LiberiaFieldEpidemiology TrainingProgramme(LFETP)LiberiaFieldEpidemiology TrainingProgrammeLFETP)

FIELDWORK2-ExpandedSurveillanceReport-

-MeaslesoutbreakInvestigationReport-

AugustusK.AlfredCountySurveillanceOfficer

Gbarpolu CountyHealthTeam

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LiberiaFieldEpidemiology TrainingProgramme(LFETP) 2

ExpandedSurveillanceReport

LiberiaFieldEpidemiology TrainingProgramme(LFETP)

Introduction• Gbarpolu issituatedintropicalrainforestofLiberia.

• Inhabitantsaremainlyminers

• Population:96,446

• Six(6)politicaldistricts

• Fivehealthdistrictswith15healthfacilities

LiberiaFieldEpidemiology TrainingProgramme(LFETP)

DiseaseSummary1/2Summaryofreportedkeynotifiablediseases,Gbarpolu County,week31-42,2015

Cumulative31-42Disease Cases Deaths CaseFatalityRate%AcuteWateryDiarrhea 210 0 0AcuteBloodyDiarrhea(Shigella) 0 0 0AFPSusp 0 0 0Meningitis 0 0 0SuspectedEVD 356 13 4SuspRabies(DogBite) 0 0 0YellowFever 0 0 0LassaFever 0 0 0Cholera 0 0 0Measles 2 0 0MaternalDeath 0NeonatalDeath 0

LiberiaFieldEpidemiology TrainingProgramme(LFETP)

DiseaseSummary2/2• Zeroreportingrequirementsweremetbyallfivereportingdistricts.

• Classificationofcases:– EVD356(S),13(D),0(C)(Allsuspectedcasescameoutnegative)

– AWD210(S),0(D),0(C)– Measles2(S),0(D),0(C)

• LabresultsforsuspectedmeaslescasesarependingS=SuspectedCaseC=ConfirmedcaseD=Death

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LiberiaFieldEpidemiology TrainingProgramme(LFETP)

Timelinessandcompletenessofreportingbydistricts,Gbarpolu County,2015

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This week

On timeT Late

L

No reportreceived

NR

%Cumulative

>=80% on time/Complete

>=50-79.9% on time/Complete

<50% on time/Complete

legend

DistrictWEEKS %Cumulative

Timeliness%CumulativeCompleteness31 32 33 34 35 36 37 38 39 40 41 42

Bopolu T L L T T T T T T T T T 83% 100%

Gbarma T NR L T T T T T T T T T 83% 92%

Belle L L L T T T T T L T T L 58% 100%

Kongba T T T T L T L T T T T L 75% 100%

Bokomu T L NR L T T T T T T T L 67% 92%

LiberiaFieldEpidemiology TrainingProgramme(LFETP)

Timelinessandcompletenessofreporting,Gbarpolu county,2015

7

0

10

20

30

40

50

60

70

80

90

100

Bopolu Gbarma Bokomu Kongba Belle

%ofrep

ortin

g

District

Timeliness

Completeness

LiberiaFieldEpidemiology TrainingProgramme(LFETP)

TrendofsuspectedEVD,Gbarpolu County,Epi week31-42,2015

05101520253035404550

#0fcases

Week#

Suspected EVDcase

Suspected EVDDeath

LiberiaFieldEpidemiology TrainingProgramme(LFETP)

Trendofsuspectedacutewaterydiarrhoea,Gbarpolu County,Epi week31-42,2015

0

5

10

15

20

25

30

35

#ofCases

Weeks

LiberiaFieldEpidemiology TrainingProgramme(LFETP)

Activitiescarriedoutbetweenweek31-42

• TrainingofclinicOICsandsurveillancefocalpersons

inIDSR.

• Measlesoutbreakinvestigation

• Follow-uponSuspectedMeaslescasesreported

fromdistricts(Bopolu andGbarma districts)

• Weeklydisseminationofsurveillancereport

LiberiaFieldEpidemiology TrainingProgramme(LFETP) 11

MeaslesCaseinvestigation

LiberiaFieldEpidemiology TrainingProgramme(LFETP)

Introduction1/2• Measlesisacontagiousdiseaseaffectingmainlychildrenunderfive.

• Itisamajorcontributortodeathinchildrenalthoughitisvaccinepreventable.

• On16th October,2015,asuspectedcaseofMeasleswasidentifiedinBopolu district

LiberiaFieldEpidemiology TrainingProgramme(LFETP)

Introduction2/2• Thecasewasreportedtothecountysurveillanceofficeon19th October,2015

• Investigationcommencedon19th October,2015

• Objectives;– verifyingthecase– determinethesourceofinfection– implementcontrolandpreventivemeasures.

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LiberiaFieldEpidemiology TrainingProgramme(LFETP)

Methods1/2• Medicalrecordsofsuspectedcasewasreviewed

• Collectedbloodspecimenforlaboratoryconfirmation

• Interviewedguardianofthepatient&healthworkers

• Activecasesearchinthecommunity

• Recommendationforpossibleactionsbasedonfindings

LiberiaFieldEpidemiology TrainingProgramme(LFETP)

Methods2/2

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Casedefinition:anypersonresidinginBopoludistrictpresentingwith;

• FeverandMaculopapularrashwith

• CoughorcoryzaorconjunctivitisOr

AnypersoninwhomacliniciansuspectmeaslesDatawasanalyzedusingMicrosoftexcel2010

LiberiaFieldEpidemiology TrainingProgramme(LFETP)

Results

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• PatientmetcasedefinitionforsuspectedMeasles

• Vaccinationstatuswasunknown

• Patienthadnorecenttravelhistoryorcontactwithsuspectedcase

• Laboratoryresultisstillpending

LiberiaFieldEpidemiology TrainingProgramme(LFETP)

Results2/2• Nonewcaseswereidentifiedfromcasesearch

• Childwasisolatedtoreducespreadthroughcontact

• Suspectedcasewastreatedwithvitamin-A,calaminelotionandtetracyclineeyeointment.

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LiberiaFieldEpidemiology TrainingProgramme(LFETP)

Discussion

• PatientmetcasedefinitionforsuspectedMeasles• Sourceofinfectionwasnotestablished• Isolationandtreatmentofcasehelpedtostoppedspreadofinfection

• Publichealthaction– distributionofprioritydiseasecommunitycasedefinitiontokeyinformers(KI)

– Communitysensitization/awareness onmeasles– Measlesimmunizationcampaignforchildrenunder5yrs

LiberiaFieldEpidemiology TrainingProgramme(LFETP)

Acknowledgement• MinistryofHealth,Liberia

• FieldEpidemiologyTrainingProgramme,Liberia

• EmoryUniversity

• CentersforDiseaseControlandPrevention

• AfricanFieldEpidemiologyNetwork

• WorldHealthOrganization

• MyMentors– StephenandJoseph19