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Annex 4D: How to conduct a register review ................................ ................................ ................. 192
Annex 4E: Sample Line List ................................ ................................ ................................ ........... 194
Annex 4F: Contacts listing sheet ................................ ................................ ................................ .... 195
Annex 4G: Contact tracin g form (follow -up) ................................ ................................ ................. 196
Annex 4H: Types of Triple Packaging of s amples during an Outbreak ................................ ......... 197
Annex 4I: Example of an aanalytical study to test hypothesis ................................ ........................ 198
Annex 4J: Example of creating a trans mission tree ................................ ................................ ........ 199
SECTION 5: PREPARE TO RESPOND TO OUTBREAKS AND OTHER PUBLIC HEALTH
EVENTS 202
5.0 Prepare to respond to outbreaks a nd other public health even ts ................................ ............... 202
5.1 The Public Health Emergency Operations Centre (Command and Control Centre) ................ 203
5.1.1 Importanc e and Operations of the PHEOC ................................ ................................ ........ 203
5.1.2 Steps in establishing PHEOC ................................ ................................ ............................. 204
5.1.3 Functions of the PHEOC ................................ ................................ ................................ .... 205
5.1.4 The Incident Management System (IMS) ................................ ................................ .......... 205
5.2 Establishing National and District Task Forces ................................ ................................ ........ 206
5.2.1 The National Task Force (NTF) ................................ ................................ ......................... 206
5.2.2 The District Task Force (DTF) ................................ ................................ .......................... 208
5.3 Establishing NTF and DTF Subcommittees ................................ ................................ ............. 209
5.4 Establishing Rapid Response Teams at all levels ................................ ................................ ..... 217
5.5 Risk assessment and mapping for outbreaks and other public health events ............................ 218
5.6 Resource Mapping ................................ ................................ ................................ .................... 218
5.7 Prepare an Emergency Preparedness and Response plan ................................ ......................... 218
5.8 Set up stockpiles of medicines, vaccines, reagents and supplies ................................ .............. 220
5.8.1 Conduct stock management for outbreak response ................................ ............................ 221
5.8.2 Update human resource available for response as well as other logistics support for
response of public health events at all levels ................................ ................................ .............. 222
Annexes to SECTION 5 ................................ ................................ ................................ .................... 223
Annex 5A: Essential stock items for responding to outbreaks ................................ ....................... 224
Annex 5B: Stock situation report ................................ ................................ ................................ .... 225
Annex 5C: IDSR stock item transaction and balance sheet ................................ ............................ 226
Annex 5D: Assignments for the committee to develop the EPR plan ................................ ............ 227
Annex 5E: Tool for assessment of surveillance and response at the district level .......................... 228
SECTION 6: RESPOND TO OUTBREAKS AND OTHER PUBLIC HEALTH EVENTS ..... 234
6.0 Respond to outbreaks and other public health events ................................ ............................... 234
6.1 Declaring an Outbreak and Activating the Response Structures ................................ .............. 234
6.2 Mobilize Rapid Response Teams (RRT) for Immediate Action ................................ ............... 234
6.3 Convene the District Task Force (DTF) ................................ ................................ .................... 235
6.4 Select and Implement Appropriate Public Health Response Activities ................................ .... 235
6.4.1 Build the Capacity of Response Staff ................................ ................................ ................ 235
6.4.2 Strengthen Case Management and Infecti on Prevention and Control (IPC) measures ..... 236
6.4.3 Enhance Surveillance During the Response ................................ ................................ ...... 236
6.4.4 Enha nce Surveillance with Neighbouring and Cross Border Districts .............................. 237
6.4.5 Engage Community During Response ................................ ................................ ............... 237
6.4.6 Inform and Educate the Community ................................ ................................ .................. 238
6.4.7 Conduct Mass Vaccination Campaigns ................................ ................................ ............. 238
6.4.8 Improve Access to Clean and Safe Water ................................ ................................ .......... 239
6.4.9 Ensure Safe Disposal of Infectious Waste ................................ ................................ ......... 240
6.4.10 Improve Food Handling Practices ................................ ................................ .................... 240
