Detection of the initial outbreak
Time is of the essence here- the sooner the outbreak is detected and characterized as an outbreak, the better the possibility of containing it within a small geographical area. Clearly, this is only possible in settings with a robust surveillance system with real-time reporting of unusual disease occurrence(s).
In typical resource-limited settings, an outbreak is detected only after a fairly large number of cases/ deaths have occurred. Often, this is due to a combination of several factors like
- poor transportation and communication facilities,
- lack of healthcare personnel,
- mistrust of the healthcare system,
- dependence on traditional healers, etc.
Cases may not be reported until the end of the month, and disease surveillance systems may be poor/ non-existent.
Delay in detecting an outbreak may inter alia result in
- rapid spread of infection within a population
- exportation of infection to other populations through trade and travel
Rapid identification reduces risk by enabling infected persons to be isolated and given appropriate clinical care. During the 2003 SARS pandemic, a one-week delay in applying control measures may have nearly tripled the size of the outbreak and increased its duration by four weeks.