Disease task force discusses mass burials

~ The group is preparing Cape Girardeau County's response to an epidemic such as avian flu.

In the minutes of the Cape Girardeau County Infectious Disease Task Force, one heading stands out as evidence officials believe a nightmare is possible.

The heading? Mass fatalities.

As the task force, made up of emergency responders, health-care officials and others, works to prepare the county's response to a major epidemic, they are discussing which circumstances could force quick burials in mass graves.

The discussions include how to record the deaths, whether to photograph the corpses and the possibility of implanting microchips into bodies for better identification if a mass grave is exhumed later for individual burials.

"I don't have a final plan," Cape Girardeau County Coroner John Clifton said. "But we are working on it, that is for sure. If we would have to do mass burials, there are a lot of issues such as location, where would be a suitable place for this."

Issues involved also include how to handle the bodies, which may be able to transmit an infection, and where to bury the bodies so that they do not contaminate ground water as they decompose, Clifton said.

The prospect of dozens, if not hundreds, of deaths in a short time isn't farfetched. During the 1918 flu epidemic, which killed 50 to 100 million people worldwide and more than 500,000 in the United States, Cape Girardeau recorded an average of four deaths per day for three months.

Based on population growth, a comparable figure today would be 20 deaths a day.

Today's threat is avian flu, which in two years has spread from poultry flocks in China across Asia, Europe and Africa. The disease is transmitted easily among birds, including wild birds. Avian flu can be passed to humans but does not move easily from one person to another.

When it does infect humans, avian flu is deadly. Of 252 confirmed human cases worldwide through Tuesday, 148 people have died. So far this year, 70 people have died out of 105 reported infections.

"We are talking about, if it hits, of the need to take drastic measures," said Charlotte Craig, director of the county health center.

The task force will test how well it has so far prepared Nov. 8 with a table-top exercise. "You present scenarios, brainstorm and decide what steps you need to take," Craig siad.

Preparation, both at the community level and at the personal level, are the most important elements of surviving a disaster, Craig said.

Community preparation has included passing a quarantine and isolation ordinance, giving Craig the power to order some areas to be off-limits and to order individuals to remain at home. Each order would have to be approved by the county commission and the county health center board of trustees.

The other main thrust of the task force will be education to help individuals prepare. The steps Craig and the task force are urging would help in any natural disaster, such as a tornado or earthquake, as well as a flu epidemic, she said.

"You have different plans for each type of disaster, but there are common threads," Craig said. "Emergency personnel, hospitals, volunteers, firemen, all would be essential personnel in both types of disaster."

For individuals, preparing at home to live without assistance is crucial, Craig said. The aftermath of Hurricane Katrina showed that in the event of a regional disaster, such as an earthquake, help would be slow to arrive.

And in the event of a flu epidemic, most locations would be fending for themselves as a nationwide emergency taxes every region.

"If we had to say 'please don't go to the grocery store,' wouldn't it be comforting to have a month's supply of canned goods?" Craig said. "Personal preparation is the key to all disaster planning."

Prosecuting Attorney Morley Swingle, who helped draft the quarantine ordinance, said research into the impact of the 1918 flu on Cape Girardeau and a book he read on the worldwide effect convinced him drastic steps could be necessary in an outbreak.

The flu epidemic that year killed more people in a few months than the entire four years of World War I, which ended in the middle of the epidemic.

"In Cape Girardeau in 1918, they closed the schools, closed the churches and that type of quick thinking prevented people from sharing the germs," Swingle said. "It prevented a greater number of deaths than otherwise would have occurred."

The task force's work, which has been ongoing for most of a year, has put Cape Girardeau County ahead of most places in Missouri in preparation for a flu epidemic or other disaster, Craig said.

"We have a wonderfully proactive group," she said. "There are times when we leave our meetings exhausted. It is overwhelming and we can't come up with all the answers, but at least we are attempting plans."

rkeller@semissourian.com

335-6611, extension 126