Hantaviral biosafety issues in the autopsy room and laboratory: concerns and recommendations

The need to perform autopsies on and examine laboratory specimens from patients with hantavirus pulmonary syndrome (HPS) has raised questions about biosafety. Human illness associated with hantaviruses is usually the result of exposure to infectious aerosols from saliva or excreta of wild rodents. It is unclear whether or nor certain autopsy and laboratory procedures can also generate similar potentially infectious aerosols. As the biosafety information developed for the HPS agent is limited and the consequences of infection are serious we recommend a cautious approach. Autopsy prosectors should use N-95 particulate respirators as a minimum standard. If aerosols will be generated they should use N-100 particulate respirators or powered air purifying respirators with high-efficiency particulate air (HEPA) filters. Centrifugation and cytocentrifugation of blood or body fluid samples should be performed in bio-contained systems and these specimen containers should be opened in a class II biological safety cabinet.