Air Transport Isolator
One of the more interesting responsibilities of the Royal Air Force (RAF) Infection Prevention Control Team is the Air Transportable Isolator (ATI). In the mid 1970s the RAF was tasked by the Department of Health with developing an ATI capability and for many years remained the only nation in possession of an ATI and therefore capable of the operational Aeromedical Evacuation (AE) of an infectious patient.
In partnership with the Department of Health, the RAF is tasked by the Ministry of Defence to provide the capability to repatriate patients with Highly Infectious Disease (HID) from worldwide locations. These patients require complete isolation throughout the transfer process necessitating specialist teams, equipment and receiving facilities.
The RAF provides this capability through the use of an ATI. This can be used for any patient (military or civilian) and is designed to provide a completely closed environment to protect healthcare workers and aircrew and prevent aircraft contamination. The escorting team is referred to as the Deployable Air Transportable Isolator Team (DAIT). The team comprises of both military and civilian subject matter experts from the Royal Free London NHS Foundation Trust.
The unique environment of RAF aircraft poses unusual and challenging infection control problems, however the basic principles of infection control remain the same; these principles form the basis for DAIT training.
Whilst the incidence of British citizens contracting a HID and requiring AE remains low, the increasing commonality of air travel and the expeditionary nature of the British Armed Forces mean that the British subjects travel to areas where they could be exposed to the possible risk of contracting a HID.
The ATI was last used in 2014 and has been used 6 times for the repatriation of 1 confirmed, and 2 suspected cases of Lassa fever, 1 suspected case of multi-drug resistant tuberculosis, and 1 confirmed case of Crimean-Congo Hemorrhagic Fever, and most recently a confirmed case of Ebola.