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Home Topics Infectious Diseases Infections A-Z Mortality Guidelines ›  Mortality Guidelines

Mortality Guidelines

Management of infection control associated with human cadavers

After death, the human body does not generally create a serious health hazard.  In practice, few of the organisms which may be present pose an infection risk to those that handle the cadaver, and in most cases, standard infection control procedures will suffice to reduce any possible risk significantly.  There are some pathogens which, if present in the recently deceased, pose a more definable threat, but these too are readily manageable with appropriate precautions.  Infection risks may be classified as follows:

  • Asymptomatic infections in which pathogens are present in tissues/body fluids but which may therefore be unrecognised (eg blood-borne viruses)

  • Non-severe infections with minimal transmission potential which can be prevented by standard procedures (most common infections)

  • Infections which cause serious illness, but with no/limited transmission potential

  • Infections for which there is known transmission potential via airborne droplets and particles; contact with tissues and body fluids; inoculation. Appropriate precautions will reduce these risks. Examples include tuberculosis, blood-borne viruses, brucellosis, leptospirosis, and gastrointestinal infections

Once cadavers have been interred for lengthy periods, the likelihood of infection remaining is usually negligible: most pathogenic organisms will not survive for long and are generally outgrown by the organisms involved in decay and putrefaction. Exceptions to this include anthrax and smallpox; a specific risk assessment may therefore be required before an exhumation or archaeological excavation of crypts and burial grounds.

The movement of human remains for repatriation or expatriation is governed by legislation pertaining to the country of origin, the receiving country, and the carrier (through the International Air Transport Association).

Disaster situations: A number of publications have evaluated the infectious hazards from dead bodies in disaster situations. There is no evidence that, following a natural disaster, dead bodies pose a risk of epidemics. However, those who handle victims could be exposed to organisms as outlined above. The risk in the specific situation can be assessed from local knowledge of disease prevalence, and the likelihood of exposure and transmission. Simple measures, such as hand washing and basic hygiene, will reduce the risk of such occupational exposures.

Specific guidance:

The Health and Safety Executive has produced guidance for controlling the risks of infection from human remains. This is directed at those involved in funeral services, including embalmers, and also those involved in exhumations. The guidance is available at Health and Safety Executive (PDF, 103 KB)  [external link]

Specific guidance also applies to the management of cadavers infected with a viral haemorrhagic fever such as Lassa fever. Current guidance available here (link to PDF)

Advice from the GMC on confidentiality issues available here. [external link]

Other sources of advice:

Young SE, Healing TD. Commun Dis Rep CDR Rev 1995; 5(5):R69-73. Infection in the deceased: a survey of management (PDF, 62 KB)  [external link]

Healing TD, Hoffman PN, Young SE. Commun Dis Rep CDR Rev 1995; 5(5):R61-8. The infection hazards of human cadavers (PDF, 61 KB)  [external link]

Bakhshi SS. Commun Dis Public Health 2001; 4(4):283-7. Code of practice for funeral workers: managing infection risk and body bagging (PDF, 36 KB)  external link

The Institute of Occupational Medicine, a WHO Collaborating Centre for Occupational Health, conducted an extensive review of the risks associated with embalming. This was published in 2004, and is available at Institute of Occupational Medicine (PDF, 2 MB)  [external link]

Disasters

Management of dead bodies after disasters: a field manual for first responders [external link] PAHO 2009 (PDF)

 Epidemics after natural disasters [external link]. Watson et al. Emerging Infectious Diseases, 2007;13(1)

 Infectious disease risks from dead bodies following natural disasters [external link] Morgan O. Rev Panam Salud Publica, 2004 (PDF)


Last reviewed: 31 December 2012