dead body with suspected or confirmed Haemorrhagic Fever case need to plug the natural orifices

[Sony SO]

Dear All,

The issue of plugging natural orifices of dead body with suspected or confirmed Haemorrhagic Fever case need to plug the natural orifices is addressed in the WHO newly released EVD guidelines – Interim Infection Prevention and Control Guidance for Care of Patients with Suspected or Confirmed Filovirus Haemorrhagic Fever in Health-Care Settings, with Focus on Ebola http://www.who.int/csr/..pdf?ua1, point 5,b, the fifth bulletin point, which states: “Wear PPE (impermeable gown, mask, eye protection and double gloves) and closed shoes or boots to handle the dead body of a suspected or confirmed case of HF. Plug the natural orifices. Place the body in a double bag, wipe over the surface of each body bag with a suitable disinfectant (e.g., 0.5% chlorine solution) and seal and label with the indication of highly-infectious material. Immediately move the body to the mortuary.”

However, we noted, the issue of NOT allowing “Plugging orifices” is addressed in the Protection Surveillance Centre, Guidelines for the Management of Deceased Individuals Harbouring Infectious Disease, http://www.hpsc.ie/A-Z/LifeStages/MoDI/File,14302,en.pdf, Appendix 5, page 49, which states: “Plugging of orifices is not permitted.”.

Furthermore, UK HSE has addressed that the “Plugging orifices” procedures may cause exposure risk in Controlling the risks of infection at work from human remains -A guide for those involved in funeral services (including embalmers) and those involved in exhumation, http://www.hse.gov.uk/pubns/web01.pdf, page 8, which states: “Some procedures carried out as part of first offices may also involve emptying the contents of the bowel and bladder and entail the plugging of orifices. Such procedures could result in exposure to body fluids such as urine and faeces, which should be addressed in your assessment.”

Thus far, we are formulating our local practices for handling dead body with suspected or confirmed Haemorrhagic Fever. Hence, we would like to know Australia’s prevailing infection prevention and control practices, in particular, the “Plugging of orifices” practices.

Regards,

Sony SO

Nursing Officer, Infection Control Branch (Team 2)

Centre for Health Protection

http://www.chp.gov.hk/tc/cindex.html

HONG KONG SAR, CHINA

office phone: +852 2125-2922; fax: +852 3523-0752

HA email sony@ha.org.hk; DH email no_icb4@dh.gov.hk
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