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Dead Bodies Do Not Cause Disease

May 20, 2008

In the wake of seemingly every major disaster in the world, the newspapers fill with articles on efforts to dispose of the large number of dead bodies in an effort to stave off disease spread in the affected area. Then, after a day or so of these stories, the WHO issues a press release reiterating that corpses do not spread disease, or cause epidemics, and that rescue workers should focus on helping the living. Yet after each disaster, the cycle repeats itself. Just last week, the WHO came out with this release in response to stories of Chinese soldiers distributing disinfectant to be used on corpses.

This type of thinking is not new. It’s actually a relic of the miasma theory of disease. Miasma theory is a very clever way of thinking about how disease is caused and lead to some of the greatest advances in public health ever. It is, however, horribly outdated, yet continues to play a part in our definition of cleanliness, disease prevention and, in this case, emergency response.

For centuries, disease was chalked up to witchcraft, karma, bad blood, “God’s Will,” and a host of other uncontrollable sources. Disease happened, and death or disfiguration usually followed. In the late nineteenth century, however, a movement that looked at disease differently began to circulate through the cities of England and Germany and ultimately, New York City. Sanitarians, they were called, and they believed that the filth and stench of the cities of the time were the reason for the staggering spread of disease, epidemic and death in these cities. Farmlands, by and large, didn’t experience the terrible outbreaks that the cities did, and it was clean and smelled natural there.

The Sanitary Movement rejected the newly introduced idea of the germ theory of disease, and strove to rid the great cities of the world of the “bad air” that they thought was causing the death and disease. They transformed the world and introduced the concepts of modern sewage disposal, plumbing standards and solid waste disposal.

If you think about it, it really does make sense. There are really only two things in nature that stink (outside of things like a skunk’s defense mechanism) – waste and decomposition. Thinking like a 19th century sanitarian, eliminating these two things should help to reduce the incidence of disease. And it does–to some extent. Keeping waste, both human and animal, from the water supply, the streets and our food cuts incidence of disease drastically. Removing decomposing corpses, however, doesn’t do much at all. Sure it would cut down on the number of animals stopping by to feed (and thus stop them from defecating by the bodies), so there is some benefit, but that’s a minimal worry.

Our sanitarian friends cleaned up the streets, cleaned up the waterways, and the incidence rate of epidemic disease fell precipitously. Most of their work are still considered best practices the world over. One of the CDC’s Ten Great Public Health Achievements of the Twentieth Century is exactly this type of work. We’re not wrong in thinking that this type of work saves lives, it’s just that why it works is wrong. And that type of thinking is why we always get this call to disinfect or mass bury bodies after disaster.

We now know that disease is caused by germs (germ theory of disease) as opposed to miasma. We’ve also figured out in what environment these germs thrive, and in which they perish. Diseases thrive in warm body temperatures and feed, breed and grow using our body’s natural functions. Stop those functions, lower the temperature (two things that generally happen after death) and disease activity stops. End of story. Dead bodies do not spread disease. Securing access to potable water, developing shelters and helping the living prevents disease.

Too late note: Revere beat me by about a day with a similar post here.

No photo today because I don’t show blood. My most sincere condolences and best wishes go out to everyone affected by the twin disasters in southeast Asia.

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