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October 4, 2000

Safety Precautions to Limit Exposure From Plague-Infected Patients

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(13):1648-1649. doi:10.1001/jama.284.13.1647

To the Editor: Dr Inglesby and colleagues1 recommend that aerosol-generating autopsies (essentially all autopsies) performed on individuals who have died of plague should be conducted in negative-pressure rooms by prosectors wearing high-efficiency particulate air–filtered respirators. However, their recommendation points to a major limitation in our national autopsy infrastructure. Deaths from known bioterrorist events are classified as homicides and therefore fall under the jurisdiction of medical examiners and coroners, who would investigate these deaths and, unless overwhelmed by large numbers of fatalities, perform autopsies of the bodies. Similarly, medical examiners or coroners might also perform autopsies of individuals who die precipitously and unexpectedly from a covert bioterrorist attack.