the rapid spread of contagious disease throughout the world. Certain diseases are not endemic to the United States; however, they can easily cross borders before they are observed or diagnosed. Individuals can carry colonies of disease and be non-symptomatic for weeks or even months as they spread disease to those they contact at home, work, or throughout their community. This course includes information on infectious diseases that rise to the level of serious public health concern. Major health organizations of the federal, state, and county epidemiology departments would be aware of the presence of individuals with serious infectious disease from the moment they were identified at the point of entry to the U.S. These agencies have jurisdiction in these cases, though in many states, if the person dies, the Transmission of infectious agents in healthcare settings The CDC, WHO, and OSHA organizations include mortuary, funeral homes, cemetery, and crematory settings under the classification of healthcare when issuing regulations and guidelines for universal precautions. Some documents contain specific information for practitioners dealing with postmortem Definitions ● Alkaline hydrolysis – an alternative to flame cremation that uses water and alkaline under high temperatures and pressure. ● Colonization – development of a bacterial infection, though the infected person may or may not have signs or symptoms of infection. ● Diathesis – predisposition or susceptibility to suffer from disease. ● Enveloped virus – the outermost shells made of proteins and surrounded by lipids and are less virulent. ● Non-enveloped virus – contain a capsid coat made of protein, are more virulent and can retain infectivity even after drying. ● Fomites – objects or materials, such as dishes, utensils, or clothing, that may carry infection and lead to transmission of disease. ● Flora – microorganisms such bacteria or fungi that live in or on the body. ● Immunity – the host’s ability to resist the pathogens that cause disease. Factors related to immunity include the following: ■ The immune state at the time of exposure to an infectious agent. ■ Interaction between pathogens. ■ Virulence factors of the pathogen. ■ Host factors, such as age, and underlying disease, such as diabetes, HIV/AIDS, malignancy, transplants, or other chronic illness. ■ Medications that alter normal flora such as antimicrobial agents, gastric acid suppressors, corticosteroids, anti-rejection drugs, antineoplastic agents, and immunosuppressive drugs. ● Infection – invasion and multiplication of pathogenic microorganisms in the body. Pathogens invade the body and CDC guidelines: Types of infectious disease and transmission Infection transmitted between an infectious agent and a host may cause disease to develop and progress causing illness or death. In some cases, the host may be temporarily or permanently colonized but show no symptoms of the infection or disease. It is possible for infection to develop from colonization and rapidly progress to disease after exposure or after an extended period of colonization. Sources of infection after death The four main sources of infection that may be present in human remains include the following: ● Blood and body fluids, including saliva, lung, and gastrointestinal fluids. ● Waste products, such as feces and urine.
body would be released to the local funeral home. At this point, the director could refuse the case or the local health agency would assist them if they chose to proceed. As of 2015, fifty-five hospitals across the U.S. were equipped to handle these cases. Funeral home directors can visit the CDC website to determine the locations near them. This course provides specific references for downloading guidelines and training resources from the CDC, OSHA, and the WHO for further information. Individual states may have additional regulations and guidelines that must be reviewed on the state government website. Information is included for the control of infectious disease encountered during mortuary services to ensure the safety of personnel, funeral attendees, the general public, and the environment. procedures for preparation at the hospital, cleaning, sterilization, transport, embalming, waste disposal, viewing, burial, or cremation. Some highly contagious, drug-resistant diseases require specific regulations for postmortem care, and current regulations are included in this course. may lead to infection or disease that disrupts the functioning of the body. Pathogenic microorganisms are found, particularly in the respiratory and gastrointestinal tracts, but may live anywhere in or on the body. ● Infectious agents – four main classes including bacteria, viruses, fungi, and parasites transmitted primarily from human sources but also inanimate environmental sources as well. ● Lumina – the inner open space or cavity of a tubular organ or cell, such as in a blood vessel or an intestine. ● Pathogens – agents that cause infection or disease including microorganisms such as a bacterium, protozoan, prions, or virus. These agents cause communicable diseases that spread easily through contact with others. ● Percutaneous exposure – caused by an injury, such as a needle stick or cut with a sharp object that allows contact of mucous membrane or nonintact skin with blood, saliva, tissue, or other body fluids that are potentially infectious. Injury can also occur through exposed skin that is chapped, abraded, or broken due to dermatitis or other skin conditions. ● Prions – small infectious disease agents carrying protein that are the smallest infectious particles. They are not bacterial, fungal, or viral and have no genetic material. Prions cause degenerative brain diseases, including mad cow disease, Creutzfeldt-Jakob disease (CJD), and inherited forms of dementia such as Gertsmann-Straeussler-Scheinker (GSS) disease. ● Susceptible host – an individual without adequate immunity to withstand exposure or contact with a particular infectious agent. ● Virulence – the ability of an agent of infection to produce disease. The virulence of a microorganism is a measure of the severity of the disease it causes. Exposure to a variety of infectious disease agents may occur when handling any deceased body. The body may remain infectious, and microbes may continue to colonize after death and be dispersed through contact. If infectious disease was present at the time of death, mortuary personnel, family, and the public may be at risk for infection, and burial practices involving touching and washing the body should be avoided, depending upon the type of infection present. ● Aerosols of infectious material might be released when moving or opening the body. ● Microbes may be present on the skin and spread through direct contact.
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