CDC has published Guidance on Air Medical Transport for Middle East Respiratory Syndrome (MERS) Patients. Excerpt:
Air Transport of MERS Patients: General Considerations
• MERS patients should be transported on a dedicated AMT[air medical transport] mission with the minimum number of crew members. Whenever possible, no passengers or patients who do not have MERS should be on board. If a parent is accompanying a sick child, the parent should use personal protective equipment (PPE) during transport as described in “Infection Control,” below.
• If possible, a primary caregiver should be assigned to the MERS patient.
ºThe primary caregiver is typically designated based upon the patient’s needs for care, and who is qualified to meet those needs. A member of the AMT crew would usually be the primary caregiver, but there might be situations where a non-crew physician needs to provide care. The primary caregiver should be determined based on the patient’s needs prior to transport.
• The number of caregivers should be limited to those required to provide essential care during the trip.
• Infection control should involve the following matrix of measures:
º Source control (i.e., confining the spread of respiratory secretions at the patient level)
º Engineering controls to limit airborne dissemination of the virus
º Locate patient as near as practical to the aircraft exhaust or the exhaust of the containment within which the patient is housed. The isolation perimeter should be at least 6 feet away from the patient.
º Use of PPE as outlined below
º Use of safe work practices to prevent exposure
The size and type of aircraft will influence the extent to which these measures can be implemented. When available, use of a portable isolation unit may be considered.
• Consideration must be given to the need for “PPE breaks” during long trips. Removal of respiratory protection is unavoidable. An area at the front of the plane (or “upwind” from the patient, depending on cabin air flow), as far as possible from the patient, should be designated for this purpose.
• International transport of patients with MERS should be coordinated with public health authorities at origin and destination.
All MERS patient transport involving entry into the United States should be reported to CDC prior to arrival, preferably before travel, by calling the CDC Emergency Operations Center at +1 770-488-7100 (24-hour number). Callers will be connected with the CDC Quarantine Station responsible for the airport of arrival. U.S. federal regulations require the commander of an aircraft destined for the United States to report any deaths and certain illnesses among travelers to CDC before arrival. For more information, see Guidance for Airlines on Reporting Onboard Deaths or Illnesses to CDC.