33.6.1 Controlling epidemics of diarrhoeal diseases
What else should you do if there is an outbreak of a diarrhoeal disease, which threatens to spread in the community?
Which bacterial or viral diarrhoeal diseases are most often associated with epidemics? Do you remember two reasons why?
Cholera and shigellosis (bacillary dysentery) can rapidly spread and cause an epidemic. The two main reasons are that very small numbers of bacteria (fewer than ten) can result in the illness if they get into a susceptible person, and people who have recovered from the illness can go on shedding the bacteria in their faeces for weeks afterwards.
Suspected cases of cholera or shigellosis (bacillary dysentery) should be immediately reported to the woreda Health Office.
Whenever you suspect there may be a single case of cholera or shigellosis in your community, you must take swift action to investigate and report it, and apply measures to control the source of infection before it can spread. Epidemic investigation techniques will be discussed in detail in Study Session 42, so here we will briefly summarise the main points.
Why do you think it is important to report suspected cases of cholera or shigellosis to the woreda (District) Health Office?
You cannot prevent an epidemic from developing on your own. Reporting suspected cases enables the woreda Health Office and other higher bodies to start epidemic investigation and laboratory diagnosis as soon as possible, and collaborate with you in taking action to control the outbreak before it spreads.
You should try to identify everyone who has been in close contact with the source patient (i.e. the first case in your community) by asking the patient, the family and neighbours about what the patient has been doing recently and who he or she has seen. It is particularly important to locate everyone who has been eating the same food or drinking water from the same place as the patient. Give these individuals advice to seek early treatment if the illness starts and to report it immediately.