Thomas Eric Duncan, the first Ebola patient diagnosed in the United States, died on Wednesday morning in Dallas. Now, for the first time, officials in America will take on the grim and dangerous task of handling the remains of an Ebola victim, a complicated procedure that can be a critical moment in stopping the transmission of the disease.
In a Wednesday statement, the Texas Department of State Health Services said it would follow federal guidelines in handling Duncan's remains. "We will continue to treat Mr. Duncan with dignity and respect, and we're taking great care to make sure there is no additional risk that others could be infected," health commissioner David Lakey said.
Health-care workers who treat Ebola patients and handle the remains those killed by Ebola face a substantial risk of catching the virus themselves if proper procedures are not followed. And the bodies of Ebola victims are even more contagious than living Ebola patients.
"When the person has just died, that is when the body is most contagious," World Health Organization spokesman Tarik Jasarevic told The Post in August. “It's when the virus is overtaking the whole body.”
Complicating that is the fact that late-stage Ebola infections can force blood, vomit and diarrhea from the body; those same fluids can pass the disease from person to person.
In August, shortly after an Ebola-stricken American doctor was repatriated to the United States for treatment, the Centers for Disease Control and Prevention issued a new document: "Guidance for Safe Handling of Human Remains of Ebola Patients in U.S. Hospitals and Mortuaries."
The guidelines warn that transmission can occur from a victim's remains to a living person through "laceration and puncture with contaminated instruments used during postmortem care, through direct handling of human remains without appropriate personal protective equipment, and through splashes of blood or other body fluids (e.g. urine, saliva, feces) to unprotected mucosa (e.g., eyes, nose, or mouth) which occur during postmortem care."
The CDC says that only workers wearing full protective equipment should handle the remains and recommends a series of procedures designed to keep contact to a minimum. Those include immediately wrapping the body in a plastic shroud, "in a way that prevents contamination of the outside of the shroud." That body must then be placed in two additional sealed bags, which are then decontaminated. That's all before any remains move to a morgue, or to a mortuary.
The guidelines also advise against autopsies and embalming the body, because of the risk of transmission inherent in either procedure. The CDC recommends cremation, or burial in a hermetically sealed casket, without removing the body from the sealed, decontaminated bags.
According to the Texas Department of State Health Services, Duncan's body will be cremated. "The cremation process will kill any virus in the body so the remains can be returned to the family," the department's statement said.
In West Africa, health officials have struggled to keep up with Ebola burials as the epidemic has raged out of control.
At least 3,857 people had died of Ebola in Sierra Leone, Liberia and Guinea through Sunday, according to the WHO. Earlier this week, several burial teams in Sierra Leone went on strike, saying that the government there had not paid their risk allowance.
Although the teams returned to work Wednesday, burial workers in Liberia are also considering a strike over pay and conditions, the Associated Press reported.
Burials have been problematic throughout the deadliest Ebola outbreak in history: As The Post noted in August, a combination of inadequate infrastructure, logistical issues, conflicts with Western health-care workers and burial traditions has contributed to widespread difficulties in containing the spread of the disease among mourners and those caring for the dead.