Health operators at the camp or site must be ready to respond to an outbreak in order to prevent high mortality or morbidity.
Overcrowding, unsanitary conditions and the very precarious nutritional situation facilitate outbreaks of diseases with epidemic potential,
such as measles, hepatitis E, cholera and shigellosis.
A) Communicable disease prevention
Improving the environment and living conditions is the most effective general measure for reducing the number of cases and controlling communicable diseases. Organising the camp in a rational manner and providing adequate water, sanitation infrastructure, food, soap and shelter will have a direct impact on the health status of the population and the spread of epidemics. Immunisation is another preventive measure.
A mass measles vaccination campaign should always be one of the first measures taken.
B) Outbreak preparedness
Having an emergency plan makes it possible to be responsive and prepared with the necessary means.
This requires knowing the epidemic-prone diseases in both the home and host countries, establishing standardised protocols, and identifying a laboratory to confirm cases, either locally or abroad.
The emergency plan must also include checking the inventory of vaccines and medical supplies and updating the map of all health care operators, and the available material and human resources.
In cholera-endemic settings, an isolation centre should be set up at a pre-planned site, along with oral rehydration centres peripherally situated.
The more immediate the access to health care, the lower the case fatality rate will be.
C) Epidemic investigations
Once an outbreak is suspected, field teams must confirm its existence immediately.
The causative agent should be identified and the diagnosis confirmed either clinically or by point-of-care rapid tests or laboratory tests.
With a system for listing and classifying cases, the course of an outbreak can be monitored on a curve, and the at-risk groups determined so that appropriate preventive and curative measures can be taken.
Community health workers from the refugee or displaced population actively look for cases, and inform the population about the measures they should take and the health services they should go to.
D) Outbreak control
Reducing the number of cases requires addressing the risk factors for transmission by distributing clean water and food, and controlling the vectors for diseases like malaria by cleaning up any standing water.
Conclusion
Outbreak control has a two-fold objective: to reduce the number of cases via preventive measures and to lower the case fatality rate through early screening and appropriate care.
