What are the health effects of corpses in Libya's disaster-stricken areas?

With the death toll from floods caused by Storm Daniel hitting the coast of Libya reaching 5300,10 and some <>,<> people missing, concerns are raised about the dangers posed by unrecovered bodies.

Mansour al-Hasadi, a member of the High Council of State for the city of Derna, warned of a danger to the city's residents after the flood disaster, and that a plan must be made to evacuate them. Al-Hasadi said – in statements to Al Jazeera – that a warning of a health and environmental disaster began to appear in some of the affected areas.

Khalifa al-Daghari, a member of parliament from Benghazi, appealed to Egypt and Algeria to send teams of divers to retrieve the bodies scattered on the beaches of the affected areas. Al-Daghari stressed – in statements to Al Jazeera – the urgent need to support hospitals in the affected areas, pointing to the shortage of medicines in these areas.

What risks do corpses pose after disasters?

According to the World Health Organization, "Contrary to popular belief, there is no evidence that corpses pose a risk of epidemic disease after a natural disaster. Most pathogens, such as bacteria and viruses, do not survive for long in the human body after death. Human remains pose no significant risk to health, except in a few special cases, such as deaths from cholera or hemorrhagic fever."

However, workers who routinely handle corpses may be at risk of tuberculosis, blood-borne viruses such as hepatitis B and C, gastrointestinal infections such as cholera and E. coli, rotavirus diarrhoea, salmonella, shigellosis and typhoid fever, she says.

Tuberculosis

TB can occur if the bacteria inhale from the remaining air in the lungs (of the corpse) or as a result of fluid flowing from the lungs through the nose or mouth while handling the corpse.

Blood-borne viruses can be transmitted through direct contact with the skin or unhealthy mucous membranes through the splashing of blood or body fluids, or from infection with bone fragments and needles.

Gastrointestinal infections can be transmitted through feces and mouth, through direct contact with the body, dirty clothing, or contaminated vehicles or equipment. Gastrointestinal infections can also spread as a result of contamination of the water supply with corpses.

General tips on dealing with corpses in disasters

• Burial in mass graves is not a recommended public health procedure. It can violate important social norms.
• Cemeteries should be located at least 30 meters from groundwater sources used for drinking water.
• The floors of the graves must be at least 1.5 m above the groundwater table.
• Surface water from cemeteries should not enter populated areas.
• Practice universal precautions taken when handling blood and body fluids.
• Use gloves only once, and dispose of them properly.
• Use body bags.
• Wash hands with soap after handling corpses, and before eating.
• Disinfection of vehicles and equipment.
• Get vaccinated against hepatitis B.

Loss of sanitation infrastructure

According to the U.S. Centers for Disease Control and Prevention, the loss of sanitation infrastructure may lead to exposure to raw wastewater, loss of local capacity to treat drinking water, and inability to maintain cooling of food and medical supplies.

She adds that human remains may contain blood-borne viruses, such as hepatitis viruses, and bacteria that cause diarrheal diseases, such as salmonella. These viruses and bacteria do not pose a danger to anyone walking nearby, nor do they cause significant environmental pollution.

Bacteria and viruses found in human remains in floodwaters make up a small portion of the total pollution that can include uncontrolled sewage, a variety of soil and water organisms, and household and industrial chemicals. There are no additional practices or precautions regarding floodwaters related to human remains, other than what is normally required for safe food, drinking water, standard hygiene and first aid.

However, for people who must directly deal with remains, such as resuscitation personnel, or people identifying remains or preparing remains for burial, there can be a risk of exposure to such viruses or bacteria.

Workers handling human cadavers should take the following precautions:

• Protect your face from spray body fluids and fecal matter. You can use a plastic face shield, a combination of eye protection (indirect ventilation safety glasses are a good option if available; safety glasses will only provide limited protection) and a surgical mask. In extreme cases, a cloth tied to the nose and mouth can be used to prevent splashing water.
• Protect your hands from direct contact with bodily fluids, as well as from cuts or other skin-piercing injuries, which may be caused by severe environmental debris or bone fragments. It is preferable to combine the glove of the inner layer that is resistant to cutting with an outer layer of latex, or a similar outer layer. Shoes should similarly protect against sharp debris.
• Keep your hands clean to prevent the transmission of diarrheal and other diseases from the stool on your hands. Wash your hands with soap and water, or with alcohol-based hand cleaner immediately after removing gloves.
• Provide prompt care – including immediate disinfection with soap and clean water, and a booster dose of tetanus if necessary – for any wounds you sustained while working with human remains.