Fears that dead bodies will cause widespread infection following a natural disaster are largely baseless and often lead to mistreatment of the bodies that unnecessarily adds to the suffering of the surviving friends and family members of victims, according to a scientific article that provides the first-ever comprehensive review of this subject. The review article appears in the May 2004 issue of the "Revista Panamericana de Salud Pública/Pan American Journal of Public Health," a peer-reviewed journal published monthly by the Pan American Health Organization (PAHO).
"There is no evidence that, following a natural disaster, dead bodies pose a risk of epidemics," says the article, which was written by Oliver Morgan, who is a research degree student with the London School of Hygiene and Tropical Medicine and who has worked with the disaster-assistance groups Oxfam and Médecins Sans Frontières (Doctors Without Borders) in Latin America, India, Africa, and the Balkans.
Historically, epidemics resulting in mass fatalities have only occurred from a few diseases, including plague, cholera, typhoid, tuberculosis, anthrax, and smallpox. However, such infections are no more likely to be present in disaster victims than in the general population. In addition, while some of these diseases are highly contagious, they are unable to survive for long in the human body after death occurs. It is therefore unlikely that such epidemics will result from contact with a cadaver. Instead, notes the article, "it is far more likely that survivors will be a source of disease outbreaks."
For the review article, Morgan conducted a thorough search for previous articles relating to natural disasters, the possibility of dangers to survivors and to persons who handle cadavers, and the proper care and disposal of bodies.
While the risks for rescue workers who handle dead bodies are higher than for the survivors of a disaster, those risks can be limited through a set of simple measures. Appropriate precautions include training military personnel and others who might have to provide assistance after a disaster, vaccinating those persons against hepatitis B and tuberculosis, using body bags and disposable gloves, washing hands after handling cadavers, and disinfecting stretchers and vehicles that have been used to transport bodies.
Unjustified worries about the infectiousness of bodies can lead to the rapid, unplanned disposal of the dead, sometimes before proper identification of the victim has been made, as well as to taking needless "precautions" such as burying the deceased in common graves and adding chlorinated lime as a "disinfectant."
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 that proper burial of bodies poses a threat to groundwater that serves as a source of drinking water.
There are various explanations for why unnecessary steps are taken after natural disasters, according to an editorial that accompanies the article. While respect for the dead is a value deeply ingrained in all cultures and religions, "it can be difficult to separate respect for the deceased from the deep fear of death itself that is common to all human beings," the editorial notes.
Sometimes feeling pressured by misleading media reports on the supposed dangers from cadavers, public officials take unwarranted measures that leave survivors with doubts concerning the whereabouts of a family member and make it harder for survivors to mourn their loss. When bodies are not identified, a surviving spouse or child can be left in a legal limbo.
"The problem," says the editorial, "is not anymore and perhaps has never been one of a lack of knowledge by epidemiologists and scientists. The issue is how those informed health professionals can and should stand up to the pressure of public opinion and protect the rights of the survivors when fears of the unknown are running rampant and officials seek an easy way to alleviate them."
The editorial was written by Claude de Ville de Goyet, an international health consultant who directed the Emergency Preparedness and Disaster Relief Program of the Pan American Health Organization (PAHO) for 25 years.
The full text of the English-language review article and the editorial can be viewed for free in PAHO's Online Bookstore (http://publications.
The "Revista Panamericana de Salud Pública/Pan American Journal of Public Health" is the main scientific and technical periodical of the Pan American Health Organization (PAHO). PAHO, which also serves as the Regional Office for the Americas of the World Health Organization, was established in 1902. PAHO Member States include all 35 countries in the Americas. Puerto Rico is an Associate Member. France, the Kingdom of the Netherlands, and the United Kingdom of Great Britain and Northern Ireland are Participating States, and Portugal and Spain are Observer States.