Infection Control Guidance for Handling of Human Remains of Severe Acute Respiratory Syndrome (SARS) Decedents
SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

Revised 2003-06-05

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The following fact sheet has been developed to assist funeral services workers involved with safe handling of human remains of (SARS) decedents. As more information about the cause of this illness becomes available, the information provided below may change. For SARS case definition and other infection control guidelines, see www.sars.gc.ca

The emergence of SARS has resulted in numerous challenges and concerns for the public, health care providers and for members of the funeral service profession. The evidence to date indicates that following routine practices¹ (sometimes known as universal or standard precautions) should be used for all work involving contact with the human remains of a SARS patient. The following are general recommendations to assist funeral service workers performing mortuary procedures, ensure their safety and avoid contamination of the workplace.

Provincial regulations must be followed when dealing with people in quarantine. If any member, friend, etc., is in quarantine, they should be advised not to come to the funeral home and to either make arrangements by phone or appoint a person who is not in quarantine to come to the funeral home to make the arrangements on their behalf. People in quarantine cannot attend a funeral. They can be advised to postpone the funeral until after the end of their quarantine period or proceed with the funeral without the attendance of the persons in quarantine. Assistance in this matter can be requested to the local Public Health.

1. Routine infection control practices should be incorporated into everyday funeral service care¹. There is no evidence to suggest that embalming the human remains of a SARS decedent poses any greater risk than embalming the remains of any other decedent. However, the fact that only a partial autopsy has been performed may create different challenges, which should be considered when handling such remains.

2. Embalmers and funeral services workers should be educated and trained about routine practices¹. Personal protective equipment (PPE) should be used according to provincial regulations and manufacturers recommendations.

3. Gloves should be worn when personnel are in contact with an unshrouded body, including during pick-up in the home². Gloves should be removed immediately after use. Hands should be washed after gloves are removed.

4. All persons performing or assisting in postmortem procedures should wear gloves, masks, protective eye wear, gowns and waterproof aprons ⁽³⁾.Where applicable, immediate family members and a religious representative who wish to attend and perform traditional prayers/rituals must also follow these guidelines and should keep a distance of 2 metres away from the remains. For frequently asked questions about masks, visit www.sars.gc.ca More information on NIOSH fit testing and certification, can be found at: http://www.cdc.gov/niosh/homepage.html

5. The remains should be unwrapped slowly from the body bag, or carefully lowered to avoid aerosolization or splattering of body substances.

6. When turning and moving the remains, care should be taken to exert minimal pressure on the abdomen and thorax to prevent expulsion of waste material from oral, nasal and other orifices.

7. When washing the remains, the water pressure should be kept low.

8. Instruments and all surfaces splattered or contaminated during postmortem procedures should be decontaminated with a hospital grade disinfectant with a virucidal label claim.

9. A steel casket or case is not necessary.

10. A closed casket is not necessary.

11. Relatives of the deceased should be discouraged from superficial contact with the body of a SARS decedent, such as touching or kissing the face.

12. There are no extra precautions required for performing cosmetic work on the body of a SARS decedent.

13. There are no extra precautions for either burial or cremation. There is no evidence that interment in a closed coffin present any significant risk of environmental contamination and there is no risk of residual infectivity after cremation.

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¹ Infection Control Guidelines Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Health Care.

² Infection Control Guidelines. Preventing the Transmission of Bloodborne Pathogens in Health Care Setting and Public Service Settings.