Death Overseas

Importation or Exportation of Human Remains

Federal quarantine regulations (42 CFR 71) govern the importation of persons, animals, or things that may be infected with a communicable disease. These regulations place explicit restrictions on the importation of the uncremated remains of humans who are known or suspected to have died from one of the following communicable diseases: cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral haemorrhagic fevers (Lassa, Marburg, Ebola, Congo-Crimean, or others not yet isolated or named) or severe acute respiratory syndrome (SARS). If the death was suspected to be the result of one of these diseases, permission to import the remains should be obtained from CDC, Division of Global Migration and Quarantine (CDC/DGMQ). Granting this permission is contingent on an assurance that the remains will be handled according to specified standards, which include a requirement that the remains be placed in a hermetically sealed casket. In addition, the remains must be interred in a below-ground grave by a facility licensed to perform these services in the United States and in accordance with local burial standards. The remains are cleared for entry into the United States by the CDC Quarantine Officer assigned to the port of arrival, upon review of a copy of the signed permission from CDC/DGMQ and the death certificate, which has been translated in English and which states the cause of death. Copies of both documents should therefore accompany the remains during shipment. The local mortician handling the remains following their importation will be subject to the regulations of the state and local health authorities for interstate and intrastate shipment and is requested to submit a letter to CDC/DGMQ certifying the appropriate disposition of the remains according to the terms of the permission.

Federal regulations also provide CDC with the authority to restrict the importation of the remains of persons who died of other communicable diseases. While such restrictions are not generally employed, CDC reserves the right to do so on a case-by-case basis when necessary to prevent the spread of disease. There are no federal restrictions on the importation of cremated human remains or the remains of persons who have died of noncommunicable diseases.

The U.S. Consulate will generally assist family members in making arrangements with local authorities for preparation and transportation of the remains. The authority and responsibilities of a U.S. Consular Officer relating to the return of remains of a deceased U.S. citizen abroad are based on established U.S. laws, treaties, and international practice. Local law and protocols of the foreign country may affect the options available to the family of the deceased.

The United States has no requirements for the exportation of human remains; however, travellers should be advised that the requirements of the country of destination must be met. Travellers should also be advised that information regarding these requirements may be obtained from the appropriate foreign embassy or consulate.

Additional, detailed information on death overseas is available through the U.S. Department of State website at http://travel.state.gov/family/issues_death.html. Information on the return of the remains of a deceased U.S. citizen can also be obtained by calling the Office of American Citizens Services, Department of State, at (202) 647-5226. Information on procedures for obtaining permission for importation of the remains of persons who died of communicable disease may be obtained by contacting CDC/DGMQ at 404-498-1600.

Bibliography
  • CDC. Interim guidance for autopsy and safe handling of human remains of monkeypox patients [monograph on the Internet]. Atlanta, GA: CDC; 2003 [cited 2004 Oct 21]. Available from: http://www.cdc.gov/ncidod/monkeypox/pdf/autopsy.pdf.
  • U.S. Department of Health and Human Services. Title 42, Part 71. Foreign quarantine [monograph on the Internet]. Washington, DC: Government Printing Office; 2003 [cited 2004 Oct 25]. Available from: http://www.access.gpo.gov/nara/cfr/waisidx_03/42cfr71_03.html.

- Ram Koppaka

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