Wednesday, October 8, 2014

US: CDC Promulgates Updated Criteria for Disposing of Bodies of Ebola Victims

According to Yahoo News,  the first patient to be diagnosed with Ebola in the United States died from the disease Wednesday (October 9) and now Dallas health officials are facing a situation they have not before experienced: how to handle a body that could remain highly contagious for several days.
Thomas Eric Duncan, 42, had been in isolation at Texas Health Presbyterian since September 28. His death comes four days after his condition was downgraded from serious to critical.
Duncan had been on a ventilator for several days and was receiving kidney dialysis. Last weekend he started receiving an experimental drug called brincidofovir.
Within hours of his death, the Texas Department of State Health Services said Duncan's body would be cremated using protocols recently issued by the CDC.
“The CDC has developed detailed instructions for handling a body infected with Ebola,” the health department said in a written statement. “The guidelines recommend careful preparation of the body before movement, including enclosing it in two bags and disinfecting the bags. After this process, the body can be transported without the need for protective gear for a driver or others who are near the body but don't handle the remains.
Dr. David Lakey, Texas state health commissioner, said the cremation plan was approved by Duncan's family.
The cremation process will kill any virus in the body so the remains can be returned to the family,” Lakey said in the statement. No protective gear is needed to handle the remains after cremation.
In early August, medical missionary Kent Brantly became the first US patient to be treated for Ebola after he contracted the disease in West Africa and was transported to Emory University Hospital in Atlanta.
Soon after, the CDC published a document titled “Guidance for Safe Handling of Human Remains of Ebola Patients in US Hospitals and Mortuaries,” which states that the “handling of human remains should be kept to a minimum.”The CDC recommends autopsies be avoided, and that no embalming be performed. It’s been a topic of discussion at the Dallas Institute of Funeral Service, where Wayne Cavender is an instructor and administrator.
“Since they don't have a good handle on controlling the disease itself, they are worried about an epidemic,” Cavender told Yahoo News. “So that's one way to help keep it from going further. Because if we embalm, we are going to come in contact with all the body fluids and everything. With universal precautions we shouldn't, but accidents happen on occasion.”
Instead, the CDC says, the “remains should be cremated or buried promptly in a hermetically sealed casket.” The casket must secure “against the escape of microorganisms” and have valid documentation for being airtight.
COMMENT: “There's really not an airtight casket,” said Cavender, who has been in the funeral business for 28 years.
“The sealer caskets that they sell are not a guaranteed-type of sealing issue. It's not completely airtight because you have to have a way to open them up and so forth. It's not like it's vacuum-sealed,” he said.
The CDC warns that at no point should the sealed bags or casket be opened for viewing.
Duncan had recently traveled to Dallas from West Africa where the World Health Organization (WHO) estimates that Ebola has killed more than 3,400 people this year. Health officials say traditional African burials, in which family members wash the body, has caused the epidemic to spread faster.
Cavender said he fully supports the CDC’s stringent standards for this country, but knows it could cost a family a proper goodbye.
“Everybody needs to bury their dead and have a funeral and viewing if that’s what they want,” he said. “That's the government saying you can't do that. It's very unfortunate for the family in that case.”

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