16 Del. Admin. Code § 4204-6.0

Current through Register Vol. 28, No. 7, January 1, 2025

Section 4204-6.0 - Preparation, Transport, And Disposal Of Bodies Dead Of Designated High-risk Diseases

6.1 The Director of the Division of Public Health or Designee shall designate communicable diseases determined to be high-risk from the point of view of handling after death. Currently designated diseases include Anthrax, Smallpox, Plague, and the various Hemorrhagic Fevers.

6.2 Should death occur before a definitive diagnosis can be made and when there is even the remote suspicion of one of these illnesses, the physician or hospital should consult with the Chief Medical Examiner or the Director of Public Health. Should it be necessary to hold a body for longer than six hours pending completion of definitive diagnostic work, the body should be sealed immediately following the taking of such specimens as may be needed. The sealing should be completed as described in Preparation a. (below) and held in isolation (refrigerated when possible) pending removal. Otherwise, removal, transport, and cremation should proceed as prescribed by these regulations.

6.3 Whenever death occurs from a designated high-risk disease, immediate notification shall be provided by the reporting physician, other provider, or the hospital to the Division of Public Health, next of kin, and the funeral director who will have responsibility to handle, transport, or dispose of said body. These reports may be made by fax, telephone, or electronic mail. After business hours, the Division of Public Health emergency line is (302) 739-4700.

6.4 The Chief Medical Examiner, hospital or funeral director shall ensure that anyone handling a body so designated shall follow strict universal precautions in a manner that minimizes contact between the body, other persons, and the environment. For information concerning universal precautions contact the Office of Vital Statistics.

6.5 Preparation:

6.5.1 The body shall be wrapped in a sheet saturated with a suitable disinfectant. This may be concentrated commercial disinfectant approved for such purpose or it may be embalming powder or high index cavity fluid. This shall be followed by enclosure in a heavy-duty impervious bag designed for such purpose to assure against leakage.

6.5.2 For transport, the body prepared as in subsection "a." shall be placed in a suitable firm container such as a "cremation container" in which case it shall be cremated therein, or it may be transported in a temporary firm protective container from which it may be removed for cremation.

6.5.3 For burial or other exempted disposition, the body shall be enclosed in a metal casket liner or a casket that is constructed so as to not allow any seepage whatsoever therefrom and is to be sealed. Burial of bodies dead of designated high-risk disease must be at a depth of at least 79 inches/ 2 meters.

6.6 Labeling:

6.6.1 It will be the responsibility of the funeral director to ensure that there are attached to the body and its containers in several visible places labels bearing in prominent legible letters the words, "This body is infected with a designated high-risk disease specified by the Division of Public Health and must be handled and transported in accordance with the precautions required by these regulations".

6.7 Handling:

6.7.1 Neither embalming nor autopsy shall be performed on such bodies unless specifically authorized by the Chief Medical Examiner or designee.

6.8 Transport:

6.8.1 Transport of a body so designated must be under the conditions described above with the addition that the body must be protected in such a way as to assure that it shall not become uncovered in any reasonably foreseeable accident. Transport out of state shall be prohibited unless approved by the Director of Public Health or designee and the receiving jurisdiction.

6.9 Removal:

6.9.1 A body may be removed from the firm protective container in which it was transported once it has reached the funeral home or crematory where the body shall be prepared for cremation or other disposition if authorized. Such container used exclusively for transport may be re-used following suitable disinfection.

6.10 Services:

6.10.1 No viewing of the body or public services in the presence of the body shall be permitted.

6.10.2 Cremation is the disposal method of choice for any designated high-risk communicable disease. If burial is permitted as an exception, it must be promptly performed and the body must remain sealed as described above throughout the burial process.

6.10.3 The Director of Public Health or designee upon request may waive any requirement of these regulations in order to accommodate religious or traditional practices if he or she is satisfied that the proposed practices present no substantial additional risk to any person or the environment.

16 Del. Admin. Code § 4204-6.0