Chapter 6Conveyance & Transportation Issues

Clare A. Dykewicz

OBTAINING US DEPARTMENT OF STATE ASSISTANCE

When a US citizen dies outside the United States, the deceased person’s family members, domestic partner, or legal representative should notify US consular officials at the Department of State. Consular personnel are available 24 hours a day, 7 days a week, to provide assistance to US citizens for overseas emergencies.

• If a family member, domestic partner, or legal representative is in the foreign country with the deceased US citizen, they should contact the nearest US embassy or consulate for assistance. Contact information for US embassies, consulates, and consular agencies overseas may be found at the Department of State website (www.usembassy.gov).
• If a family member, domestic partner, or legal representative is located in the United States or Canada, he or she should call the Department of State’s Office of Overseas Citizens Services in Washington, DC, from 8 am to 8 pm Eastern Time, Monday through Friday, at 888-407-4747 or 202-501-4444. For emergency assistance after working hours or on weekends and holidays, call the Department of State switchboard at 202-647-4000 and ask to speak with the Overseas Citizens Services Duty Officer.

Emergency services provided by US consular officials can include advising the family, domestic partner, or legal representative about options and costs for disposing of the remains and personal effects of the deceased. Preparing and returning human remains to the United States can be an expensive and lengthy process. The Department of State does not pay for this; these costs are the responsibility of the deceased person’s family, domestic partner, or legal representative. Consular officials may also serve as provisional conservators of the deceased person’s estate, if no other legal representative is present in the foreign country where the death occurred.

IMPORTATION OF HUMAN REMAINS FOR INTERMENT

General Guidance

Except for cremated remains, human remains intended for interment (placement in a grave or tomb) must be accompanied by a death certificate stating the cause of death. A death certificate is an official document signed by a coroner, physician, or other official authorized to make a declaration of cause of death. Death certificates written in a language other than English must be accompanied by an English translation.

Remains of a Person Known or Suspected To Have Died from a Quarantinable Communicable Disease

Federal quarantine regulations (42 CFR Part 71.55) state that the remains of a person who is known or suspected to have died from a quarantinable communicable disease may not be brought into the United States unless the remains are properly embalmed and placed in a hermetically sealed casket, cremated, or accompanied by a CDC permit to allow importation of human remains, issued by the CDC director.

Quarantinable communicable diseases include cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers (Lassa, Marburg, Ebola, Crimean-Congo, or others not yet isolated or named), severe acute respiratory syndrome (SARS), and influenza caused by novel or reemergent influenza viruses that are causing or have the potential to cause a pandemic. A hermetically sealed casket is one that is airtight and secured against the escape of microorganisms. It should be accompanied by valid documentation certifying that it is hermetically sealed.

If a CDC permit is obtained to allow importation of human remains, CDC may impose additional conditions for importation beyond those listed above. Permits for the importation of human remains of a person known or suspected to have died from a quarantinable communicable disease may be obtained from CDC by calling 1-866-694-4867 or the CDC Emergency Operations Center at 770-488-7100. A copy of the CDC permit must accompany the human remains at all times during shipment.

Remains of a Person Who Died of Any Cause Other Than a Quarantinable Communicable Disease

When the cause of death is anything other than a quarantinable communicable disease, the remains may be cleared, released, and authorized for entry into the United States if one of the following conditions is met:

1. The remains meet the standards for importation found in 42 CFR 71.55 (i.e., the remains are cremated or properly embalmed and placed in a hermetically sealed casket or are accompanied by a permit issued by the CDC director).
2. The remains are shipped in a leakproof container. A leakproof container is one that is puncture resistant and sealed so that there is no leakage of fluids outside the container during handling, storage, transport, or shipping.

CDC may also require additional measures, including detention, disinfection, disinfestation, fumigation, or other related measures, if there is evidence that the human remains are or may be infected or contaminated with a communicable disease and that such measures are necessary to prevent the introduction, transmission, or spread of communicable diseases into the United States.

(Updated October 25, 2011)

EXPORTATION OF HUMAN REMAINS

CDC places no restrictions on the exportation of human remains outside the United States, although other federal, state, and local regulations may apply. Exporters of human remains and travelers taking human remains out of the United States should be aware that the importation requirements of the destination country must be met. Information regarding these requirements may be obtained from the appropriate foreign embassy or consulate.

BIBLIOGRAPHY

1. CDC. Quarantine Stations: Quarantine Station Contact Lists and Jurisdictions. Atlanta: CDC; 2010 [cited 2010 Nov 2]. Available from: http://www.cdc.gov/quarantine/QuarantineStations.html.
2. Federal Register. Executive order 13295 of April 4, 2003—revised list of quarantinable communicable diseases. Washington, DC: Federal Register; 2003. p. 17255.
3. US Department of Health and Human Services. Title 42. Public Health. Chapter 1. Public Health Service, Department of Health and Human Services. Part 71. Foreign Quarantine. US Government Printing Office; 2001.
4. US Department of State. International Travel Information: Country Specific Information. Washington, DC: US Department of State. Available from: http://travel.state.gov/travel/cis_pa_tw/cis/cis_4965.html.
5. US Department of State. Death or Injury of an American Citizen Abroad. Washington, DC: US Department of State. Available from: http://travel.state.gov/travel/tips/emergencies/death/death_3878.html.
6. US Department of State. Emergencies and Crises. Washington, DC: US Department of State. Available from: http://travel.state.gov/travel/tips/emergencies/emergencies_1212.html.
7. US Department of State. Emergency Abroad Getting Help. Washington, DC: US Department of State. Available from: http://www.travel.state.gov/travel/tips/emergencies/emergencies_1212.html.
8. CDC. Guidance for Importation of Human Remains into the United States for Interment. Available from: http://www.cdc.gov/quarantine/human-remains.html