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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 HIV."

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 ludicrous."

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."

Vital Information:

  • 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.

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