Narrative:

I was assigned to fly to ZZZ departing XA00L. The cockpit and cabin crew were rested and properly prepared for this originating flight. The first officer was on the first leg of his 3 day assignment. I was assigned to fly to ZZZ and then deadhead home in the same duty period to commence days off. On this leg I was acting as the PF. Initial preflight briefings and duties were routinely accomplished; and the flight departed 6 mins early with 174 passenger and 7 crewmembers. Planned en route flight time was 3 hours 21 mins; with low ceilings forecast for ZZZ. The flight progressed normally for approximately 2 hours 30 mins. On the flight deck we had conducted a routine operation. We had each consumed coffee; orange juice; and identical crew meals; eaten approximately 30 mins apart with the first officer eating first. We had been carrying on casual conversation during the cruise portion of the flight. Midway first officer commented that he didn't 'feel good.' ironically; we had just been discussing the company's sick leave monitoring program and I initially took his comments as a humorous interjection. I looked away briefly; and when I looked back; first officer again commented that he 'really didn't feel well;' and wanted to recline his seat. At that time; I observed his color to have paled and he appeared to be in physical distress. The elapsed time between normal conversation to expression of discomfort to acute symptoms was less than 2 mins by my estimation. Realizing that this was not an attempt at humor and concerned by the rapid onset of this condition; I asked if he were alright. I received non-verbal response; as if he understood; but was reluctant to speak; possibly due to an impending regurgitation. I reached out to make physical contact with his arm. His skin was quite warm to the touch. We made eye contact and acknowledgement of my question; but still no verbal response. I immediately sounded the 'all call' cabin intercom and directed the purser to the cockpit. Her response was rapid. By the time she arrived (less than 1 min) I had verbal response from first officer and he complained of feeling extremely nauseous and weak. He was cognitively aware of where he was; and even though the acute nature of his symptoms seemed to have passed; he was obviously still in physical distress. The purser assisted by getting him a cold cloth and orange juice which seemed to provide some relief. He began breathing 100% oxygen from the crew station mask and continued in the fully reclined seat position. With the purser still attending; I text messaged flight dispatch via ACARS to 'call me md' to set up a phone patch with medical. We did not solicit onboard medical assistance; hoping to avoid any onboard distraction directed at the cockpit. I increased cruise speed to .83 mach. I advised ATC that we had a medical emergency in progress and would be off frequency to talk to the company. ATC was cooperative and extremely helpful throughout this event with the exception of wanting to know the nature of the medical emergency. While I realize that it is a mandatory part of their protocol; it resulted in a bit of consternation on my part. At this point I was essentially flying solo trying to ensure the continued safety of my flight; plus