Autopsy Biosafety

Abstract

Introduction: As invasive meningococcal disease progresses rapidly, often affects youth, and has a fairly high mortality rate, such cases are likely to fall under medical examiner/coroner (ME/C) jurisdiction. Morgue personnel may be at risk of contracting secondary meningococcal disease. We review the current scientific literature regarding Neisseria meningitidis infection and provide recommendations for the prevention of meningococcal disease at autopsy. Methods:A PubMed search utilizing applicable medical subject heading terms was performed retrieving articles for review from the preceding two decades. Pertinent current guidelines from multiple national organizations were also retrieved. Results:Invasive meningococcal disease is transmitted by direct contact with large respiratory droplets or oral secretions. While a surgical mask would normally provide adequate protection from large droplet spread, it does not prevent inhalation of smaller aerosolized particles such as those generated at autopsy. Prosectors are advised to routinely wear N-95 respirator masks or powered respirator hoods. All published cases of secondary meningococcal disease transmission to healthcare workers invariably arose in scenarios in which face masks/respirators were not employed; none of these cases involved meningococcal disease transmission to ME/C or other morgue staff. Discussion:In the event that no mask-or inadequate coverage such as a surgical mask-is employed during autopsy of a decedent suspected/confirmed to have invasive meningococcal disease, antibiotic prophylaxis is advisable. Assuming appropriate personal protective equipment is utilized, chemoprophylaxis is unnecessary. Routine meningococcal vaccination is not recommended, except for ME/C with specified immunocompromising conditions or traveling to hyperendemic/endemic meningococcal regions. Acad Forensic Pathol. 2018 8(2): 328-339 Downloaded from www.afpjournal.com by an AFP Journal subscriber This article is for personal use only and may not be shared or distributed in any fashion REVIEW ARTICLEImage 1: Recommended personal protective equipment (PPE) includes a surgical cap, impervious surgical gown with full sleeve coverage, shoe covers, respirator mask, full face shield, and double gloves.

No-Touch Automated Room Disinfection after Autopsies of Exhumed Corpses

“…The literature addressing safety issues in dissection rooms recommend the use of personal protective equipment, such as gloves, goggles or masks during autopsies [ 2 , 3 , 4 ]. Current guidelines regarding decontamination are limited to cleaning and disinfection of surfaces and tools, depending on the potential infectious agent [ 26 ].…”

“…Forensic pathologists are at an increased risk of various infections, particularly those associated with hepatotropic viruses, coronaviruses, meningococci, or Mycobacterium tuberculosis [ 1 , 2 , 3 , 4 , 5 ]. Moreover, autopsies of exhumed bodies pose a particular risk of infections with pathogenic strains of bacteria or fungi from decomposing bodies or environment, which can be life-threatening even in immunocompetent people [ 5 , 6 ].…”

Biossegurança e transmissão respiratória de doenças infecciosas

“…Existem evidências da produção não apenas de gotículas, mas também de aerossóis na necropsia de um indivíduo que veio a óbito por essa doença. Por isso, em caso de o profissional não utilizar corretamente os equipamentos de proteção individual (EPI), como o respirador facial N95, recomenda-se a realização de quimioprofilaxia com antibiótico (Brooks e Utley-Bobak, 2018). No quadro 3 são descritas as medidas pós-exposição das principais enfermidades transmitidas por gotículas.…”