Communicable Diseases and Emerging Pathogens: The Past, Present, and Future of High-Level Containment Care

  • Theodore J. CieslakEmail author
  • Jocelyn J. Herstein
  • Mark G. Kortepeter


High-level containment care involves the management of patients with highly hazardous communicable diseases in specialized biocontainment units possessing a unique collection of engineering, administrative, and personnel controls. These controls are more stringent than those found in conventional airborne infection isolation rooms and provide additional safeguards against nosocomial disease transmission. Borne amidst a convergence of events in 1969, the employment of HLCC units was validated during the 2014–2016 Ebola virus disease outbreak, and the United States (as well as many other nations) is in the process of expanding its HLCC capacity. Beyond Ebola, however, the specific diseases that might warrant care in a HLCC unit remain unclear. We review here the fascinating history of HLCC and of biocontainment units and make recommendations regarding those highly hazardous communicable diseases that might optimally be managed in these units.


High-level containment care Highly hazardous communicable diseases Biocontainment 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Theodore J. Cieslak
    • 1
    Email author
  • Jocelyn J. Herstein
    • 2
  • Mark G. Kortepeter
    • 1
  1. 1.The Nebraska Biocontainment Unit, Department of Epidemiology, College of Public HealthUniversity of Nebraska Medical CenterOmahaUSA
  2. 2.Department of Environmental, Agricultural & Occupational Health, College of Public HealthUniversity of Nebraska Medical CenterOmahaUSA

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