tend to the immediate needs of my first officer. I relayed to ATC that the medical emergency was with a crewmember. They asked 'which crewmember' and wanted to know the nature of the condition. I replied that I didn't want to discuss it on an open frequency; but they were adamant to know the information. Reluctantly; with more than a bit of frustration; and wanting to end the '20 questions;' I replied; 'first officer incapacitation;' or words to that effect. With their curiosity satisfied; I switched to the company phone patch with dispatch and medical. The radio link was weak; and the on call doctor and I had some difficulty communicating. I believe this was due to our position relative to the remote transmitters; since I was later able to talk normally with dispatch. After describing the symptoms and physical condition of first officer with the on call doctor; realizing that we were less than 1 hour from ZZZ andwith the concurrence of dispatch that ZZZ was the closest and most suitable medical divert; the plan was made to continue to destination. At this time I was also concerned that; since we had both consumed identical food and beverage items; that if first officer's symptoms were the result of a contaminated meal or food borne pathogens that I also could be at serious risk; and therefore also the safety of my flight. I returned to en route ATC; declared an emergency and requested clearance direct to ZZZ. Shortly after this transpired; one of the flight attendants working in the aft cabin called the cockpit and volunteered that he was a commercial/instrument rated pilot; and asked if he could be of assistance. I readily accepted his offer; and upon his arrival to the cockpit I directed the purser back to the cabin and told her that this flight attendant would remain in the cockpit for the approach and landing to provide safety and communications backup; as well as provide assistance if first officer's acute symptoms returned. There were five working flight attendants on board; with an FAA minimum staffing level of four; so I deemed this course of action to be no compromise to safety; and indeed an enhancement given the circumstances. First officer had continued to be alert during this entire time though at reduced physical capacity; at his crew seat in a fully reclined position breathing 100% oxygen. During this time; I had also detected the odor of intestinal gas on several occasions. First officer asked to go to the lavatory and left the cockpit for about 5-7 mins. When he stood up he appeared weak and still in physical distress; but was ambulatory and was able to go to and from the lavatory without assistance. During his absence from the flight deck; I briefed the flight attendant on the approach procedure; exit plan; and special duties I wanted him to perform; if necessary. Upon his return from the lavatory; first officer appeared to be in less physical distress; though still a bit pale and weak. He was alert and attentive and assumed his normal crew position and performed all normal PNF duties to the conclusion of the flight at the gate in ZZZ. He was alert enough to catch two minor omissions in my after landing and parking checklist flows. We were met at the gate by paramedics who attended to first officer and transported him to a local medical facility for further evaluate.