6.4.11 Reduce Exposures to Infectious or Environmental Hazards ................................ ............ 240
6.4.12 Ensure Safe and Dignified Burial and Handling of Dead Bodies ................................ .... 241
6.4.13 Ensure Appropriate and Adequate Logistics and Supplies ................................ .............. 241
6.5 Provide Regular Situation Reports on the Outbreak and Events ................................ .............. 242
6.6 Document the Response ................................ ................................ ................................ ............ 242
Annexes to SECTION 6 ................................ ................................ ................................ .................... 243
Annex 6A: Treat Cases During an Outb reak ................................ ................................ .................. 244
Annex 6B: Preparing Disinfectant Solutions from Ordinary Household Products ......................... 251
Annex 6C: Planning an emergency immunization act ivity ................................ ............................. 253
Annex 6D: Estimating vaccine supplies for immunization activities ................................ ............. 255
Annex 6E: Recommended Immunization Practices ................................ ................................ ........ 257
Annex 6F: Outbreak Communication ................................ ................................ ............................. 258
Annex 6G: Guide to Infection Prevention and Control Measures ................................ .................. 259
Annex 6H: Response to Chemical and Radio -nuclear Events ................................ ........................ 267
Annex 6I: Documenting Key Outbreak Response Milestones ................................ ....................... 273
SECTION 7: RISK COMMUNICATION ................................ ................................ ...................... 275
7.0 Risk Communication and Community Engagement ................................ ................................ . 275
7.0.1 Importance of effective risk communication: ................................ ................................ .... 275
7.1 Risk Communication in the context of IDSR ................................ ................................ ........... 276
7.1.1 Benefi ts of Risk Communication ................................ ................................ ....................... 276
7.1.2 Target audiences for risk communication ................................ ................................ .......... 277
7.1.3 Approaches for Risk Communication ................................ ................................ ................ 277
7.2 Community engagement and its importance in public health emergency preparedness and
response ................................ ................................ ................................ ................................ .......... 278
7.2.1 Steps for community engagement ................................ ................................ ...................... 278
7.2.2 Importance of effective community engagement: ................................ .............................. 278
7.2.3 Effective community entry ................................ ................................ ................................ . 279
7.3 Integrated Risk Com munication Model ................................ ................................ .................... 279
7.4 Principles for Effective Risk Communication ................................ ................................ .......... 280
7.5 Create an enabling environment for effective risk commu nication ................................ .......... 283
7.6 Communicating before, during and after the public health event ................................ ............. 284
7.6.1 Pre -Outbreak/Routine Risk Communication ................................ ................................ ..... 284
7.6.2 Risk communication during outbreak response ................................ ................................ . 286
7.6.3 Ri sk communication after outbreak response ................................ ................................ .... 292
Annexes to SECTION 7 ................................ ................................ ................................ .................... 293
Annex 7A: Sample Fact Sheet -Influenza A Virus ................................ ................................ .......... 294
Annex 7B: TOR for Risk Communication and community engagement ................................ ....... 297
Annex 7C: Sample Messages for Community Education ................................ ............................... 298
Annex 7D: Sample District Outb reak Report ................................ ................................ ................. 302
SECTION 8: MONITOR, SUPERVISE, EVALUATE AND PROVIDE FEEDBACK TO
IMPROVE SURVEILLANCE AND RESPONSE ................................ ................................ ......... 306
8.0 Monitor, s upervise, evaluate and provide feedback to improve the surveillance and response
system ................................ ................................ ................................ ................................ ............. 306
8.1 Identify targets and indicators ................................ ................................ ................................ ... 307
8.1.1 Use indicators in accordance with national goals and specific plans ................................ . 307
8.2 Monitor the core functions for IDSR at district level ................................ ............................... 308
8.3 Monitor the quality of IDSR activities at district Level ................................ ............................ 310
8.3.1 Monitoring other attributes for assessing the quality of the IDSR system ......................... 310
8.4 Timeliness of Reporting ................................ ................................ ................................ ............ 312