foodpoisonjournal.com. “CDC’s Top 5 Food-borne Bugs in U.S.” , Marler, B. Jan- uary 13, 2018. 3. medicalnewstoday.com. Kandola, A. Last reviewed 26 May 2017. “What’s to Know About Airborne Disease” . Reviewed by Jill Seladi-Schulman, PhD. 4. michigan.gov. “Food-borne Illness and Emergency Response.” , Fiscal year 2013, Michigan Department of Agriculture and Rural Development Food and Dairy Division, 5. ncbi.nim.nih.gov. “CDC’s Strategic Plan for Bioterrorism Preparedness and Response.” Kaplan, J, MD, MPH, Public Health Reports, 2001. 6. onlinelibrary.wiley.com. “The Role of the Nurse in Emergency Preparedness.” First published 29 February 2012, an official publication of AWHONN, approved December 2011. 7. sphweb.bumc.bu.edu. ” Transmission of Infectious Disease” Boston University School of Public Health (teaching tool for disease transmission). 8. who.int. “World Health Organization Fact Sheet: Vector-borne Diseases.” , October 31, 2017. FOCUS ON EDUCATION  |  COVER STORY www.elitecme.com | 2019 | INFECTIOUS DISEASE, DISASTER PLANNING & WOUND CARE 7