Managing ill people on aircraft if Ebola is suspected
is important to assess the risk of Ebola by getting more
information. Ask sick travelers whether they were in a
country with an Ebola outbreak. Look for or ask about
Ebola symptoms: fever (gives a history of feeling
feverish or having chills), severe headache, muscle
pain, vomiting, diarrhea (several trips to the
lavatory), stomach pain, or unexplained bleeding or
The risk of spreading Ebola to passengers or crew on an
aircraft is low because Ebola spreads by direct contact
with infected body fluids. Ebola does NOT spread through
the air like flu.
Even if the person has been in a country with Ebola,
cabin crew won’t know for certain what type of illness a
sick traveler has. Therefore, cabin crew should follow
routine infection control precautions for all travelers
who become sick during flight, including managing
travelers with respiratory illness to reduce the number
of droplets released into the air. If in-flight cleaning
is needed, cabin crew should follow routine airline
procedures using personal protective equipment available
in the Universal Precautions Kit.
Follow these routine precautions
•Keep the sick person separated from others as much as
•Wear waterproof disposable gloves before directly
touching the sick person, blood,
or other body fluids.
•When providing direct care to a sick traveler who came
from a country with an Ebola outbreak, also wear
surgical mask (to protect from splashes or sprays), face
shield or goggles, and protective apron or gown (see
below: Universal Precaution Kit).
•Do NOT give a surgical mask for someone who is
nauseated or vomiting. Wearing a mask could harm a
traveler who is vomiting. Give an air sickness bag if
traveler is vomiting or reports feeling nauseated. ◦Give
a plastic bag for disposing used tissues or soiled air
•Give a surgical mask if a sick traveler is coughing or
sneezing, if the sick person can tolerate wearing one.
If a mask cannot be tolerated, provide tissues and ask
the person to cover mouth and nose when coughing or
Notify cleaning crew: Cabin crew should notify the
airline's ground and cleaning crews about any ill
traveler on board an aircraft so that preparations can
be made to clean the aircraft after passengers have
Universal Precaution Kits: Airplanes traveling to
countries affected with Ebola should carry Universal
Precaution Kits, as recommended by the
International Civil Aviation Organization (ICAO),
for managing ill travelers.
Reporting ill travelers
The pilot of an international flight bound for the United States is required by law to
report any onboard deaths or ill travelers who have
certain symptoms to the Centers for Disease Control and
Prevention (CDC) before arrival. This is consistent with
mandatory reporting standards of ICAO (ICAO document
4444 and Annex 9, Ch. 8, of the Chicago Convention).
CDC staff can be consulted to assist in evaluating an
ill traveler, provide recommendations, and answer
questions about reporting requirements. Reporting to CDC
does not replace usual company procedures for in-flight
medical consultation or getting medical assistance.
When necessary, CDC routinely conducts contact
investigations to alert passengers and crew of their
exposure to ill travelers with certain diseases who were
possibly contagious on their flight.
What to do if you think you have been exposed
a traveler is confirmed to have had infectious Ebola on
a flight, CDC will conduct an investigation to assess
risk and inform passengers and crew of possible
exposure. Any airline crew, cleaning, or cargo personnel
who think they were exposed to Ebola either through
travel, assisting an ill traveler, handling a
contaminated object, or cleaning a contaminated aircraft
should take the following precautions:
•Notify your employer immediately.
•Monitor your health for 21 days. Watch for symptoms of
Ebola: fever (temperature of 101.5°F/38.6°C or higher),
severe headaches, muscle pain, diarrhea, vomiting,
stomach pain, unexplained bleeding or bruising.
When to see a health care provider
•If you develop symptoms after possible exposure to
Ebola, get medical attention right away. ◦Before
visiting a health care provider, alert the clinic or
emergency room in advance about your possible exposure
to Ebola so that arrangements can be made to prevent
transmission to health care staff or other patients.
◦When traveling to get medical care, limit your contact
with other people. This includes avoiding public
transportation. Avoid all other travel until you have
been medically evaluated.
•If you are not in the
United States, contact
your employer for help with locating a health care
provider. The U.S. embassy or
consulate in the country where you are located can also
provide names and addresses of local physicians.
Guidance for airline cleaning personnel
Ebola spreads through direct contact by touching the
blood or other body fluids (like feces, saliva, urine,
vomit, and semen) of a person who is sick with Ebola.
Infected blood or other body fluids can spread Ebola
through breaks in your skin or if they get into your
eyes, nose, or mouth.
Treat any body fluid as though it is infectious. Hand
hygiene is the most important infection control measure.
When cleaning aircraft and any contaminated areas after
a flight with a sick traveler who may have Ebola, CDC
recommends that personnel:
Use disposable protective equipment while cleaning the
passenger cabin and lavatories. If working with reusable
equipment, properly clean and disinfect it after use.
•Waterproof gloves ◦Change gloves if they become dirty
or damaged during cleaning.
◦Consider double-gloving if cleaning large amounts of
blood or other body fluids.
◦Throw away used gloves according to your company's
recommended infection control precautions.
◦Clean hands with soap and water immediately after
gloves are removed or when changing gloves. (When soap
is not available, use waterless alcohol-based hand
sanitizer with at least 60% alcohol.) Use only soap and
water if hands are visibly dirty.
•Eye protection: goggles or face shield
•Long-sleeved, waterproof gown
•Closed-toe shoes and shoe covers. If increased risk of
splashing or area appears highly contaminated with body
fluids, wear rubber boots or shoe covers. Wear gloves to
carefully remove shoe covers to avoid contamination of
Safe removal and hygiene
•Carefully remove protective equipment to avoid
contaminating yourself or your clothes.
•After removing protective equipment, clean your hands.
Use only soap and water if hands are visibly dirty.
Clean affected areas
Use an Environmental Protection Agency (EPA)-registered
cleaner/disinfectant that has been tested and approved
for use by the airplane manufacturers.
•Lavatory surfaces: door handle, lock, faucet, sink,
walls, counter, and toilet seat.
•Sick traveler’s seat and the seats around it, seat
backs, armrests, tray tables, video monitor, light and
air controls, and adjacent walls and windows ◦If a seat
cover or carpet is obviously dirty from blood or body
fluids, it should be removed and discarded by the
methods used for biohazardous material.
•If surfaces are contaminated with large amounts of body
fluids (such as blood, vomit, feces), clean off the
material before applying disinfectant.
•Special cleaning of upholstery, carpets, or storage
compartments is not indicated unless they are obviously
dirty from blood or other body fluids.
•Special vacuuming equipment or procedures are not
•Do NOT use compressed air, pressurized water or similar
procedures, which might create droplets of infectious
Guidance for air cargo personnel
Packages or luggage should not pose a risk. Ebola virus
is spread through direct contact with blood or body
fluids (like feces, saliva, urine, vomit, and semen)
from an infected person.
•Don’t handle packages visibly dirty from blood or body
•Wash your hands often to prevent other infectious