Key facts

Transmission: airborne, droplet-borne or direct contact

When infected people cough, sneeze, blow their nose or spit, they spread small particles or droplets through the air, which are then breathed in by other people
Direct contact (for example, through kissing, sharing cups or eating utensils) with infected saliva or nose mucous

Most vulnerable to severe consequences

Pregnant women and unborn babies
People (especially children) who are malnourished or who have weakened immune systems

Most vulnerable to contracting the disease

People who are not vaccinated
Displaced populations and those who live in crowded, cramped conditions

General symptoms

(** These diseases spread quickly through unvaccinated populations. It is important to be alert to groups or clusters of any of the following symptoms. **)

Fever (usually)
Tiredness (usually)
Feeling unwell (usually)
Loss of appetite (sometimes)
Headache (sometimes)
Runny nose (sometimes)

Disease-specific Symptoms

Disease	Symptoms
Diphtheria	Sore throat Difficulty/pain when swallowing Swollen neck glands Difficulty breathing (sometimes)
Varicella/chickenpox	Itchy, small blisters (usually start on chest, back or face and then spread all over the body)
Mumps	Pain and swelling in glands through the mouth, jaw, cheeks and throat (on one or both sides) High fever (sometimes) Stiff, sore neck (sometimes) Severe headache (sometimes) Deafness (sometimes) Abdominal pain (sometimes)
Rubella	Rash Swollen glands in neck and head (sometimes) Pink-eye/conjunctivitis (sometimes) Joint pain (sometimes)
Whooping cough	Cough with a high “whoop” sound and cough may become worse at night (cough not always present in very young children) Gasp sound when breathing in Difficulty breathing (sometimes)

What can you do to prevent and control an epidemic?

Monitoring the community and identifying sick people

Identify and isolate sick people before they spread the disease to others

Treatment and management

Refer those with illness to health facilities
Manage and improve nutritional situation, especially of children
- 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)
- Check the nutritional status of children under five years (MUAC screening)
  - Refer cases of suspected malnutrition to health services and support nutritional programming
- Provide psychosocial support to the sick person and their family members

Safe shelters and spaces

Reduce overcrowding and improve ventilation in living shelters, workplaces and schools if possible

Hand and respiratory hygiene

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
Promote respiratory hygiene and coughing etiquette (cover cough or sneeze using a sleeve or tissue, wash hands after coughing or sneezing, do not spit onto the ground or in public)
Use personal protection (for example, face mask)

Social mobilization and health promotion

Find out the specific advice being given by health and other relevant authorities
- Promote recommended health practices (such as routine vaccination programmes, social distancing, separation of healthy people and sick people, etc.)
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

Immunization

Promote routine vaccination programmes for children
Support mass vaccination campaigns

Mapping and community assessment

Make a map of the community.
Mark the following information on the map:
- How many people have fallen sick with a vaccine-preventable disease? Where?
- How many people have died? Where? When?
- Who and where are the vulnerable people?
- Where are the local health facilities and services? (include traditional healers)
Record the following information on the back of the map:
- When did people start to fall sick with a vaccine-preventable disease?
- How many people live in the affected community? How many are children under five years?
- Are most children in the community vaccinated against childhood diseases?
  - Is there a vaccination campaign planned?
- Do people generally have enough food?
- How common is it for people to live together in crowded spaces? Is there ventilation and fresh air in homes, schools and workplaces?
- Are children badly affected by vaccine-preventable disease(s)? Are there other groups (specific ages, occupations, geographic areas, etc.) that are badly affected?
- What are the community’s habits, practices and beliefs about vaccinations? Are there societal, cultural or religious beliefs or perceptions that prevent people from getting vaccinated?
- 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?
- Is a social mobilization or health promotion programme in place?
- Which sources do people use/trust the most for information?
  - Are there rumours or misinformation about vaccine-preventable disease(s)? Are there rumours or misinformation about vaccines? What are the rumours?

Volunteer actions

25. Mass vaccination campaigns 24. Routine vaccinations 01. Community-based surveillance 02. Community mapping 03. Communicating with the community 04. Community referral to health facilities 05. Volunteer protection and safety 12. Managing fever 13. Breastfeeding 14. Infant and young child feeding in emergencies 15. Measuring acute malnutrition in emergencies 17. Measuring mid upper arm circumference (MUAC) 19. Psychosocial support 20. Isolating sick people 23. Chemoprophylaxis 26. Respiratory hygiene and coughing etiquette 27. Shelter and ventilation 28. Physical distancing 29. Hygiene promotion 34. Handwashing with soap 43. Social mobilization and behaviour change