(This 2011 photo provided by Wilmot Chayee shows Thomas Eric Duncan, the first Ebola patient diagnosed in the U.S., at a wedding in Ghana. Texas Health Presbyterian Hospital Dallas, where Duncan was being treated for the disease, on Wednesday, Oct. 8, 2014 said Duncan has died. (AP/Wilmot Chayee)
With the death of the first U.S.-diagnosed Ebola patient announced by a Dallas hospital Wednesday, it begs the question: What will be done with Thomas Eric Duncan’s body?
At this point it’s generally well-known that the Ebola virus is spread through direct contact with bodily fluids, but even U.S. hospitals have had to face hurdles to find methods and companies that are equipped to handle the infectious materials from the few patients that have come to the country with the virus.
According to the Centers for Disease Control and Prevention, a body postmortem is still considered infectious and needs to be handled following certain procedures.
“Ebola virus can be transmitted in postmortem care settings by laceration and puncture with contaminated instruments used during postmortem care, through direct handling of human remains without appropriate personal protective equipment, and through splashes of blood or other body fluids (e.g. urine, saliva, feces) to unprotected mucosa (e.g., eyes, nose, or mouth) which occur during postmortem care,” the CDC’s website explained.
As such, those tasked with handling the remains will need to take the same protective precautions as those who cared for the patient while alive. As for the disposition of the remains, the CDC gives this guidance:
Remains should be cremated or buried promptly in a hermetically sealed casket.
Once the bagged body is placed in the sealed casket, no additional cleaning is needed unless leakage has occurred.
No [personal protective equipment] is needed when handling the cremated remains or the hermetically sealed closed casket.
Only personnel trained in handling infected human remains, and wearing PPE, should touch, or move, any Ebola-infected remains.
Handling of human remains should be kept to a minimum.
Autopsies on patients who die of Ebola should be avoided. If an autopsy is necessary, the state health department and CDC should be consulted regarding additional precautions.
Embalming is not recommended for patients who died from Ebola.
If the body has to be transported — something the CDC says should be limited — it needs to be coordinated with the appropriate local, state and CDC officials. Air transportation “must be considered carefully, taking into account distance and the most expeditious route. If shipping by air is needed, the remains must be labeled as dangerous goods in accordance with Department of Transportation regulations (49 Code of Federal Regulations 173.196),” the CDC’s website stated.
While the U.S. had a few small Ebola outbreaks in the 1990s, no deaths resulted from these cases. This appears to be the first Ebola-related death on U.S. soil. Five American patients have been brought back to the U.S. from West Africa for treatment. Three of these recovered from the virus and were released, while two remain in hospital care. The only known American Ebola victim to die in this outbreak succumbed to the virus in Nigeria.
Several countries in West Africa where more than 3,400 people have died from the Ebola since March are facing a harder time with the bodies.
(Health workers in protective gear carry the body of a woman suspected to have died from Ebola virus, from a house in New Kru Town at the outskirt of Monrovia, Liberia, Wednesday, Oct. 8, 2014. (AP/Abbas Dulleh)
Burial teams went on strike in Sierra Leone this week, abandoning the bodies of Ebola victims in the capital saying they were not being paid.
The Sierra Leone Broadcasting Corporation reported that bodies of Ebola victims were being left in homes and on the streets of Freetown because of the strike by burial teams, who complained they had not been paid. The bodies of Ebola victims are highly contagious.
Speaking on a radio breakfast program Wednesday, deputy health minister Madina Rahman said the strike had been resolved, though organizers could not immediately be reached to confirm it was over.
Rahman said the dispute centered on a one-week backlog for hazard pay that had been deposited in the bank but was not given to burial teams on time.
“The health ministry is going to investigate the delay,” Rahman said.
There are 600 workers in the burial teams, organized in groups of 12, health ministry spokesman Sidie Yahya Tunis said.
Tunis described the situation as “very embarrassing.”