NEW DELHI: The Union health ministry has banned the cross-border transportation of human remains of confirmed or suspected Ebola virus disease (EVD) patients into India and prescribed protocols for deaths from the disease in Indian hospitals.
Aimed at preventing potential outbreaks, this public health directive details the safe and dignified handling of human remains of Ebola patients and highly infectious casualties. The new rules were drafted by the Directorate General of Health Services (DGHS) after considering recommendations from the World Health Organization and the Centers for Disease Control and Prevention in Atlanta.
"The cross-border transportation of the HRs of confirmed/suspected EVD cases into India is prohibited," the DGHS said in the document reviewed by Mint.
If an infected body arrives at an airport under unavoidable circumstances, it will trigger an immediate biosecurity response. According to the new rules, the human remains must be double-packed in a 150-micrometre thick plastic sheet and a zinc-lined coffin, evaluated by a specialized forensic task force and cremated under strict police supervision.
The guidelines mandate that burial sites must be dug at least two metres deep, with unprotected attendees maintaining a 50-metre safety perimeter from the site. Also, traditional final rites involving washing, touching and kissing the deceased are strictly prohibited to prevent environmental contamination.
“Unsafe burial practices involving physical contact have been flagged as a major driver of outbreaks in Africa. In other words, unlike covid-19 where transmission occurs primarily while the patient is alive, Ebola remains highly contagious after the patient has died,” said Dr Rajeev Jayadevan, a public health expert. “This transmission occurs through direct contact with a patient’s bodily fluids or by physically touching a deceased patient's body during final rites.”
No vaccine, treatment
The guidelines were issued in the backdrop of a global public health emergency involving a rare Bundibugyo strain currently spreading in Central Africa. According to the WHO, the ongoing Ebola outbreak in Central Africa has surpassed 1,200 cases and 250 deaths.
The current outbreak was caused by a strain for which there is no approved vaccine or specific antiviral treatment, Dr Jayadevan said. The focus must be on breaking the chain of transmission rather than relying on medical treatment. Having stringent biosecurity protocols in place in advance will completely neutralize the risk of the virus entering the country via repatriated human remains, he added.
While India has reported zero cases to date, the health ministry has intensified its domestic defenses. Additionally, India has dispatched emergency medical supplies to Africa to support containment efforts and ensured high alerts across national ports of entry.
Special teams of forensic experts will also be set up at every international airport for essential evaluations. For mid-flight deaths, pilots must report symptoms immediately and the airline is required to isolate nearby passengers and crew and obtain their contact details for a mandatory 21-day surveillance period managed by the Integrated Disease Surveillance Programme (IDSP).
Dr Sujeet Singh, former director at the National Centre for Disease Control, noted that the incubation period spans up to 21 days.
"A strict, specialized watch mechanism must be maintained for any traveler arriving with a 21-day history in the Democratic Republic of Congo, Uganda or South Sudan to prevent undetected community spillovers," Dr Singh said.
Screening networks
Dr Singh added that the government should involve seasoned medical experts to refine clinical isolation rules and rapidly align domestic procedures with shifting global guidelines.
"Unlike covid, the Ebola virus can be 100% contained at points of entry. Because only symptomatic individuals transmit Ebola, they can be easily caught at airports by installing robust thermal screening networks," Dr Singh noted.
The rules apply to bodies of confirmed or suspected Ebola patients, including exhumed bodies, but exclude cremated ashes. The guidelines also apply to deaths in Indian hospitals and place strict limits on traditional funeral practices to keep families safe.
"Washing the dead body is strictly prohibited in such cases," the DGHS said.
The guidelines noted that if the family chooses a burial, all hospital staff, police officers and burial workers handling the body must wear complete personal protective equipment, which must be disinfected in a chemical solution for 30 minutes before being burned.