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3.7.1 What to do during the investigation?
- Collect information on all suspected cases.
- Verify the effectiveness of the surveillance and strengthen it, if necessary.
- Collect laboratory samples to confirm the causative agent.
- Make sure that patients are being managed effectively.
- Decide whether outbreak response vaccination is needed.
During the investigation, also collect information on the current response and available resources, and assess the response capacity in the field:
- appropriate patient management ;
- availability of drugs (name and quantity) ;
- access to treatment: geographic coverage, cost per patient, sufficient number of staff ;
- estimated vaccination coverage in recent years ;
- cold chain capacity ;
- previous outbreak response vaccinations and lessons learned.
3.7.2 Composition of the investigation team
The team should include an epidemiologist (or experienced person), a lab technician (or experienced person), and a logistic officer. Each person’s role should be clearly defined, to ensure that all activities are covered without any duplication.
Recruit a driver who knows the region and, if possible, the local language.
3.7.3 Preparing for the investigation
Rigorous preparation makes the teams’ work in the field easier. This includes:
- studying the responses to previous outbreaks (reports, surveillance data) and anticipated responses to future outbreaks (annual response strategy);
- identifying the locations to be investigated, according to the alert from the surveillance system or information reported by the population;
- obtaining pre-authorisation from the relevant central authorities;
- organising the logistical resources;
- preparing the supplies and the information and data collection forms;
- preparing the supplies for collecting and transporting samples;
- preparing “simple case” and “complicated case” treatment kits, to be distributed, if necessary, to the health posts and hospitals visited;
- informing the local authorities;
- drawing up the budget and make it available.
3.7.4 Supplies and documents
Logistics and communications
- A terrain-appropriate vehicle in good working order
- Maps of the region
- Functional, appropriate means of communication
A camera and a GPS may be useful.
Laboratory
- Specimen collection and shipment supplies (e.g., syringes, needles, tubes, gloves, compresses, adhesive tape, filter paper, triple packaging bags)
- Information cards for samples
- Cold chain for samples, if necessary (vaccine carrier, ice packs and thermometer)
Data collection
- Population census
- List of health care facilities, personnel (health system) and contacts
- Inventory sheets for drugs, medical supplies and the cold chain
- Reference documents (case definition, data collection sheets)
- Paper, pens, calculator
Medical supplies
- Treatment protocols
- Treatment kits
- First aid kit