1. Prions “small proteinaceous infectious agents without a nucleic acid genome……produce spongiform encephalopathies”

2. Pathogenicity abnormally folded proteins that cause the proteins to clump diseases have a long incubation time CNS damage is insidious no fever and inflammation

3. Readings Question #1 Why are prions of a particular concern to embalmers?

4. Creutzfeldt-Jakob Disease transfers/removals embalming non-posted Remains embalming posted remains decontamination

5. 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

6. Embalming Non-posted(cont’d) other precautions: purge medical devices washing instruments surfaces disposables

7. Embalming Posted Remains viscera preservative powder completion viscera bag cranial cavity calvarium

8. Decontamination sodium hypochlorite incineration detergent solution of 1:10 sodium hypochlorite/water

9. Viruses Readings question #2: How do viruses replicate? Readings question #3: How can some viruses become inactivated? Why? Give 1 example.

10. 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)

11. 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

12. 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

13. 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?

14. Pneumotropic (URT) Diseases Influenza: strains are “antigenic shifts” - vaccines are usually “multivalent” - pandemic 1918-1919 - 2 new drugs: zanamivir (Relenza) oseltamivir phosphate (Tamiflu)

15. Pneumotropic Diseases (cont’d) Common Cold: Hantavirus Pulmonary Syndrome (HPS): Severe Acute Respiratory Syndrome (SARS):

16. 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

17. 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

18. 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”

19. Viscerotropic Disease (cont’d) Infectious Mononucleosis: Cytomegalovirus: “inclusion bodies” Epidemic Parotitis (Mumps)

20. 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?