Thursday, January 06, 2005

Cadavers pose no health risk after disasters

"Dead bodies do not pose health risk in natural disasters." By Scott Gottlieb, BMJ, 5th June 2004 (BMJ 328:1336).

'A search was conducted by Oliver Morgan using the PubMed online databases of the US National Library of Medicine for relevant literature on the infection risks for public safety workers and funeral workers as well as for guidelines for the management of the dead and prevention of infection. A small but important literature was also reviewed regarding the disposal of the dead and the contamination of groundwater by cemeteries.'

"Dr Morgan found that in natural disasters people usually die from trauma and are unlikely to have acute or “epidemic-causing” infections. This indicates that the risk that dead bodies pose for the public is extremely small.

However, people who are involved in close contact with the dead—such as military personnel, rescue workers, volunteers, and others—may be exposed to chronic infectious hazards, including hepatitis B and C viruses, HIV, enteric pathogens, and Mycobacterium tuberculosis. Suitable precautions for these people include training, use of body bags and disposable gloves, good hygiene practice, and vaccination for hepatitis B and tuberculosis.

But Dr Oliver found little evidence of microbiological contamination of groundwater from burial. Concern that dead bodies are infectious can be considered a “natural” reaction by persons wanting to protect themselves from disease. “However, clear information about the risks is needed so that responsible local authorities ensure that the bodies of disaster victims are handled appropriately and with due respect,” Dr Oliver writes."

From the PAHO press release, 23 Sep 2004:

'Contrary to popular belief, epidemics do not occur spontaneously after a natural disaster, and dead bodies will not lead to catastrophic outbreaks of exotic diseases, according to disaster experts at the Pan American Health Organization (PAHO).

The belief that dead bodies pose a serious health threat often leads authorities to take misguided action, such as mass burials, which can add to the burden of suffering already experienced by survivors. The key to preventing diseases is improving sanitary conditions and informing people, PAHO experts emphasize.

"Unfortunately, we continue to see the use of mass graves and mass cremations to dispose of bodies quickly, based on the myth that they pose a high threat of disease outbreaks," PAHO Director Mirta Roses writes in the introduction to a PAHO book "Management of Dead Bodies in Disaster Situations". The fact is that infectious agents do not survive long in dead bodies.

"The worst part of this is that these actions are taken without respecting the processes of identifying and preserving bodies, something that not only goes against cultural norms and religious beliefs but also has social, psychological, emotional, economic and legal consequences that add to the suffering directly caused by the disaster."

Dead bodies must be managed in such a way that it is eventually possible to identify them, say PAHO experts.

See also WHO page, "Myths and realities in disaster situations" and "Dead bodies pose no epidemic threat, say experts." By Debora MacKenzie, news, 05 Jan 2004.

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