June 1, 2026

Two potentially deadly viruses have been in the news lately. The Andes strain of the hantavirus, though not considered highly transmissible, was responsible for three deaths aboard a cruise ship in early May. And an Ebola outbreak in the Democratic Republic of Congo and Uganda was responsible for at least 18 confirmed deaths and hundreds of suspected deaths as of May 29, according to the U.S. Centers for Disease Control and Prevention.

In both cases, the risks within the United States remain low. Yet, Johns Hopkins clinicians are ready to care for patients if the need arises. Three experts explain how the Johns Hopkins Biocontainment Unit (BCU) prepares for these medical emergencies.

How does Johns Hopkins prepare for outbreaks like hantavirus and Ebola?

Officials at Johns Hopkins are closely monitoring both outbreaks of the Andes strain of hantavirus and Ebola Bundibugyo to see if they will need to activate the BCU for patient care. Currently, for both viruses, the risk of infection within the United States remains low.

“Our feelers are up, and we are as primed for activation as we can be,” says Jade Flinn, the BCU’s director of operations.

What is the Johns Hopkins Biocontainment Unit?

The Johns Hopkins Biocontainment Unit is designed to keep both patients and clinicians safe while providing the best possible care for high-consequence infectious diseases. The BCU doesn’t often have patients; it is typically used in cases where transmission risks are high and medical treatments don’t yet exist.

The unit opened at The Johns Hopkins Hospital in the spring of 2015 in response to the Ebola outbreak occurring in West Africa at that time. The 7,900-square-foot area includes several ways to contain infection risk while caring for patients. It has been used for isolation, testing and care of rule-out cases of viral hemorrhagic fevers, like Ebola. It was the first clinical space at The Johns Hopkins Hospital to admit patients with COVID-19 in March of 2020. The unit has:

• Space to care for four patients in a highly contained setting.
• Air filtration systems that are separate from the hospital’s ventilation system.
• Dedicated rooms for clinicians to put on or remove gear.
• Pass-through steam sterilizers for inactivation of infectious medical waste.
• An on-site laboratory.
• Equipment to perform routine surgeries and critical care interventions.

The BCU is one of 13 federally funded Regional Emerging Special Pathogen Treatment Centers. It serves Maryland and surrounding states, as well as the District of Columbia.

How is the BCU kept ready?

Though the BCU was last used during a viral hemorrhagic fever outbreak in April 2023, it is maintained to ensure rapid admission and care of patients. Keeping the unit ready is the full-time job of Jon Olesen, the BCU’s deputy director of operations.

“The biggest thing that we do is weekly readiness checks, where we literally walk through the space, check all the utilities, the toilets, the sinks and the airflow, and report anything that’s not working to the appropriate people,” he says. A seven-day supply of clinical supplies, including personal protective gear, is on-site at all times.

About 200 Johns Hopkins clinicians have volunteered to be part of the BCU staff, including physicians, nurses, advanced practice providers, respiratory therapists, infection control practitioners, paramedics, emergency medical technicians, radiology technologists, laboratory personnel and child life specialists. This highly engaged and motivated team regularly refreshes skills by:

• Conducting quarterly drills focusing on specifics such as safely putting on (donning) and taking off (doffing) the personal protective equipment (PPE) they wear in the unit, which includes head-to-to-toe coverings, double layers of gloves and battery-powered air-purifying respirators, known as PAPRs.
• Learning how to safely handle lab specimens and waste and respond to contamination scenarios like spills or PPE breaches.
• Team building, which is emphasized to ensure the clinicians can work well together under potentially stressful conditions.

In 2025, the BCU participated in a full-scale exercise simulating an infectious disease outbreak, which is highlighted in this video, “Johns Hopkins Hospital Hosts National Infectious Disease Transport Drill.”

What can patients and families expect in the BCU?

If a person needs to be treated in the BCU for a high-consequence infectious disease, he or she can expect the best possible care. “Because we use a self-selector model, you’re going to have the most engaged healthcare workers in the hospital,” says Flinn.

Every shift, the BCU forms a multidisciplinary team to provide comprehensive care across the spectrum of clinical specialties, with elevated staffing ratios of up to seven nurses assigned to a single patient, ensuring clinical safety and attentive bedside care. The clinicians will wear extensive PPE ensembles.

The BCU’s infrastructure supports the ability to cohort two patients, such as partners or a parent and child, in one room together if they have the same exposure or infection concern. If they are able, patients can connect with their families and others through telecommunication to keep up to date and avoid feelings of isolation.

“Whether that’s a baby and a mom or a critical care adult patient, we’re going to care for the patient and work with one another.”

How was the BCU used during COVID?

When the COVID-19 pandemic began, little was known about the virus or how it spread, and no vaccines or medicines were available. The BCU was activated Feb. 29, 2020, as a treatment site that would contain the virus and be safe for healthcare workers. It stayed activated for about a month, caring for patients with the first confirmed cases in the region.

“That gave us time to go to the rest of the hospital and say, ‘This is how we should design your patient flow to make sure that contamination stays in the areas that it needs to,’ ” says Flinn.

How does use of the BCU align with other infection control measures at Johns Hopkins?

The BCU is part of a larger infection prevention program that operates across Johns Hopkins Health System, says Carrie Billman, the BCU’s director of education and lead infection preventionist.

The infection prevention specialists who are part of the BCU provide consultation and expertise regarding appropriate disinfection products, training and personal protective equipment for the entire health system.

“We are constantly in contact with each other and making sure that every one of our Hopkins hospitals is as prepared as it can possibly be,” she says.

Medically reviewed by: Jade Flinn, Jon Olesen and Carrie Billman.