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How infectious
are dead bodies?
Wednesday,
January 05, 2005
Transmission of
infection
requires the
presence of an
infectious
agent, exposure
to that agent,
and a
susceptible
host. It is,
therefore,
possible to
characterise the
infectious risk
from dead bodies
following a
natural disaster
by considering
these elements.
The human body
is host to many
organisms, only
some of which
are pathogenic.
When the body
dies, the
environment in
which pathogens
live can no
longer sustain
them. However,
this does not
happen
immediately, and
transmission of
infectious
agents from a
cadaver to a
living person
may occur.
Infectious
hazards for
individuals who
routinely handle
cadavers include
tuberculosis,
group A
streptococcal
infection,
gastroenteritis,
transmissible
spongiform
encephalopathies
(such as
Creutzfeldt-Jakob
disease),
hepatitis B,
hepatitis C, HIV
infection, and
possibly
meningitis and
septicemia
(especially
meningococcal).
Micro-organisms
involved in the
decay process
(putrefaction)
are not
pathogenic.
Do victims of
natural
disasters have
these infections
when they die?
Usually disaster
victims die from
trauma, burns,
or drowning, and
they are no more
likely than the
local population
to have acute
infections
(meningitis and
septicemia) or
rare diseases (eg
Creutzfeldt-Jakob
disease).
Instead, where
disease is
present, it is
far more likely
to be due to
chronic
infections with
blood-borne
viruses
(hepatitis B
virus, hepatitis
C virus, and
HIV), enteric
pathogens, and
possibly
Mycobacterium
tuberculosis.
Historically,
epidemics
resulting in
mass casualties
have only
occurred from a
few diseases,
including
plague, cholera,
typhoid,
tuberculosis,
anthrax, and
smallpox. As
previously
noted, such
infections are
no more likely
to be present in
disaster victims
than in the
general
population.
Furthermore,
although some of
these diseases
are highly
contagious,
their causative
agents are
unable to
survive long in
the human body
following death.
It is,
therefore,
unlikely that
such epidemics
will result from
contact with a
cadaver.
Indeed,
survivors
present a much
more important
reservoir for
disease. Where
dead bodies have
contaminated
water supplies,
gastroenteritis
has been the
most notable
problem,
although
communities will
rarely use a
water supply
where they know
it to be
contaminated by
dead bodies.
Source: PAHO
http://www.jamaicaobserver.com/news/html/20050104T190000-0500_72605_OBS_HOW_INFECTIOUS_ARE_DEAD_BODIES_.asp
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Thursday
Edition: Do Dead
Bodies Really
Create Disease
Risk?
By Al Tompkins
(more by author)
As I read and
watched the
tsunami
coverage, I
wanted to know
more about the
risk of disease
that thousands
of unburied
bodies might
create. I have
read press
accounts of
natural
disasters
stretching back
several years
now, and many
report about the
need to bury the
dead because of
a risk of
spreading
disease. But
even the World
Health
Organization
says that is not
true. In a
December 27
update, WHO
said: "Dead
bodies do not
pose any health
threat, but they
feed fears and
can divert
precious
attention and
resources from
effective relief
efforts."
The WHO
statement is one
of a growing
number of
reports that say
that bodies of
people killed by
trauma pose no
overwhelming
health risk
unless the dead
were infected
with disease
before they
died. Here is a
1999 Slate story
on the topic,
after a
devastating
earthquake in
Turkey.
The New York
Times' coverage
Wednesday
included a
passage that
indicated there
should be no
rush to bury.
Even as local
health officials
out in the field
were racing to
create mass
graves or pyres
to deal with the
rising tide of
bodies, saying
the bodies posed
immediate health
risks, officials
of the World
Health
Organization
emphasized that
the biggest risk
of an outbreak
was posed by
survivors.
The agency's
officials said
Tuesday that
because there
was little
danger of
epidemics from
unburied bodies,
immediate mass
burials and
cremations were
not necessary.
Instead, they
said, family
members and
friends should
be given time,
where possible,
to identify the
bodies first.
I have seen
similar articles
elsewhere. This
is from News-Medical.net
"There is no
evidence that,
following a
natural
disaster, dead
bodies pose a
risk of
epidemics," says
Oliver Morgan,
at the London
School of
Hygiene and
Tropical
Medicine, who is
author of the
article and who
has worked with
the
disaster-assistance
groups Oxfam and
Médecins Sans
Frontières
(Doctors Without
Borders) in
Latin America,
India, Africa,
and the Balkans.
Historically,
epidemics
resulting in
mass casualties
have only
occurred from a
few diseases,
including
plague, cholera,
typhoid,
tuberculosis,
anthrax, and
smallpox.
However, such
infections are
no more likely
to be present in
disaster victims
than in the
general
population. In
addition, while
some of these
diseases are
highly
infectious, they
are unable to
survive for long
in the human
body after death
occurs. It is
therefore
unlikely that
such epidemics
will result from
contact with a
cadaver.
Instead, notes
the article, "it
is far more
likely that
survivors will
be a source of
disease
outbreaks."
That article
said:
While the risks
for rescue
workers who
handle dead
bodies are
higher than for
the survivors of
a disaster, they
can be limited
through a set of
simple measures.
Appropriate
precautions
include training
military
personnel and
others who might
have to provide
assistance after
a disaster,
vaccinating
those persons
against
hepatitis B and
tuberculosis,
using body bags
and disposable
gloves, washing
hands after
handling
cadavers, and
disinfecting
stretchers and
vehicles that
have been used
to transport
bodies.
Wired.com
published a
story about what
American
disaster
officials
learned about
body disposal
after the
September 11,
2001 attacks.
The Real Risks
Make no mistake
about it. The
health problems
in the tsunami
areas are
overwhelming.
Experts are now
warning that as
many people
could die of
diseases as from
the actual
tsunami. The
World Health
Organization
says these are
currently the
biggest
problems:
South East Asia
is endemic for
malaria and
dengue fever.
Flooding and
stagnant water
create favorable
conditions for
the mosquito
vector.
Overcrowding
facilitates
mosquito bites
and therefore
transmission ...
Poor quality and
quantity of
water and
insufficient
sanitation,
overcrowding,
and poor hygiene
in temporary
camps will bring
forward the risk
for outbreaks of
different
diarrheal
diseases.
Thorough and
sustained water
purification is
an absolute
priority ...
Apart from
biological
pollution, the
possibility that
the environment
may be polluted
by leaks or
overflows from
flooded chemical
factories and
warehouses must
also be taken
into
consideration.
Water can be
contaminated by
gasoline and oil
leaking from
damaged vehicles
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