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Original NASA ASRS Text

Title: B757 FLT CREW MEMBER BECOMES ILL; EMER DECLARED AND FLT LANDS.

Narrative: I WAS ASSIGNED TO FLY TO ZZZ DEPARTING XA00L. THE COCKPIT AND CABIN CREW WERE RESTED AND PROPERLY PREPARED FOR THIS ORIGINATING FLT. THE FO WAS ON THE FIRST LEG OF HIS 3 DAY ASSIGNMENT. I WAS ASSIGNED TO FLY TO ZZZ AND THEN DEADHEAD HOME IN THE SAME DUTY PERIOD TO COMMENCE DAYS OFF. ON THIS LEG I WAS ACTING AS THE PF. INITIAL PREFLT BRIEFINGS AND DUTIES WERE ROUTINELY ACCOMPLISHED; AND THE FLT DEPARTED 6 MINS EARLY WITH 174 PAX AND 7 CREWMEMBERS. PLANNED ENRTE FLT TIME WAS 3 HRS 21 MINS; WITH LOW CEILINGS FORECAST FOR ZZZ. THE FLT PROGRESSED NORMALLY FOR APPROX 2 HRS 30 MINS. ON THE FLT DECK WE HAD CONDUCTED A ROUTINE OP. WE HAD EACH CONSUMED COFFEE; ORANGE JUICE; AND IDENTICAL CREW MEALS; EATEN APPROX 30 MINS APART WITH THE FO EATING FIRST. WE HAD BEEN CARRYING ON CASUAL CONVERSATION DURING THE CRUISE PORTION OF THE FLT. MIDWAY FO COMMENTED THAT HE DIDN'T 'FEEL GOOD.' IRONICALLY; WE HAD JUST BEEN DISCUSSING THE COMPANY'S SICK LEAVE MONITORING PROGRAM AND I INITIALLY TOOK HIS COMMENTS AS A HUMOROUS INTERJECTION. I LOOKED AWAY BRIEFLY; AND WHEN I LOOKED BACK; FO AGAIN COMMENTED THAT HE 'REALLY DIDN'T FEEL WELL;' AND WANTED TO RECLINE HIS SEAT. AT THAT TIME; I OBSERVED HIS COLOR TO HAVE PALED AND HE APPEARED TO BE IN PHYSICAL DISTRESS. THE ELAPSED TIME BTWN NORMAL CONVERSATION TO EXPRESSION OF DISCOMFORT TO ACUTE SYMPTOMS WAS LESS THAN 2 MINS BY MY ESTIMATION. REALIZING THAT THIS WAS NOT AN ATTEMPT AT HUMOR AND CONCERNED BY THE RAPID ONSET OF THIS CONDITION; I ASKED IF HE WERE ALRIGHT. I RECEIVED NON-VERBAL RESPONSE; AS IF HE UNDERSTOOD; BUT WAS RELUCTANT TO SPEAK; POSSIBLY DUE TO AN IMPENDING REGURGITATION. I REACHED OUT TO MAKE PHYSICAL CONTACT WITH HIS ARM. HIS SKIN WAS QUITE WARM TO THE TOUCH. WE MADE EYE CONTACT AND ACKNOWLEDGEMENT OF MY QUESTION; BUT STILL NO VERBAL RESPONSE. I IMMEDIATELY SOUNDED THE 'ALL CALL' CABIN INTERCOM AND DIRECTED THE PURSER TO THE COCKPIT. HER RESPONSE WAS RAPID. BY THE TIME SHE ARRIVED (LESS THAN 1 MIN) I HAD VERBAL RESPONSE FROM FO AND HE COMPLAINED OF FEELING EXTREMELY NAUSEOUS AND WEAK. HE WAS COGNITIVELY AWARE OF WHERE HE WAS; AND EVEN THOUGH THE ACUTE NATURE OF HIS SYMPTOMS SEEMED TO HAVE PASSED; HE WAS OBVIOUSLY STILL IN PHYSICAL DISTRESS. THE PURSER ASSISTED BY GETTING HIM A COLD CLOTH AND ORANGE JUICE WHICH SEEMED TO PROVIDE SOME RELIEF. HE BEGAN BREATHING 100% OXYGEN FROM THE CREW STATION MASK AND CONTINUED IN THE FULLY RECLINED SEAT POS. WITH THE PURSER STILL ATTENDING; I TEXT MESSAGED FLT DISPATCH VIA ACARS TO 'CALL ME MD' TO SET UP A PHONE PATCH WITH MEDICAL. WE DID NOT SOLICIT ONBOARD MEDICAL ASSISTANCE; HOPING TO AVOID ANY ONBOARD DISTR DIRECTED AT THE COCKPIT. I INCREASED CRUISE SPD TO .83 MACH. I ADVISED ATC THAT WE HAD A MEDICAL EMER IN PROGRESS AND WOULD BE OFF FREQ TO TALK TO THE COMPANY. ATC WAS COOPERATIVE AND EXTREMELY HELPFUL THROUGHOUT THIS EVENT WITH THE EXCEPTION OF WANTING TO KNOW THE NATURE OF THE MEDICAL EMER. WHILE I REALIZE THAT IT IS A MANDATORY PART OF THEIR PROTOCOL; IT RESULTED IN A BIT OF CONSTERNATION ON MY PART. AT THIS POINT I WAS ESSENTIALLY FLYING