Experts Say Corpses Do Not Increase Risk of Disease

Residents of the Indian Ocean coastal areas where the massive tsunami struck Sunday have grief and personal and economic upheaval to deal with, but -- contrary to common belief -- face little serious disease risk from bodies of the dead, experts in disasters and infectious diseases said Tuesday.

Serious outbreaks of disease caused by contaminated drinking water or crowding, although always a risk, do not automatically occur after large-scale disasters.

The risk can be greatly reduced by aggressive attempts to provide clean drinking water, experts added.

“Infectious disease outbreaks and in particular epidemics are very, very rare in relation to natural disasters; that’s one of the misconceptions that people have,” said Dr. Mark Keim, a medical officer in the international emergency and refugee health branch of the U.S. Centers for Disease Control and Prevention. “We don’t see it with earthquakes, we don’t see it with hurricanes and we don’t see it with tsunamis.”

Some risks, such as contaminated water, clearly exist. Damage to the regions’ sewage systems and exposure of water to fecal material from survivors, who may be crowded together with no clearly designated latrines, mean drinking water is more likely to contain disease-causing microbes and viruses.

“If people are thirsty, they are going to drink whatever water they can -- thirst doesn’t stop,” said Dr. Martin Blaser, president elect of the Infectious Diseases Society of America and chair of medicine at New York University.

Illnesses, including hepatitis, cholera and typhoid fever, are endemic in some of the areas affected by the tsunami.

In addition, if large groups of refugees remain crowded, respiratory infections are more likely to be spread. The elderly and young children are the most vulnerable to such ailments.

Securing the water supply involves multiple measures such as shipping in clean water, providing the means to decontaminate water either through boiling or chemical treatment and repairing damaged infrastructure.

Delivering clean water to some regions may be extremely difficult, said Dr. Dana Van Alphen, regional advisor for the disaster program for the Pan American Health Organization, which is helping in relief efforts.

“We have to ensure that people have at least 20 liters [5.3 gallons] of water a day per person,” she said. “I don’t know how they are going to bring it in because certain areas are not accessible. Roads are closed. Bringing water with helicopters is very difficult, very costly -- water is heavy.”

Increased levels of diarrheal diseases have followed some disasters. Many refugees suffered from diarrheal diseases after flooding in Mozambique in 2000, and thousands died of cholera in Goma, Congo, after the 1994 Rwandan genocide.

Those were not typical, Keim said. The more common experience was the lack of significant disease that followed landslides in Venezuela in 1999 that killed up to 30,000.

What dangers exist are unlikely to come from corpses, experts say. The dead from this disaster did not die of disease. Moreover, infectious agents in corpses do not survive long, said Oliver Morgan, an epidemiologist at the London School of Hygiene and Tropical Medicine.

“After these big events where there are large numbers of fatalities, there is a rush to dispose of the dead and a lot of scare stories about imminent epidemics,” Morgan said. “But the risk of any disease transmission is really coming from the surviving population.”