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Cluster of unexplained illnesses or deaths

Cluster of unexplained illnesses or deaths

Last update: 2022-01-27

Key facts


  • A “cluster of illness or death” is a group of people or animals in the same area who become sick with the same symptoms (signs of illness) at about the same time. The people or animals may get sick and recover or may die from the disease
  • “Unexplained” means that the germ or thing that is making people sick is unknown


  • In the beginning, how the disease spreads is not known. It might be spreading from person to person by touching or may be transmitted through the air, via animals, or through water or food.


  • Symptoms are signs of illness. For example, fever, vomiting, diarrhoea, coughing or feeling very tired.
  • Make a note of the symptoms that sick people are reporting.


  • Community-based surveillance
  • Rapid detection of sick people and their referral to health facilities
  • Social mobilization and behaviour change communication
  • Safe and dignified funerals and burials
  • Handwashing with soap
  • Isolation of sick people and animals
  • Exclusive breastfeeding for at least the first six months of life
  • Safe clean drinking water (including a clean, covered container in the household)
  • Use of appropriate sanitation facilities (sound, clean latrines)
  • Good food hygiene (well cooked, covered food, clean utensils, etc.)

Vulnerable people

  • In the beginning, it is not clear who is vulnerable to the disease
  • If most people falling sick are near the same age (for example, young children) or members of a particular group (for example, pregnant women or men working in farming), this provides clues about who might be vulnerable to the disease

If an epidemic occurs

  • Begin community surveillance
  • Detect sick people rapidly and refer them to health facilitities
  • Increase social mobilization and behaviour change communication
  • Support safe and dignified funeral and burial practices
  • Promote handwashing with soap
  • Isolate sick people and animals
  • Encourage women to breastfeed, including when their infants are sick
  • Promote safe, clean water (including a clean, covered water container in households)
  • Promote appropriate sanitation (sound, clean latrines)
  • Promote good food hygiene (well cooked and covered food, clean utensils, etc.)

Community-based assessment - questions

  • When did people start to fall sick?
  • How many people have fallen sick? Where?
  • How many people have died? Where?
  • How many people live in the affected community or area? How many children under five years of age live in the area?
  • Who and where are the vulnerable people?
  • Are children in the affected area generally well nourished?
  • Do people always have enough food?
  • How common is breastfeeding?
  • Where are the local health facilities and services? (Include traditional and community carers from whom people seek advice.)
  • What are the community’s habits, practices and beliefs about caring for and feeding sick people? Who looks after sick people? Are they isolated?
  • Is a social mobilization or health promotion programme in place?
  • Which sources of information do people use most?
  • Are rumours or is misinformation spreading in the community?
  • What can I do to protect myself?

What can I do to protect myself? Some things are always good to do. In addition, they may help to protect you from becoming sick.

  • Make sure that sick people go to health facilities as soon as possible
  • Inform the health authorities that members of the community are falling sick
  • Encourage frequent handwashing with soap
  • Encourage use of latrines
  • Encourage the community to clear away rubbish and garbage
  • Encourage good personal hygiene
  • Encourage women to breastfeed their children up to six months of age
  • Encourage women to continue breastfeeding after six months, while giving children a wide variety of other foods
  • Listen carefully to the health authorities and to community leaders when they share information