Is the plane that transports Ebola patients completely safe?

By: Debra Ronca

Phoenix Air Group is the airline that transports Ebola patients out of Africa to hospitals where they can get advanced medical care.
Phoenix Air Group is the airline that transports Ebola patients out of Africa to hospitals where they can get advanced medical care.
© Tami Chappell/Reuters/Corbis

When we fly the friendly skies we know — at least on some level — that in between flights, a cleaning crew comes in and tidies up the plane for the next batch of travelers. Every airline does this, but there's one airline that takes clean to the next level. And it's an airline you've probably never heard of.

Phoenix Air Group transports severely ill and highly contagious patients from one part of the world to another. It's also the airline that transports Ebola patients out of Africa to hospitals where they can get advanced medical care.

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Typically, Ebola patients airlifted out of Africa are health care workers who've contracted the virus through working with infected people under insufficient medical conditions. For example, in August 2014, a special plane flew two health care workers from Africa to Atlanta, Georgia, for treatment after they contracted the virus.

During an Ebola outbreak, health care workers are among those most at risk of contracting the disease. Health care workers often perform their jobs in remote areas under unsanitary medical conditions and can come into contact with patients' bodily fluids, which transmit the disease [source: Freedman].

Symptoms of Ebola include:

  • Fever and weakness
  • Muscle pain
  • Headache
  • Vomiting
  • Diarrhea
  • Impaired organ function
  • Internal and external bleeding

If someone contracts Ebola and begins exhibiting symptoms, he or she can rapidly become severely ill. Getting a patient back to his or her home country for medical care is paramount, and air travel is the quickest way to do it. However, because the more severe symptoms involve bodily fluids, a patient must be transported in the safest, most sterile way possible in order to prevent infecting others.

Enter Phoenix Air.

The two health care workers flown from Africa to the United States in summer 2014 didn't travel on a regular passenger plane or even a private jet. They traveled on what Phoenix Air calls "Emergency Rooms in the Sky." These planes, used exclusively for patient evacuation and transfer, are custom equipped to handle sick and contagious people.

Providing air ambulance services for more than 20 years, Phoenix Air first partnered with the Centers for Disease Control and Prevention (CDC) in 2003 during the SARS outbreak [source: Crist]. The two organizations worked together and designed the perfect airplane to transport contagious patients safely from one end of the world to the other, without spreading infection. The CDC has official guidelines for all air medical transport services. These incredibly comprehensive guidelines include [source: CDC]:

  • Coordination with public health and aviation authorities at departure and arrival points
  • Infection-control policy implementation
  • Properly trained personnel
  • Correct use of personal protective equipment

Fortunately, the CDC never needed their services during the SARS outbreak, but when the Ebola patients needed help, Phoenix Air was ready.

So how do you take a regular plane and turn it into a safe, sterile ambulance in the sky while ensuring the health and safety of the pilot, the crew and the medical professionals on board (not to mention the patient)?

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Transporting Ebola Patients

Phoenix Air calls the planes they use for patient evacuation and transfer "Emergency Rooms in the Sky."
Phoenix Air calls the planes they use for patient evacuation and transfer "Emergency Rooms in the Sky."
© Tami Chappell/Reuters/Corbis

The planes used to transport Ebola patients are highly modified Gulfstream jets. These jets are dedicated aircraft, used exclusively for patient transfer. One of the major modifications is a structure called the Aeromedical Biological Containment System (ABCS). The ABCS is basically a framed, clear plastic tent. It features a HEPA-filtered air supply that keeps the inside sterile and the rest of the cabin free of germs and infection. The ABCS must be large enough to contain not only the patient, but also medical personnel (in protective suits) to care for the patient, who is typically severely ill. It's an airborne isolation unit.

Before embarking on a flight, the crew makes arrangements for every possible scenario. They take into account possible flight diversions, delays, stops for fuel, weather issues and maintenance problems. Every airfield along the flight path is identified and authorities at each one are notified in the event the plane needs to land unexpectedly.

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Each flight crew transporting the passenger is made up of essential members only, who have as little exposure to the patient area as possible. In fact, the ABCS is so contained, the flight crew didn't even wear full protective gear on their mission to pick up Nancy Whitebol, the second American Ebola patient (Kent Brantly had taken the maiden voyage two days earlier) [source: Crist]. All crew members are prepped on how to perform self-evaluation for symptoms after each flight, in addition to where and how to report them on the small chance any symptoms do appear.

Once the flight is over and a medical team in personal protective equipment safely removes the patient, a maintenance team (again, wearing protective gear) takes down the tent according to CDC protocol. The tent is built for single use and collapses in on itself. The crew then disposes of the tent as medical waste, and it's incinerated. Next, the entire cabin is sprayed down with disinfectant and decontaminated.

Of course, we're not talking Lysol-type disinfectant here. When the plane is decontaminated, the cleaning crew's to-do list includes:

  • Disinfecting every surface, regardless of whether it was touched, with hospital-grade cleaner
  • Disposing of any patient-care equipment as biohazard material
  • Cleaning and disinfecting anything reusable
  • Discarding linens
  • Following a stringent process of removing protective equipment and clothing and washing hands afterward

Phoenix Air operates missions not only for the CDC, but also the Defense Department, the Department of the Interior and NASA [source: Freedman].

As you can see, the CDC and Phoenix Air take every precaution to ensure that everyone on board, from the patients to the flight crew, are as safe as possible. And then the next time they get a call, they do the whole thing again.

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Lots More Information

More Great Articles

  • Centers for Disease Control and Prevention. "Guidance on Air Medical Transport for Patients with Ebola Virus Disease." Sept. 17, 2014. (Sept. 21, 2014) http://www.cdc.gov/vhf/ebola/hcp/guidance-air-medical-transport-patients.html
  • Crist, Carolyn. "Inside the Flying Quarantine Ward Used to Transport Ebola Patients." Wired. Aug. 8, 2014. (Sept. 21, 2014) http://www.wired.com/2014/08/inside-the-flying-quarantine-used-to-transport-ebola-patients/
  • Freedman, Andrew. "The Obscure Airline That Evacuated the American Ebola Patients." Mashable. Aug. 5, 2014. (Sept. 21, 2014) http://mashable.com/2014/08/05/shadowy-airline-flew-american-ebola-patients-home/
  • Hsu, Jeremy. "SARS Outbreak Isolators Helped 'Ebola Air' Fly Infected Patients." Scientific American. Sept. 18, 2014. (Sept. 21, 2014) http://www.scientificamerican.com/article/sars-outbreak-isolators-helped-ebola-air-fly-infected-patients/
  • Phoenix Air Group Inc. 2014. (Sept. 21, 2014) http://phoenixair.com/home.html
  • World Health Organization. "Frequently asked questions on Ebola virus disease." Aug. 8, 2014. (Sept. 21, 2014.) http://www.who.int/csr/disease/ebola/faq-ebola/en/

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