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Rules and Regulations of the State of Georgia
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Subject 511-2-6 HANDLING AND DISPOSITION OF HUMAN REMAINS INFECTED WITH A DANGEROUS VIRUS

Rule 511-2-6-.01 Handling of Infected Human Remains When Death Occurs in a Hospital or Medical Facility

(1) This Chapter 511-2-6 shall govern the handling and disposal of human remains which are infected with a dangerous virus. The term "dangerous virus" includes Alkhurma, Chapare, Ebola, Marburg, or any other virus specifically designated as dangerous by the State Health Officer.
(2) The term "disinfect" as used in this Chapter shall mean to clean thoroughly with an EPA-registered hospital disinfectant with a label claim for one of the non-enveloped viruses (e.g., norovirus, rotavirus, adenovirus, or poliovirus) or, if that is not available, a solution of one part household bleach to nine parts water.
(3) The body shall be prepared for transport at the site of death by persons trained in the safe handling of infected articles and human remains, wearing appropriate personal protective equipment.
(4) After identification of the body and collection of information necessary to complete the death certificate, the body shall be prepared as follows:
(a) Any medical tubing, intravenous needles, or other devices inserted into the body during treatment shall be left in place.
(b) The body shall be placed into a leakproof body bag of at least 150 microns thickness. If the bag is not designed to be sealed through the use of adhesives, then a durable tape shall be used to securely cover the zipper. The outside of the bag shall be disinfected immediately.
(c) The body shall next be placed into a second leakproof body bag of at least 150 microns thickness. If the bag is not designed to be sealed through the use of adhesives, then a durable tape shall be used to securely cover the zipper. The outside of the bag shall be disinfected immediately.
(d) The body shall then be placed into a zipperless body bag of aluminum-impregnated material, such as the BioSeal System 5 or equivalent, which is designed to be hermetically sealed through heat-welding. The outside of the bag shall be disinfected immediately.
(e) The double-bagged body shall then be placed in a transport container suitable for cremation or a hermetically metal casket of no less than 20-gauge metal. The placement shall occur immediately outside the site of death and the casket taken directly to the transport vehicle.
(f) The transport vehicle shall take the body directly to the crematorium or burial site.

Rule 511-2-6-.02 Disposition of Infected Human Remains

(1) Infected human remains shall be cremated using an 8-hour cycle unless cremation is not feasible by reason of obesity, medical implants, or objection made on bona fide religious grounds within 24 hours of death by the person with legal right to control the disposition of the body. The cremation authorization may be signed by any representative of the Department of Public Health, County Board of Health, coroner, or medical examiner.
(2) If the body cannot be cremated, then it shall be buried in a hermetically sealed casket of no less than 20-gauge metal.
(3) The body shall not be transported out of state except with the consent of the chief public health officer of the receiving state and in coordination with the Centers for Disease Control.
(4) No autopsy or embalming shall be performed without the consent of the State Health Officer.

Rule 511-2-6-.03 Decontamination of Site of Death

(1) The site of a death by a dangerous virus shall be thoroughly decontaminated in accordance with the latest guidance from the Centers for Disease Control. Until decontamination is complete, no persons shall be allowed at the site of death except persons trained in the safe handling of infected articles and human remains, wearing appropriate personal protective equipment.
(2) The body shall be removed from the site of death as provided in DPH Rule 511-2-6-.01 before decontamination of the site of death.
(3) Sharps waste shall be placed in a sturdy authorized sharps container. The sharps container and all clothes, towels, bed linens, paper, fabric, or non-durable porous materials that may have come in contact with the deceased during the period of illness shall be placed into plastic bags of 150 microns thickness or more, and the outside of the bags shall be disinfected immediately. Each bag shall then be placed into a second bag of 150 microns thickness or more, and the outside of that bag disinfected immediately.
(4) All such bags and their contents shall be either disinfected by autoclave or incinerated on the grounds of the hospital or healthcare facility, or incinerated offsite at the nearest disposal facility. If the bag is to be incinerated offsite, then it shall be secured inside a rigid container for transport as a Category A Infectious Substance in accordance with the Hazardous Materials Regulations of the U. S. Department of Transportation (49 C.F.R. Parts 171- 180.)
(5) All surfaces that may have come in contact with the deceased, or with the bodily fluids of the deceased, shall be disinfected immediately after removal of the body.

Rule 511-2-6-.04 Handling of Infected Human Remains When Death Occurs Outside of a Hospital or Medical Facility

(1) Any person who becomes aware of a death that occurs outside of a hospital or healthcare facility, or otherwise without medical attendance, in circumstances where a diagnosis of a dangerous virus disease is possible, shall immediately notify the Director of Health Protection of the Georgia Department of Public Health or designee and the county coroner or medical examiner. "Circumstances where a diagnosis of a dangerous virus disease is possible" exist when the following occurred:
(a) the deceased came into contact with a person infected with the virus within 35 days prior to death, or the deceased visited, within 30 days prior to death, an area of the world experiencing an outbreak or epidemic of a dangerous virus disease; and
(b) the deceased experienced any of the following symptoms immediately prior to death:
1. fever of 100 degrees Fahrenheit or more;
2. diarrhea;
3. vomiting;
4. unexplained bleeding or bruising;
5. severe abdominal pain;
6. severe muscle pain or weakness;
7. severe headache.
(2) The site of death shall be immediately closed off and secured, and only persons trained in the safe handling of infected articles and human remains, using appropriate personal protective equipment, shall be permitted at the site until the completion of testing as provided in subsection (3) and (4) below. The body shall be handled in accordance with DPH Rule 511-2-6-.01(4)(a) through (d) above and shall remain on site pending the results of testing. The remaining site shall not be disturbed or handled without express permission from the Director of Health Protection of the Georgia Department of Public Health or designee. Any bed linens, clothes, towels, or other articles that came in contact with the deceased shall likewise not be disturbed or handled.
(3) A blood or tissue sample shall be taken by a person or company approved by the Department and transported directly to a laboratory for testing as directed by the Director of Health Protection of the Georgia Department of Public Health or designee.
(4) The test results shall be reported immediately to the family or property owner and to the county coroner or medical examiner. If the sample tests negative for a dangerous virus, then this Chapter shall no longer apply and the county coroner or medical examiner shall assume jurisdiction over the body and the site of death. If the sample tests positive for a dangerous virus, then the body and the site of death shall be handled in accordance with DPH Rules 511-2-6-.01 through -.03 above.