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Transporting a highly infectious patient for treatment requires attention to their medical needs while ensuring adherence to strict anti-transmission protocols. When the patient must be transferred to a different country, medical air transport is frequently the best option. In early May 2026, three hantavirus patients were transported from the cruise ship MV Hondius to the Netherlands for supportive care, according to AirMedandamp;Rescue.17 Americans' Medical Evacuation
In addition, 17 American passengers departed on a U.S.-bound medical evacuation flight on May 10. When the patients left the MV Hondius, the vessel was docked off the city of Tenerife in Spain's Canary Islands, according to NBC News.
Of the medically evacuated Americans, two were placed in the aircraft's biocontainment units. One passenger tested mildly PCR positive for the Andes virus [hantavirus strain] while the other had mild symptoms at boarding time, a United States Department of Health and Human Services (HHS) statement said.
The American passengers' destination was the Administration for Strategic Preparedness and Response Regional Emerging Special Pathogen Treatment Center (RESPTC) at Omaha's University of Nebraska Medical Center/Nebraska Medicine. The mildly symptomatic passenger was scheduled to be transported to a different RESPTC site.
The HHS statement further said each arriving passenger would receive a detailed medical assessment with their care based on the results. "Upon arrival at each facility, each individual will undergo clinical assessment and receive appropriate care and support based on their condition."
Infectious Patient Air Transport Protocols
Dr. Ryan Copeland, the International SOS Regional Medical Director for the Middle East, detailed the multiple factors involved in planning the hantavirus patient transport operation, according to an interview in AirMedandamp;Rescue. International SOS is a recognized global workforce security and health consulting firm. Dr. Copeland said medical transport plans must "account for critical factors such as the pathogen's characteristics, incubation period, transmission mode, and the patient's clinical stability."
Further, Dr. Copeland said transport protocols must include involvement (and sign-offs) from all relevant authorities. "Strict coordination with public health authorities is essential, covering the point of origin, any transit or overflight jurisdictions, and the destination country. Approvals must be secured before movement can proceed. Equally important is confirming medical acceptance at a receiving facility equipped with appropriate isolation capabilities and specialist treatment resources."
Looking at the bigger picture, Dr. Copeland said every air medical evacuation is essentially a balancing act. Although the patient must continue to receive timely care, every precaution must be taken to minimize risks to the medical team and flight crew. Ground ambulance personnel's safety must also be taken into consideration. The hantavirus patient transport operations are being coordinated through European Air Ambulance and Redstar Aviation, two globally recognized medical air transport service providers.
European Air Ambulance Snapshot
Based at Luxembourg Airport, European Air Ambulance (EAA) operates fixed-wing aircraft suitable for short- and long-range medical evacuation missions. Most longer-range trips can be completed without en route fuel stops. Each medical jet contains a complete ICU, oxygen delivery, and monitoring equipment.
The EAA flight coordination team determines whether each mission is a scheduled trip, an urgent transfer, or an emergency medical transport. Based on that finding, the team selects the proper aircraft, flight plan, and medical crew. An ICU physician, flight nurse, and targeted medical specialist typically comprise the onboard medical team.
The EAA Fleet
The LearJet 45XR: Ideal for shorter, fast-turnaround international missions, this medical jet's STOL capabilities enable the aircraft to utilize smaller airports closer to medical treatment facilities.The Bombardier Challenger 605: This medical jet is equipped to transport patients requiring specialized or intensive care. The Challenger 605 can also handle long-range and/or complex missions (including infectious isolation patient transport).
Specialized EAA Units
Infectious Disease Unit: This unit offers extensive protection for one (or more) patients and the medical crew. The unit was created for Ebola patients and modified for COVID-19 patient use.
Intensive Care Unit: This unit provides the highest in-transit critical care from a selected medical crew. A detailed risk/benefit evaluation is first required.
Neonatal and Pediatric Care Unit: An incubator supports the medical transfer of a newborn to a specialized medical unit. An ICU pediatric flight nurse may be required.
RedStar Aviation Snapshot
Since 1989, Redstar Aviation has provided global medical air transport services. Redstar's Istanbul headquarters ideally positions the company to serve Asian, European, African, and South American clients. Redstar Aviation's multilingual alarm center staff enables the company to serve clients with diverse language profiles. Unlike similar providers, Redstar Aviation conducts operations in war zones and other areas with geopolitical conflict.
In 2022, Redstar Aviation was named the ITIJ Air Ambulance Company of the Year. Ozan Alemdaroglu, the company's Deputy General Manager, applauded the firm's ability to routinely provide a ‘consistent level of service' while ‘thriving in the face of adversity'. "Our ability to operate smoothly under such circumstances [as the Covid-19 pandemic] is a testament to the diverse configuration of our fleet, our existing capabilities, and, most notably, our renowned attributes of flexibility and adaptability," he said, according to AirMedandamp;Rescue.The Redstar Aviation Fleet
The LearJet 45XR: This well-equipped medical jet executes long-range missions by integrating planned fuel stops. Each LearJet 45XR can efficiently transport two patient stretchers and all required medical equipment.
The Bombardier Challenger 605: The Challenger 605's ICU unit rivals those in many hospitals. Besides intensive-care-level stretchers, the Challenger accommodates Epishuttle isolation units and an Extracorporeal membrane oxygenation unit (ECMO). The Challenger 605's spacious interior supports single-patient or multiple-patient loads.
The Leonardo AW139: This twin-engine, mid-sized helicopter is ideal for short-range medical evacuations. With a range of 570nm and fuel capacity for up to five hours, the Leonardo AW139 is well equipped to service offshore energy platforms. When embarking on an EMS flight, the Leonardo AW139 can transport up to four stretchers.
Aeromedical Modules: A Medical Transport Alternative
Air ambulances have long been regarded as the "gold standard" for complex and/or long-distance medical evacuations. The European Air Ambulance and Redstar Aviation fixed-wing aircraft fleets are equipped with the latest technology and experienced medical crews to safely execute demanding missions. Once the patient arrives at the destination airport, the subject mission is effectively complete.
In contrast, San Antonio-based Knight Aerospace has built a thriving business using a drastically different approach. In the COVID-19 pandemic's early days, Knight Aerospace engineers debuted the company's Universal Patient Module (or UPM). This self-contained medical treatment facility rolls neatly into large C-130 and C-17 military aircraft. During a typical flight, medical personnel treat and monitor up to 12 sick, injured, or contagious patients. Each customizable UPM can integrate multiple critical care functionalities, according to Port San Antonio.
When an aircraft transports a self-contained UPM, the module's patients are physically separated from the flight crew. This reduces infection exposure risks and means the aircraft does not have to undergo time-consuming decontamination procedures after the flight. Once the transport is complete, the UPM remains functional even when rolled off the aircraft.
Bianca Rhodes, Knight Aerospace President and CEO, put the company's mission into perspective. "Our mission is focused on providing an innovative system that will save lives. In the wake of increasingly severe natural disasters, fast-spreading pandemics, and other emergency scenarios around the world, there is a great deal of interest in our technology from governments, relief organizations, and other parties.
"They realize that with an advanced system that offers an operating room-quality environment inside an aircraft, the medical attention that is provided—up to and including emergency surgery—can begin the moment the patient is on board. This system revolutionizes medical air transport, and we are focused on dramatically improving outcomes as a result," Bianca Rhodes said.Knight Aerospace's aeromedical modules can also play an integral role in disaster recovery efforts. For instance, if someone is injured in a natural disaster, the unit can support the patient during transport to higher-level care facilities. The aeromedical modules are also ideal during humanitarian aid programs, according to Axios San Antonio.