Biological emergency management: The case of ebola 2014 and the air transportation involvement

The putative spread after the outbreak of the haemorrhagic fever epidemic caused by Ebola virus in West Africa, in the early months of 2014, puts the spotlight on the management of biological risks involving air transportation. Ebola virus is a highly pathogenic agent, causing a haemorrhagic fever defined Ebola HF, characterized by a high fatality. This virus is generally considered to be self-limiting in terms of diffusion; its lethality is in fact so high as to prevent the exit from rural areas where outbreaks generally occur. However, when the virus comes from rural areas and reaches urban places, it is important to assess the risk of spreading even in areas far from the outbreak of origin. Therefore, the development or strengthening of strategies and plans to take action with timely and effective response in order to reduce the consequences of public health emergencies is paramount. During Ebola virus outbreak in West Africa in 2014, World Health Organization focused attention on many airports, stops of main flights coming from Africa; the aviation, due to its nature, has the potential to help boost the global spread of transmissible diseases, since air travel allow to reach the most remote locations in hours. The management of biological emergencies during ordinary operations of airlines and airports represents a real constraint in the event of contrast epidemic situations or endemic outbreaks. An effective response plan should include a careful assessment of the risks and the establishment of procedures to carry on board of aircrafts or on the ground. To ensure that this complex system works correctly, a broad and effective cooperation between the different actors involved is required. On the international level, several documents and recommendations relating to the management of contagious diseases in aeronautical environment have been produced by authoritative agencies. In this paper, after an overview on the international response to public health emergencies in the aviation environment, the attention is focused on emergency response to the Ebola virus crisis in 2014, including an evaluation of the potential dispersion of the pathogen.