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This course presents an overview of the communicable diseases most likely to impact funeral professionals, and discusses ways in which they can protect themselves. By the end of the course, learners should be familiar with: ❑ Transmission of Communicable Diseases ❑ Common Communicable Diseases Hepatitis B, Hepatitis C, Human Immunodeficiency Virus (HIV), Methicillin-Resistant Staphylococcus aureus (MRSA), Streptococcus pyogenes, Non-typhoidal Salmonella, Mycobacterium tuberculosis, Severe Acute Respiratory Syndrome (SARS), Creutzfeldt-Jakob disease (CJD) ❑ Other Communicable Diseases of Current Concern The Zika Virus, Ebola, Healthcare Settings ❑ Sterilization Techniques in the Embalming and Preparation Room ❑ Risk Education Methods Bloodborne Pathogens Standard, Personal Protective Equipment Standard NOTE: Links and illustrations provided within the course material are for informational purposes only. No endorsement of processes or products is intended or implied. 2 | Funeral Service Academy COMMUNICABLE DISEASE AND FUNERAL PROFESSIONALS Communicable Diseases Communicable diseases are those that can be transmitted directly or indirectly from one individual to another.1 These diseases can be passed from person to person in a variety of different ways, including contact with blood and bodily fluids. Although there is an abundance of research available regarding healthcare workers and their risk of exposure to communicable diseases, there are not many published studies about the risk of exposure to communicable diseases to those in the funeral profession. However, in 1996, the Centers for Disease Control and Prevention (CDC) issued a study report indicating that there is ample reason for concern about the exposure funeral service professionals, particularly embalmers, may have to bloodborne pathogens and airborne pathogens.2 This is why it is important for funeral service professionals, particularly those who handle dead human bodies, to refresh and maintain their knowledge of communicable diseases. In this course, we will discuss the multiple ways communicable diseases can be spread, exploring each transmission method relevant to funeral professionals. We will also take a closer look at the many communicable diseases, some very common and some not as well known, that should be of concern to funeral service professionals. Finally, since the routine tasks carried out by funeral professionals put them at significant risk of exposure to infectious agents, we will take an in-depth look at the implementation and effectiveness of the essential infection control practices that should be observed at funeral homes and crematories.3 Transmission of Communicable Diseases There are several different ways an infectious agent may be transmitted from its natural reservoir to a susceptible host. Direct transmission refers to an infectious agent that is transferred from a reservoir to a susceptible host by direct contact or droplet spread. 4 Direct contact occurs through skin-to-skin contact, needlesticks, kissing, and sexual intercourse.5 Direct contact could also refer to contact with soil or vegetation that is harboring an infectious organism.6 Droplet spread refers to spray with relatively large, short-range aerosols produced by sneezing, coughing, or even talking.7 This mode of transmission is classified as direct because transmission is by direct spray over a few feet, prior to the droplets hitting the ground or another surface.8 Droplet transmission could also be through subsequent touching of mucous membranes of the mouth, nose, and eyes when hands are contaminated with infective agents. Indirect transmission refers to the transfer of an infectious agent from a reservoir to a host by suspended air particles (airborne), inanimate objects (vehicles), or animate intermediaries (vectors).9 Airborne transmission happens when an infectious agent is carried by dust or droplet nuclei suspended in air.10 Droplet nuclei are dried residue of less than 5 microns in size.11 In contrast to droplets that fall to the ground within a few feet, droplet nuclei may remain suspended in the air for long periods of time and may be blown over great distances.12 Vehicles that may indirectly transmit an infectious agent include food, water, biologic products such as blood, and fomites (inanimate objects such as handkerchiefs, bedding, or surgical scalpels).13 A vehicle may passively carry a pathogen, or the vehicle may provide an environment in which the agent grows, multiplies, or produces toxin.14 Vectors such as mosquitoes, fleas, and ticks may carry infectious agents through purely mechanical means or they may support growth or changes in the agent.15 Mode of Transmission Communicable Disease Examples Direct Contact gonorrhea, hookworm, head lice, MRSA, hepatitis B, hepatitis C, HIV Droplet Spread influenza, pertussis Airborne Transmission Tuberculosis, SARS Vehicle Transmission hepatitis A, norovirus, Clostridium bolulinum Vector Transmission Shigella, Yersinia pestis, dengue fever, malaria For funeral professionals, a couple of these modes of
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