The development of a protocol for post-mortem management of Ebola virus disease in the setting of developed countries
The management of the recent Ebola virus disease (EVD) epidemic continues to pose currently insuperable challenges to health care providers in the resource-deprived countries of West Africa. In an age where air travel facilitates rapid movement of people between countries and continents, there is an urgent requirement for health systems around the globe to develop management strategies and protocols in the event that EVD cases are suspected or confirmed. Departments of forensic pathology play an important, and underestimated, role in public health service delivery, particularly at times of novel infectious disease emergence. This role can include disease identification, characterization, and notification, as well as close engagement with agencies responsible for disease surveillance and treatment provision. A mass outbreak of EVD in the Western world is considered highly unlikely; however, there is clear responsibility on departments of forensic pathology to develop protocols for rapid assessment of sporadic or suspected cases while ensuring the health and safety of mortuary and pathology personnel. The Ontario Forensic Pathology Service and the Victorian Institute of Forensic Medicine have collaborated on the development of a protocol for management of EVD cases presenting at a scene or in the mortuary. It is hoped that this trans-national, inter-departmental exercise will serve as a model for future co-operative endeavors. The protocol has been distributed to forensic pathology departments around Australia and may be modified to accommodate local resource capabilities.
KeywordsEbola virus Post-mortem Management
- 1.World Health Organisation. Frequently asked questions on Ebola virus disease. August, 2014. http://www.who.int/csr/disease/ebola/faq-ebola/en/.
- 2.Report of an International Commission Ebola haemorrhagic fever in Zaire, 1976. Bull World Health Org. 1978;56:271–93. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2395567/.
- 3.Commonwealth of Australia. Department of Health. Ebola virus disease (EVD) outbreaks in Western Africa. Important information for clinicians in secondary or tertiary care. November 2014. http://health.gov.au/internet/main/publishing.nsf/Content/ohp-ebola.htm/$File/ebola-clinicians.pdf.Google Scholar
- 4.International Committee for the Red Cross, Management of dead bodies after disasters: a field manual for first responders. 2009. https://www.icrc.org/eng/resources/documents/publication/p0880.htm.
- 5.World Health Organization. Infection prevention and control guidance for care of patients in health-care settings, with focus on Ebola. WHO reference number: WHO/HIS/SDS/2014.4. September, 2014. http://www.who.int/csr/resources/publications/ebola/filovirus_infection_control/en/.
- 7.Public Health Agency of Canada. Interim Guidance—Ebola Virus Disease: Infection Prevention and Control Measures for Borders, Healthcare Settings and Self-Monitoring at Home. http://www.phac-aspc.gc.ca/id-mi/vhf-fvh/ebola-ipc-pci-eng.php.
- 8.Public Health Agency of Canada. Interim Biosafety Guidelines for Laboratories Handling Specimens from Patients Under Investigation for Ebola Virus Disease. http://www.phac-aspc.gc.ca/id-mi/vhf-fvh/ebola-biosafety-biosecurite-eng.php.
- 9.European Centre for Disease Prevention and Control (ECDC). http://www.ecdc.europa.eu/en/Pages/home.aspx.
- 10.ECDC. Ebola and Marburg fevers: factsheet for health professionals. http://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=4&cad=rja&uact=8&ved=0CDAQFjAD&url=http%3A%2F%2Fwww.ecdc.europa.eu%2Fen%2Fhealthtopics%2Febola_marburg_fevers%2Ffactsheet-for-health-professionals%2FPages%2Ffactsheet_health_professionals.aspx%3Fpreview%3Dyes%26pdf%3Dyes&ei=TdGQVInhH5Tf8AXTkICIBw&usg=AFQjCNF3TyGpK2iSiLzCxaqnCCUhogSbVw&bvm=bv.82001339,d.dGc.
- 11.Public Health Ontario, Viral haemorrhagic fever: Update for clinicians. 2014-07-16. http://www.publichealthontario.ca/en/BrowseByTopic/InfectiousDiseases/Pages/Viral-Hemorrhagic-Fevers.aspx.
- 12.Public Health Ontario, Viral Haemorrhagic Fevers (VHFs) – Sample collection and submission guide. 2014-08-22. http://www.publichealthontario.ca/en/eRepository/Viral_Haemorrhagic_Fevers_(VHF)_Guidelines.pdf.
- 13.Ebola Virus Disease. Information for Healthcare Workers and Settings. http://www.cdc.gov/vhf/ebola/hcp/index.html.