Handling of Bodies by Funeral Directors During an Influenza Pandemic

Influenza is a viral disease that occurs seasonally, usually in winter, and causes a number of deaths every year.

Last updated: 01 December 2007

What is influenza pandemic?

Influenza is a viral disease that occurs seasonally, usually in winter, and causes a number of deaths every year. An influenza pandemic occurs when a new strain of influenza virus emerges, spreading around the globe and infecting many people at once and the number of deaths may increase dramatically.

The highly pathogenic avian influenza virus known as H5N1, currently circulating in domestic and wild bird populations around the world, is a public health concern because of its potential to transform into a pandemic strain. As long as the virus continues to circulate in birds and animals, there will be opportunities for this virus to change and adapt to humans.

People have no natural immunity to a newly formed adapted virus which can easily spread from person to person and cause a pandemic. In this case the virus may also spread very rapidly by persons coughing or sneezing and may be contracted by inhaling infectious droplets or by touching infected surfaces then that person touches his or her mouth, nose or eyes.

Handling of bodies

There is unlikely to be a risk of influenza infection to funeral industry personnel who handle bodies of persons suspected of having, or confirmed to have died from influenza by the time the body is transported to the funeral home. The risk of influenza transmission to funeral industry personnel will be through contact with families and friends of the deceased.

Funeral directors should always maintain routine body handling procedures consistent with infection control procedures when they handle any deceased bodies.

Personal protective equipment and hygiene

Standard infection control and occupational health and safety guidelines should be followed at all times. A person having contact with a body (e.g., placing in body bag or wrapping a body) must wear:

• A clean protective outer garment such as a gown, overalls or jumpsuit
• A clean pair of disposable gloves
• A disposable surgical mask and appropriate eye protection.

After use, those items must be placed in a clean plastic bag and then laundered as soon as practicable, or otherwise disposed of as soon as practicable as clinical waste.

Embalming of bodies

Commonwealth of Australia Interim Pandemic Influenza Infection Control Guidelines advise that embalming is not recommended during an influenza pandemic. However if this procedure needs to be undertaken for social or cultural reasons:

• A person who embalms a body must have a certificate of proficiency from an institute approved by the Director-General of NSW Health.
• Embalmers and persons involved in performing embalming should wear full personal protective equipment (properly fitted P2 (N95) mask, gown, gloves, cap and eyewear).

If the person died from pandemic influenza, and had a List B disease, such as diphtheria, plague, respiratory anthrax, smallpox, tuberculosis or a viral haemorrhagic fever the body must not be embalmed.

Retention of bodies

• A person who is not a funeral director may only retain the body of the deceased up to 5 days after death.
• Funeral directors may retain an un-embalmed body of the deceased for up to 7 working days after the issue of a death certificate, or a burial permit or a cremation permit issued by a coroner.

If there is a need to retain a body for a longer period, the person or funeral director must obtain permission from the Director-General of NSW Health through a Public Health Unit.

Transportation

No special vehicle or conditions other than that required in the Public Health (Disposal of Bodies) Regulation 2002, are needed for transportation of a deceased body infected with influenza.

When transporting the body of the deceased, the body must be placed and secured in a body bag or wrapping. The body bag or wrapping must be of a type approved by the Director-General, so as to prevent the leakage of body fluids. Commonwealth of Australia Interim Pandemic Influenza Infection Control Guidelines recommend that a surgical mask or cloth should be placed on the body's nose and mouth when the body is moved.

When there is reason to believe that the body is infected with a List A disease (Creutzfeld-Jacob disease, hepatitis C, human immunodeficiency virus infection) or List B disease (diphtheria, plague, respiratory anthrax, smallpox, tuberculosis and viral haemorrhagic fevers) in addition to pandemic influenza, the bag or wrapping must clearly be marked with the appropriate words either "Infectious Disease - List A - Handle with Care" or "Infectious Disease - List B - Handle with Care."

Body viewing

When carrying out procedures to prepare the body for viewing, standard precautions should be followed in the same way as they would be in handling or performing invasive procedures on any deceased body. Family members should still be allowed to view the body.

• Family members should wash their hands or use an antiseptic hand lotion after touching the body.
• Gloves are not necessary for family members unless there are visible secretions or other bodily fluids present on the body.
• Although the infection risks are extremely low, family members should be advised not to kiss the body of the deceased.

When a person has died from pandemic influenza and, in addition, had infection with a List B disease, the body must not be made available for viewing.

During an influenza pandemic, many people in the community may be infected with the virus, especially those who have recently cared for someone with pandemic influenza. Like any public gathering, there is potential for transmission of the pandemic influenza amongst those attending a funeral, related to the gathering of people in an enclosed space. To minimise transmission, restrictions may be placed on the type and size of the gathering. For example, attendance at funerals could be restricted to close family and friends, and it could be suggested that the gathering take place in an open-air venue rather than an enclosed space.

Further information

For further information, please contact:

• Department of Health and Ageing Information Hotline 1800 004 599
• Local Public Health Units (listed below)

  Further Information

  • Commonwealth of Australia Interim Infection Control Guidelines for Pandemic Influenza in Health Care  http://www.health.gov.au/internet/wcms/publishing.nsf/Content/ohp-pandemic-infect-control-gl.htm