Disease Outbreak Preparedness – LSHTM

Disease Outbreak Preparedness – LSHTM


Outbreaks of infectious
diseases have always taken place, the plague
in the Middle Ages, cholera in the 19th century,
and the influenza epidemics in the 20th century. We can’t stop
outbreaks happening. But we can better prepare
to reduce their impact. Large-scale disease
outbreaks, such as diphtheria in the Rohingya refugee
camps in Bangladesh, and recurrent epidemics such
as cholera and Lassa fever, highlight the need for robust
local and, if necessary, international preparedness and
rapid responses to save lives. When an outbreak is undetected,
and a response is not triggered rapidly
and effectively, the human cost can be high,
as we saw in West Africa with Ebola. A preparedness plan enables
individuals, communities, emergency response
organisations, and governments to better
anticipate and respond to outbreaks. They need to be in place at
community, sector-cluster, national, regional, and
international levels. Linked to the country’s overall
preparedness plan at community level, a preparedness plan
informs people how to respond to protect themselves, their
family, and their neighbours. Sector or cluster-level
plans defined how actors work
together to achieve sector-specific outbreak
prevention and response actions. In the water, sanitation, and
hygiene cluster, for example, different organisations may
take responsibility for flash chlorination of wells, while
the nutrition cluster might plan to maintain a supply of food
supplements for vulnerable groups. Country-level preparedness
aims to catalyse and coordinate outbreak prevention
and response efforts. Forming a country plan
across sectors, including case management, nutrition,
wash, communications, and logistics
ensures coordination and reduces duplication
during an active outbreak. Globally, there are institutions
and organisations involved in preparedness. Through global working
groups and networks, these organisations
develop tools, such as standardised guidelines,
special clinical treatment, and logistic kits. So what triggers an
outbreak alert and response? A country’s health authorities
set disease-specific thresholds based on international
guidance, which trigger an outbreak alert. Alerts are set
depending on what’s normal for that location,
and the risk of transmission. In Nola’s town, the recent
outbreak of cholera. When Nola arrived at the
cholera treatment unit with her two-year-old
son, Jarno, he was showing all the
signs of severe dehydration. Thanks to the fast
response and care he received, he
improved within hours. And after three days,
he was fully recovered. Cholera treatment centres
were set up in line, with a preparedness
plan, where patients were isolated and treated
according to guidelines. Oral rehydration points were
installed within 48 hours of the outbreak being declared. Wash partners activated
plans to improve the provision of safe water. These plans included
encouraging and enabling people to chlorinate their own
water, activating NGO plans to rehabilitate latrines in
schools and health facilities, and triggering 400
pre-trained community hygiene promoters to boost the
message that handwashing can prevent the spread of cholera. Health promotion plans were
activated with partners broadcasting radio messages,
enabling communities to recognise and respond to the
signs and symptoms of cholera. At the request of the
Ministry of Health, the World Health
Organization provided emergency medical supplies,
rapid diagnostic test kits, and technical support to NGOs,
to implement correct case management. Prepositioning medical
and diagnostic supplies to all states, setting up an
effective surveillance system, and training health
workers enabled early detection and treatment
of people infected with cholera. Timely triggering of an
outbreak alert and response helped save Jarno’s life. In his community and country,
outbreak preparedness led to more lives saved,
reduced suffering, efficient use of scarce resources, and
increased value for money. Responding to outbreaks tomorrow
is about preparing today.

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