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Prions “small proteinaceous infectious agents without a nucleic acid genome……produce spongiform encephalopathies” Pathogenicity • abnormally folded proteins that cause the proteins to clump • diseases have a long incubation time • CNS damage is insidious • no fever and inflammation Readings Question #1 • Why are prions of a particular concern to embalmers? Creutzfeldt-Jakob Disease • • • • transfers/removals embalming non-posted Remains embalming posted remains decontamination NJ Dept. of Health/NJSFDA Embalming Non-posted Remains • • • • • • • • Protective attire Positioning Topical disinfection Washing and positioning Injection site selection Injection chemicals No cavity aspiration Aspiration alternative Embalming Non-posted(cont’d) • • • • • • • other precautions: purge medical devices washing instruments surfaces disposables Embalming Posted Remains • • • • • • viscera preservative powder completion viscera bag cranial cavity calvarium Decontamination • • • • sodium hypochlorite incineration detergent solution of 1:10 sodium hypochlorite/water Viruses Readings question #2: How do viruses replicate? Readings question #3: How can some viruses become inactivated? Why? Give 1 example. Dermatropic (Skin) Diseases • Smallpox: vaccination ended in the 1970s • Monkeypox: • Measles: Readings question #4: What is the virus responsible for measles? What is the only reservoir for this virus? • MMR vaccine (measles, mumps, rubella) Dermatropic Diseases (cont’d) • German Measles: • Readings question #5: what is the virus that is responsible for this disease? How is it spread? • Chickenpox and Shingles: – Shingles rarely occurs in people under the age of 20 Reye’s Syndrome • severe complication of chickenpox, influenze and some other viral diseases • persistent vomiting • signs of brain dysfunction • coma and death • survivors: neurological damage • children and teenagers • aspirin Dermatropic Diseases (cont’d) • Herpes Simplex 1 and 2: Readings question #6: What is caused by the Herpes Simplex 1 virus and how is it transmitted? What is caused by the Herpes Simplex 2 virus and how is it transmitted? Pneumotropic (URT) Diseases • Influenza: strains are “antigenic shifts” - vaccines are usually “multivalent” - pandemic 1918-1919 - 2 new drugs: zanamivir (Relenza) oseltamivir phosphate (Tamiflu) Pneumotropic Diseases (cont’d) • Common Cold: • Hantavirus Pulmonary Syndrome (HPS): • Severe Acute Respiratory Syndrome (SARS): Neurotropic (CNS) Diseases • Rabies: Readings question #7: Why is the immune system unable to suppress the infection caused by the rhabdovirus when it reaches the central nervous system? - not found in squirrels, rabbits, rats, or mice Neurotropic Diseases (cont’d) • Poliomyelitis: • Readings question #8: Describe the path of the poliovirus once it is ingested. • Viral Encephalitis: • West Nile Virus: 1999 New York City Viscerotropic (Visceral) Diseases • Hepatitis: Hepatitis A (HAV) Hepatitis B (HBV) • Readings question #9: According to OSHA’s Blood-borne Pathogen Rule, what are the rights of funeral home employees regarding the HBV vaccine? Hepatitis C (HCV): “silent epidemic” Viscerotropic Disease (cont’d) • Infectious Mononucleosis: • Cytomegalovirus: “inclusion bodies” • Epidemic Parotitis (Mumps) Immunological Disease • HIV (Human Immunodeficiency Virus) Readings question #10: What is the major threat to embalmers when embalming AIDS victims? What can the embalmer do to protect him/herself?