First steps for managing an outbreak of acute diarrhoea

Overview

1. Is this the beginning of an outbreak?

You might be facing an outbreak very soon if you have seen an unusual number of acute diarrhoeal cases this week and the patients have the following points in common:

• they have similar clinical symptoms (watery or bloody diarrhoea)

• they are living in the same area or location

• they have eaten the same food (at a burial ceremony for example)

• they are sharing the same water source

• there is an outbreak in the neighbouring community

 or

You have seen an adult suffering from acute watery diarrhoea with severe dehydration and vomiting

If you have some statistical information from previous years or weeks verify if the actual increase of cases is unusual over the same period of time.

2. Is the patient suffering from cholera or shigella?

Acute diarrhoea could be a common symptom. Therefore it is important to differentiate between shigella or cholera in order to improve case manage ment and to estimate needed supplies

• Establish a clinical diagnosis for the patient you have seen (Table1)

• Do the same for the other family members who are suffering from acute diarrhoea

• Try to take stool samples and send them for immediate analysis. If it is not possible to send the samples immediately, collect stool specimens in Cary Blair or TCBS transport medium and refrigerate.

Don’t wait for laboratory results to start treat ment and to protect the community.

Not all the cases need to be laboratory confirmed.