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A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

Date, Tue, 28 Dec 2004
From: Martin Rieder  <>

As I am watching the news about the catastrophe in the Indian Ocean
area, I am amazed how often it is mentioned that because of the fear
of epidemics, dead bodies have to be buried as quickly as possible.
Looks like we are still in the 19th century, with all the theories
about miasma (meaning bad air, hence "malaria") and dead bodies.

As far as I remember, several scientific studies have shown that
after natural disasters, the dead bodies of victims do not cause any
increase in the spread of communicable diseases.  It is the
accompanying situation (lack of safe water, lack of proper sanitation
for "still alive" human beings -- well, lack of everything....) that
constitutes a threat.  Those who fell victim to the disaster and
their bodies do no harm, apart from looking ugly and smelling while

Whatever infectious agents the deceased victims of the tsunami
harbored while still alive will pose less threat to the public health
than when they were alive, and no new organisms will develop while
the dead bodies are rotting.  The real threat to public health is
posed by those still living, some of whom may spread infectious
agents, and the worsened conditions that help spread whatever they
may carry.

Therefore, the utmost priority from a public health point of view is
not to bury all the dead immediately (which is what people on TV seem
to be telling us), but to restore the safety of the water supply. In
fact, for many of the affected countries, it is not a matter of
"restoring" but establishing a safe source of water!!!  It will also
be important to pay attention to environmental issues like vector
control, waste disposal, and hygiene education.

Martin Rieder, DTMPH