Infectious disease risks from dead bodies following natural disasters
Infectious disease risks from dead bodies following natural disasters
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DOI：
10.1590/s1020-49892004000500004
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发表时间：
2004-05-01
期刊：
影响因子：
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通讯作者：
Morgan, Oliver
中科院分区：
文献类型：
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作者：
Morgan, Oliver
客观的。回顾现有文献，评估自然灾害发生后尸体感染的风险，包括谁的风险最大、应采取哪些预防措施以及如何安全处置尸体。方法。疾病传播需要存在传染性病原体、接触该病原体以及易感宿主。这些元素被认为表征了尸体带来的传染病风险。利用美国国家医学图书馆PubMed在线数据库，检索有关公共安全人员和殡葬人员感染风险的相关文献以及死者管理和感染预防指南。还回顾了有关死者处置和墓地地下水污染的少量但重要的文献。结果。自然灾害的受害者通常死于创伤，不太可能患有急性或“引起流行”的感染。这表明尸体对公众构成的风险极小。然而，与死者密切接触的人员，例如军事人员、救援人员、志愿者等，可能会接触到慢性传染病，包括乙型肝炎病毒、丙型肝炎病毒、艾滋病毒、肠道病原体和结核分枝杆菌。对这些人的适当预防措施包括培训、使用裹尸袋和一次性手套、良好的卫生习惯以及接种乙型肝炎和结核病疫苗。尸体的处置应尽可能尊重当地的习俗和做法。当遇难者人数较多时，土葬可能是最合适的处置方法。几乎没有证据表明埋葬对地下水造成微生物污染。结论。对于想要保护自己免受疾病侵害的人来说，担心尸体具有传染性可以被视为一种“自然”反应。然而，需要有关风险的明确信息，以便负责的地方当局确保灾害受害者的尸体得到适当处理和应有的尊重。本文为那些不幸管理这些机构的人提供了信息来源。
Objective. To review existing literature to assess the risks of infection from dead bodies after a natural disaster occurs, including who is most at risk, what precautions should be taken, and how to safely dispose of the bodies.Methods. Disease transmission requires the presence of an infectious agent, exposure to that agent, and a susceptible host. These elements were considered to characterize the infectious disease risk from dead bodies. Using the PubMed on-line databases of the National Library of Medicine of the United States of America, searching was done for relevant literature on the infection risks for public safety workers and funeral workers as well as for guidelines for the management of the dead and prevention of infection. A small but significant literature was also reviewed regarding the disposal of the dead and the contamination of groundwater by cemeteries.Results. Victims of natural disasters usually die from trauma and are unlikely to have acute or "epidemic-causing" infections. This indicates that the risk that dead bodies pose for the public is extremely small. However, persons who are involved in close contact with the dead-such as military personnel, rescue workers, volunteers, and others-may be exposed to chronic infectious hazards, including hepatitis B virus, hepatitis C virus, HIV, enteric pathogens, and Mycobacterium tuberculosis. Suitable precautions for these persons include training, use of body bags and disposable gloves, good hygiene practice, and vaccination for hepatitis B and tuberculosis. Disposal of bodies should respect local custom and practice where possible. When there are large numbers of victims, burial is likely to be the most appropriate method of disposal. There is little evidence of microbiological contamination of groundwater from burial.Conclusions. Concern that dead bodies are infectious can be considered a "natural" reaction by persons wanting to protect themselves from disease. However, clear information about the risks is needed so that responsible local authorities ensure that the bodies of disaster victims are handled appropriately and with due respect. This paper provides a source of information for those who are in the unfortunate position of managing those bodies.