Cluster of unexplained illnesses or deaths
A cluster of illness or deaths is a group of people or animals in the same area who become sick with the same symptoms at about the same time. The people or animals may get sick and recover or may die from the disease.
Unexplained means the cause of the illness or the deaths is not known.
- In the beginning, when it is unknown how the disease spreads, volunteers should assume it may be spread by any method (for example: person-to-person through the air, via animals, or through water or food)
Vulnerable groups are usually unknown, especially at the beginning
- It is important to identify what affected people have in common
- Are they near the same age (for example young children or the elderly)?
- Do they share a health or physical condition (for example, pregnant women)?
- Do they do the same type of work (for example, farmers)?
- Do they live or work in the same place (for example, school dormitory)?
- Do they share food or water sources?
- Symptoms will depend on the type of disease affecting people. Make a note of the symptoms that sick people are reporting or that families report after a person has died.
What can you do to prevent and control an epidemic?
Monitoring the community and identifying sick people and animals
- Detect sick people quickly for referral to health facilities
- Monitor the community for clusters of sick or dead animals
- Report any clusters to your supervisor, animal health and welfare authorities and/or health authorities
- Encourage quarantining sick animals away from healthy ones
- Discourage community members from taking sick animals to markets or other places where they may encounter other animals or humans
- Encourage minimal contact between sick animals and humans
Treatment and management
- Rapidly refer suspected cases of illness to health services
- Support safe and dignified funeral and burial practices is required
- Provide psychosocial support to the sick person and their family members
Sanitation and waste management
- Discourage open defecation
- Encourage use of toilets/latrines
- Solid waste management
- Encourage the community to clear away rubbish and garbage
Food and water hygiene and safety
- Encourage household water treatment for safe drinking water
- Store water in clean, covered water container
- Promote thorough cleaning and cooking and secure storage of food
- Cover and store food safely (protected from insect/animal contamination)
- Use clean utensils and storage containers
- Encourage exclusive breastfeeding for the first six months of life, and complementary breastfeeding until the age of two years (especially when a child is sick)
- Promote good hand hygiene (handwashing with soap)
- BEFORE: preparing food; eating; feeding a child; treating wounds; or caring for sick people
- AFTER: using the toilet or cleaning a baby; touching garbage or waste; touching or feeding animals; blowing nose, coughing, or sneezing; treating wounds; or caring for sick people
Social mobilization and behaviour change
- Find out the specific advice being given by health and other relevant authorities
- Model following this advice and inform community members of current health practice advice
- Offer support and encouragement to follow the advice
- Try to gain understanding about if and why health practice advice is not being followed
- With the guidance of your supervisor and health authorities, work with communities to overcome barriers to following health advice and recommended practices
Special considerations for volunteers during unknown illness
(** These recommendations are always sensible action, but in times of unknown illness they may also prevent you and others from becoming sick. **)
- Inform health authorities that members of the community are falling sick or have died
- Encourage sick people to go to health facilities as soon as possible
- Encourage good personal hygiene
- Encourage women to continue breastfeeding after six months, while giving children a wide variety of other foods
- Listen carefully to the health authorities and community leaders when they share information
- Encourage others to listen to health authority and community leader messages
Mapping and community assessment
- Make a map of the community.
- Mark the following information on the map:
- How many people (differentiate women, men, girls and boys)/animals have fallen sick? Where?
- How many people/animals have died? Where? When?
- Who and where are the people/animals who are getting sick and dying?
- Where are the local health/animal health facilities and services? (include traditional healers)
- Where do people obtain their drinking water?
- Record the following information on the back of the map:
- When did people/animals start to fall sick with an unexplained illness?
- How many people/animals live in the affected community? How many are children under five years?
- Are children in the community generally well-nourished?
- Do people always have enough food?
- Is breastfeeding common?
- Is the water source safe?
- Do people know how to treat water? How do they do it?
- What sanitation facilities are available? (put communal toilets/latrines on map)
- Do people use them?
- What handwashing facilities are available? (put communal handwashing stations on map)
- Do they have soap?
- What are the community’s habits, practices and beliefs about caring for and feeding sick people? Consider any differences in roles and responsibilities between men and women.
- When babies and infants are sick, do women continue to breastfeed them?
- Who looks after sick people?
- Do sick people isolate from healthy people?
- What are people doing to protect themselves currently?
- Is a social mobilization or health promotion programme in place?
- What are the habits, practices and beliefs about hygiene, sanitation and water?
- What are the roles, responsibilities, specific needs and priorities of women and girls, men and boys, and people with disabilities in handling, storing and treating water? (Make sure you think about cultural and social traditions and perceptions, household decision-making, livelihoods such as agriculture and livestock raising etc.)
- What are the barriers people face in accessing water points and sanitation and hygiene facilities, of all gender identities, ages, disabilities and backgrounds?
- Which sources do people use/trust the most for information?
- Are there rumours in the community about why people are becoming sick or dying? What are the rumours?