SOLO TRYING TO ENSURE THE CONTINUED SAFETY OF MY FLT; PLUS TEND TO THE IMMEDIATE NEEDS OF MY FO. I RELAYED TO ATC THAT THE MEDICAL EMER WAS WITH A CREWMEMBER. THEY ASKED 'WHICH CREWMEMBER' AND WANTED TO KNOW THE NATURE OF THE CONDITION. I REPLIED THAT I DIDN'T WANT TO DISCUSS IT ON AN OPEN FREQ; BUT THEY WERE ADAMANT TO KNOW THE INFO. RELUCTANTLY; WITH MORE THAN A BIT OF FRUSTRATION; AND WANTING TO END THE '20 QUESTIONS;' I REPLIED; 'FO INCAPACITATION;' OR WORDS TO THAT EFFECT. WITH THEIR CURIOSITY SATISFIED; I SWITCHED TO THE COMPANY PHONE PATCH WITH DISPATCH AND MEDICAL. THE RADIO LINK WAS WEAK; AND THE ON CALL DOCTOR AND I HAD SOME DIFFICULTY COMMUNICATING. I BELIEVE THIS WAS DUE TO OUR POS RELATIVE TO THE REMOTE XMITTERS; SINCE I WAS LATER ABLE TO TALK NORMALLY WITH DISPATCH. AFTER DESCRIBING THE SYMPTOMS AND PHYSICAL CONDITION OF FO WITH THE ON CALL DOCTOR; REALIZING THAT WE WERE LESS THAN 1 HR FROM ZZZ ANDWITH THE CONCURRENCE OF DISPATCH THAT ZZZ WAS THE CLOSEST AND MOST SUITABLE MEDICAL DIVERT; THE PLAN WAS MADE TO CONTINUE TO DEST. AT THIS TIME I WAS ALSO CONCERNED THAT; SINCE WE HAD BOTH CONSUMED IDENTICAL FOOD AND BEVERAGE ITEMS; THAT IF FO'S SYMPTOMS WERE THE RESULT OF A CONTAMINATED MEAL OR FOOD BORNE PATHOGENS THAT I ALSO COULD BE AT SERIOUS RISK; AND THEREFORE ALSO THE SAFETY OF MY FLT. I RETURNED TO ENRTE ATC; DECLARED AN EMER AND REQUESTED CLRNC DIRECT TO ZZZ. SHORTLY AFTER THIS TRANSPIRED; ONE OF THE FLT ATTENDANTS WORKING IN THE AFT CABIN CALLED THE COCKPIT AND VOLUNTEERED THAT HE WAS A COMMERCIAL/INST RATED PLT; AND ASKED IF HE COULD BE OF ASSISTANCE. I READILY ACCEPTED HIS OFFER; AND UPON HIS ARR TO THE COCKPIT I DIRECTED THE PURSER BACK TO THE CABIN AND TOLD HER THAT THIS FLT ATTENDANT WOULD REMAIN IN THE COCKPIT FOR THE APCH AND LNDG TO PROVIDE SAFETY AND COMS BACKUP; AS WELL AS PROVIDE ASSISTANCE IF FO'S ACUTE SYMPTOMS RETURNED. THERE WERE FIVE WORKING FLT ATTENDANTS ON BOARD; WITH AN FAA MINIMUM STAFFING LEVEL OF FOUR; SO I DEEMED THIS COURSE OF ACTION TO BE NO COMPROMISE TO SAFETY; AND INDEED AN ENHANCEMENT GIVEN THE CIRCUMSTANCES. FO HAD CONTINUED TO BE ALERT DURING THIS ENTIRE TIME THOUGH AT REDUCED PHYSICAL CAPACITY; AT HIS CREW SEAT IN A FULLY RECLINED POS BREATHING 100% OXYGEN. DURING THIS TIME; I HAD ALSO DETECTED THE ODOR OF INTESTINAL GAS ON SEVERAL OCCASIONS. FO ASKED TO GO TO THE LAVATORY AND LEFT THE COCKPIT FOR ABOUT 5-7 MINS. WHEN HE STOOD UP HE APPEARED WEAK AND STILL IN PHYSICAL DISTRESS; BUT WAS AMBULATORY AND WAS ABLE TO GO TO AND FROM THE LAVATORY WITHOUT ASSISTANCE. DURING HIS ABSENCE FROM THE FLT DECK; I BRIEFED THE FLT ATTENDANT ON THE APCH PROC; EXIT PLAN; AND SPECIAL DUTIES I WANTED HIM TO PERFORM; IF NECESSARY. UPON HIS RETURN FROM THE LAVATORY; FO APPEARED TO BE IN LESS PHYSICAL DISTRESS; THOUGH STILL A BIT PALE AND WEAK. HE WAS ALERT AND ATTENTIVE AND ASSUMED HIS NORMAL CREW POS AND PERFORMED ALL NORMAL PNF DUTIES TO THE CONCLUSION OF THE FLT AT THE GATE IN ZZZ. HE WAS ALERT ENOUGH TO CATCH TWO MINOR OMISSIONS IN MY AFTER LNDG AND PARKING CHKLIST FLOWS. WE WERE MET AT THE GATE BY PARAMEDICS WHO ATTENDED TO FO AND TRANSPORTED HIM TO A LCL MEDICAL FACILITY FOR FURTHER EVAL.

Data retrieved from NASA's ASRS site as of January 2009 and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.