The creation of a biocontainment unit at a Tertiary Care Hospital the Johns Hopkins Medicine Experience

Brian T. Garibaldi, Gabor D. Kelen, Roy G. Brower, Gregory Bova, Neysa Ernst, Mallory Reimers, Ronald Langlotz, Anatoly Gimburg, Michael Iati, Christopher Smith, Sally MacConnell, Hailey James, John J. Lewin, Polly Trexler, Meredith A. Black, Chelsea Lynch, William Clarke, Mark A. Marzinke, Lori J. Sokoll, Karen C. CarrollNicole M. Parish, Kim Dionne, Elizabeth L.D. Biddison, Howard S. Gwon, Lauren Sauer, Peter Hill, Scott M. Newton, Margaret R. Garrett, Redonda G. Miller, Trish M. Perl, Lisa L. Maragakis

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


In response to the 2014-2015 Ebola virus disease outbreak inWest Africa, Johns HopkinsMedicine created a biocontainment unit to care for patients infected with Ebola virus and other high-consequence pathogens. The unit team examined published literature and guidelines, visited two existing U.S. biocontainment units, and contactednational andinternational experts to informthedesignof the physical structure and patient care activities of the unit. The resulting four-bed unit allows for unidirectional flow of providers andmaterials and has ample space for donning and doffing personal protective equipment. The air-handling system allows treatment of diseases spread by contact, droplet, or airborne routes of transmission. An onsite laboratory and an autoclave waste management system minimize the transport of infectious materials out of the unit. The unit is staffed by self-selected nurses, providers, and support staff with pediatric and adult capabilities. A telecommunications system allows other providers and family members to interact with patients and staff remotely. A full-time nurse educator is responsible for staff training, including quarterly exercises and competency assessment in the donning and doffing of personal protective equipment. The creation of the Johns Hopkins Biocontainment Unit required the highest level of multidisciplinary collaboration.When not used for clinical care and training, the unit will be a site for research and innovation in highly infectious diseases. The lessons learned from the design process can inform a new research agenda focused on the care of patients in a biocontainment environment.

Original languageEnglish (US)
Pages (from-to)600-608
Number of pages9
JournalAnnals of the American Thoracic Society
Issue number5
StatePublished - May 2016


  • Biocontainment
  • Ebola virus disease
  • Infectious diseases

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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