HIV SEROPHOBIA IN THE MORTUARY - AN ALGORITHM SYSTEM FOR HANDLING HIGH-RISK FORENSIC CASES

A serophobia of the human immunodeficiency virus type 1 (HIV-1) is ver y noticeable in mortuaries handling high-risk cases. The morbid anxiet y about occupationally acquired HIV infection in the forensic practice has made mortuary workers unduly overcautious. Despite the availabili ty of codes of practice and informed principles of health and safety, there is considerable anxiety that an HIV carrier with no identifiable risk factors may be overlooked or a seronegative body may be inadvert ently assumed to be uninfected. In contrast, a false sense of safety c an pose a health hazard and has public health implications. An algorit hm system is outlined for selective handling of unsuspected or unrecog nized high-risk cases. It is necessary that guidelines are reasonably simple and incorporate statutory health and safety regulations and loc al safe working practice in the mortuary. Although it is not a legal o bligation, approval by the coroners should facilitate consistent imple mentation of a protocol. A common experience in public and NHS hospita l mortuaries in the London coroners' jurisdictions is characterized.