While injection of a known or suspected CJD case is not recommended, the exposure level can be greatly reduced if injection of the intact body is done with no drainage.

With this method, exposure is limited to incidental leakage at the injection site.

Restrict embalming room access to essential personnel only.

Minimize the number of instruments used.

Use universal precautions as with all embalming procedures. ie: gloves, gown, face mask and eye shield, head and shoe covers.

Prepare remains for injection like any other case, ie: position body, wash remains, set features, etc.

Cover table with disposable plastic sheet or place small disposal emesis basin under incision site to catch incidental leakage and avoid contamination of table. Soak up any incidental leakage and dispose of towel or cotton in sealed plastic bag.

Injection point: Single injection point of the embalmer's preference. Carotid injection is recommended to eliminate need to reverse tube to inject lower leg and ease in controlling incidental leakage.

Fluid: Standard arterial fluid chosen based on overall condition of body.

Concentrated fluid: Same as would be used if this were a normal injection based on overall body condition.

Diluted fluid solution: No more than 2 gallons total. A "normal" body can easily retain this amount of fluid in the arterial/venous system without swelling. For a small or emaciated case, this amount may be reduced to 1 to 1.5 gallons. Mix total amount of concentrated fluid to be used to make this amount of solution.

That is, if you would normally use 16 oz. of arterial to 2 gallons of fluid to embalm this body and then use another 16 oz. in a final 2 gallon injection-- in this case you would mix the entire 32 oz of fluid into 2 gallons (or less) of diluted solution.

Pressure: Use same injection pressure as if this were a normal injection based on overall body condition.

Rate of flow: Use minimum rate of flow. This is the secret to success. Monitor body closely for signs of swelling. If distention or swelling occurs, it is because of too high a rate of flow, not too much pressure or too much fluid.

Note that some older machines are incapable of operating at a rate of flow low enough to prevent distention or swelling.

Do not aspirate body. If abdominal gases must be relieved, use a large bore needle into the intestinal spaces taking care not to produce leakage or puncture of internal organs that may house the prion.

Containerize and dispose of all instruments, tubes, needles, etc.

Clean table and other embalming room surfaces with Clorox.

Place all gloves and other PPE in sealed plastic bag for disposal.

Wash hands with disinfectant soap.

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