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Aeromedical Evacuation of Patients with Contagious Infections

  • Garibaldi, Brian T.1
  • Conger, Nicholas G.2, 3
  • Withers, Mark R.4
  • Hatfill, Steven J.5
  • Gutierrez-Nunez, Jose J.6
  • Christopher, George W.7
  • 1 Johns Hopkins Biocontainment Unit, Johns Hopkins University School of Medicine,
  • 2 Wright Patterson Air Force Base,
  • 3 Wright State University School of Medicine,
  • 4 Office of Medical Support & Oversight, U.S. Army Research Institute of Environmental Medicine,
  • 5 George Washington University Medical School,
  • 6 University of Puerto Rico School of Medicine, Department of Medicine, San Juan Veterans Administration Medical Center,
  • 7 Col, USAF, MC (ret.), Medical Countermeasure Systems, Joint Program Executive Office for Chemical and Biological Defense,
Published Article
Aeromedical Evacuation
Publication Date
Feb 27, 2019
DOI: 10.1007/978-3-030-15903-0_20
PMCID: PMC7123148
PubMed Central
  • Article


Most patients with infectious diseases, including biologic warfare casualties, can be safely transported by aeromedical evacuation (AE) using standard precautions. However, certain contagious diseases (e.g., tuberculosis, pneumonic plague, viral hemorrhagic fever) require transmission-based precautions to protect the other patients, medical personnel, and aircrew. AE planning for these patients must take into account international public health regulations. Given adequate resources, foresight, and expertise, the AE of infected patients and biologic warfare casualties can be safely accomplished. This chapter provides a review of the aeromedical evacuation of patients with communicable diseases. Topics include a review of the ecology of aircraft cabins and engineering features of aircraft ventilation systems that minimize the risk of disease transmission; examples of point source outbreaks related to air travel; in-flight preventive measures including the use of patient isolators; and US military and international policy and legal aspects of transporting patients with communicable diseases. Examples include in-flight transmission of tuberculosis, severe acute respiratory syndrome (SARS), smallpox, and measles.The chapter will also discuss experience in transporting patients with contagious diseases including viral hemorrhagic fevers and new patient isolation technologies that were used for the long-distance transport of patients with Ebola virus disease during the 2014–2016 West African epidemic.

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