A 2009 cross-sectional survey of procedures for post-mortem management of highly infectious disease patients in 48 isolation facilities in 16 countries: data from EuroNHID.
OBJECTIVE
The handling of human remains may pose a risk for transmission of highly infectious agents. The use of appropriate biosafety measures is very important in case of management of patients deceased from highly infectious diseases (HIDs), such as Ebola virus disease. This paper presents the capabilities and resources in this field in 16 European countries, and suggests indications for the safe post-mortem management of HID patients.


METHODS
The European Network for Highly Infectious Diseases conducted in 2009 a survey in 48 isolation facilities in 16 European countries. A set of standardized checklists, filled during on-site visits, have been used for data collection.


RESULTS
Thirty-nine facilities (81.2%) reported to have written procedures for the management of human remains, and 27 (56.2%) for the performance of autopsies in HID patients. A Biosafety Level 3 autopsy room was available in eight (16.6%) facilities, other technical devices for safe autopsies were available in nine (18.7%). Overall, four facilities (8.3%) reported to have all features explored for the safe management of human remains. Conversely, in five (10.4%) none of these features were available.


CONCLUSIONS
The level of preparedness of surveyed isolation facilities in the field of post-mortem management in case of HIDs was not satisfactory, and improvements are needed.
National Institute for Infectious Diseases (INMI) "L. Spallanzani", Via Portuense 292, 00149, Rome, Italy. francescomaria.fusco@inmi.it.
Francesco M
http://orcid.org/0000-0002-1293-5976
FM
Fusco
National Institute for Infectious Diseases (INMI) "L. Spallanzani", Via Portuense 292, 00149, Rome, Italy. lucia.scappaticci@inmi.it.
Lucia
L
Scappaticci
Department of Infectious Diseases, J W Goethe University, Frankfurt, Germany. Stefan.Schilling@kgu.de.
Stefan
S
Schilling
National Institute for Infectious Diseases (INMI) "L. Spallanzani", Via Portuense 292, 00149, Rome, Italy. giuseppina.deiaco@inmi.it.
Giuseppina
G
De Iaco
Department of Infectious Diseases and Tropical Medicine, CHU Nord and URMITE IRDCNRS UMR 6236, Marseille, France. philippe.brouqui@univ-amu.fr.
Philippe
P
Brouqui
Hellenic Center for Disease Control and Prevention, Athens, Greece. helen-maltezou@ath.forthnet.gr.
Helena C
HC
Maltezou
Department of Infectious Diseases, J W Goethe University, Frankfurt, Germany. reinhard@brodt.net.
Hans-Reinhard
HR
Brodt
Department of Infectious Diseases, Royal Free Hospital, London, UK. b.bannister@nhs.net.
Barbara
B
Bannister
National Institute for Infectious Diseases (INMI) "L. Spallanzani", Via Portuense 292, 00149, Rome, Italy. giuseppe.ippolito@inmi.it.
Giuseppe
G
Ippolito
National Institute for Infectious Diseases (INMI) "L. Spallanzani", Via Portuense 292, 00149, Rome, Italy. vincenzo.puro@inmi.it.
Vincenzo
V
Puro
D001344:Autopsy / Q000379:methods*; D003141:Communicable Diseases / Q000175:diagnosis* / Q000473:pathology*; D003264:Containment of Biohazards / Q000379:methods*; D003430:Cross-Sectional Studies; D005060:Europe; D006801:Humans
Autopsy; Biosafety; Highly infectious diseases; Hygiene; Infection control; Isolation facilities