Posted: August 7, 2014
With news of the Ebola outbreak in West Africa generating headlines worldwide, many healthcare organizations have looked at their preparedness in the event of an outbreak in the United States.
John H. Fitch Jr. and Lesley Witter of the National Funeral Directors Association's Advocacy Division met at the Centers for Disease Control on Ebola guidance for hospitals and hospital workers in treating infected patients. "As always, we brought up the issue of infected dead bodies and what specific guidance there was for funeral directors," Fitch said. "We were actually supported by several hospital representatives and doctors since they also wanted to know how to handle the deceased if they died in the hospital."
"We not only raised the issues related to prep room protocols and whether to embalm or not, but also whether an open-casket viewing could or should be held and whether the body can be buried or must it be cremated," Fitch added. "The CDC said it was in the process of developing that guidance and would advise us when it was available."
In the meantime, the World Health Organization has called attention to a document issued in 2008 offering interim infection control recommendations for patients with suspected or confirmed diagnoses of filovirus haemorrhagic fever (HF), including Ebola or Marburg haemorrhagic feversebola. In the WHO's Interim Infection Control Recommendations for Care of Patients With Suspected or Confirmed Filovirus (Ebola, Marburg) Haemorrhagic Fever, it is recommended that the handling of human remains be kept to a minimum. Further, WHO said remains should not be sprayed, washed or embalmed. WHO also noted that personnel handling remains should wear personal protective equipment (gloves, gowns, apron, surgical masks and eye protection) and closed shoes.
Protective equipment is not required for individuals driving or riding in a vehicle to collect human remains, WHO suggests. However, protective equipment should be put on at the site of collection of human remains and worn during the process of collection and placement in a body bag. WHO advised that protective equipment should be removed immediately after remains have been placed in a body bag and then placed inside a coffin, and remains should be wrapped in sealed, leak-proof material and buried promptly.
Application of disinfectants should be preceded by cleaning. WHO recommends:
For post-mortem examinations, HF patient remains should be limited to essential evaluations only, and those evaluations should be performed by trained personnel. Personnel examining remains should wear eye protection, mask, gloves and gowns as recommended for patient care.
In addition, WHO recommends that personnel performing autopsies of known or suspected HF patients should wear a particulate respirator and eye protection or face shield, or a powered air purifying respirator.
WHO also recommends:
Source: Interim Infection Control Recommendations for Care of Patients With Suspected or Confirmed Filovirus (Ebola, Marburg) Haemorrhagic Fever by the World Health Organization (www.who.int/csr/bioriskreduction/interim_recommendations_filovirus.pdf).
This article originally appeared in the August 7, 2014, issue of the Memorial Business Journal.
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