First Case of TB Transmission From Cadaver to Embalmer
"With that information in hand," Sterling tells WebMD, "they
tried to find if there was a link between the two people, and they saw that the
embalmer had signed the man's death certificate." There was no known
evidence, Sterling writes, that the two people had any contact before the
embalming, thus no evidence the transmission had occurred before the embalming.
The embalmer reportedly had 15 years' experience, always wore gloves, and
usually wore a mask.
"Tuberculosis ... has been around for thousands of years, and that
speaks to how well it's been able to adapt to many different situations. There
are still many things about tuberculosis we don't know," Sterling tells
WebMD. But it is known, he writes, that a study of embalmed cadavers for
medical school anatomy classes showed tuberculosis "organisms remain viable
and therefore infectious for at least 24 to 48 hours after an infected cadaver
has been embalmed."
As for embalmers, Sterling says stronger guidelines may be in order: "I
think a very good first step would be the use of universal precautions, which
would be gloves and a mask, just using it always. Universal precautions implies
that you cannot figure out just from visual inspection who may or may not have
an infection, whether it's tuberculosis or HIV, so you use the same precautions
every time because you just don't know," he tells WebMD.
Kelly Smith, the spokesman for the National Funeral Directors Association
says, "it's not a big deal. Funeral directors have known about the threat
of TB for generations." He says funeral directors "are aware of the
importance of universal precautions ... [especially] when dealing with highly
communicable, potentially lethal diseases such as hepatitis, tuberculosis, and
A search of Occupational Safety and Hazard Administration (OSHA) regulations
turned up nothing specifically related to tuberculosis and funeral homes, and a
call to OSHA was not immediately returned.
Still, Smith says "to suggest that OSHA or the funeral service
profession hasn't implemented programs to prevent a situation such as this is
He says OSHA requires a hazardous communication plan, a formaldehyde
exposure plan, and a blood-borne pathogen plan in funeral homes. Included among
those plans, he tells WebMD, are "universal precautions."
Smith says one funeral director told him if "an employee ... fails to
use universal precautions in the embalming room, there's a three-step process.
It's called education, communication, and termination."
- Researchers report what they believe to be the first documented case of
embalmer-contracted tuberculosis from a cadaver.
- The most common route of transmission is through the air, and it is likely
that the embalming process produced infectious aerosols.
- Embalmers can protect themselves by always wearing gloves and a mask when
working with cadavers.