Epidemiology module of practical skills for mbbs student

Vaccine failure: The vaccines currently in use are relatively safe and effective. However, these vaccines are not 100% effective. For example, the efficacy of measles vaccine is estimated to be approximately 85% when given at 9 months.

Cold chain failure: If the efficacy of the vaccine appears to have been low across all age groups, especially during a specific period of time, review the cold chain to ensure that it has been functioning correctly. Identify and rectify the factors contributing to a cold chain failure.

STEP 7: WRITE THE REPORT

After conducting the outbreak investigation, prepare a short comprehensive report with the following sections:

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  ƒ Introduction and background information about the area affected (population structure, health facilities, regularity of RI sessions, health seeking behavior)
  
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  ƒ Review of status of VPDs and routine immunization (coverage data)
  
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  ƒ Short review of the VPD outbreaks in the past
  
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  ƒ VPD reporting and surveillance system
  
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  ƒ Confirmation of outbreak by serology (lab reports)
  
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  ƒ Data collection methodology (sample size, number of investigating teams, approach etc.)
  
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  ƒ Data analysis
  

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  ƒ Time, place and person analysis of cases (charts, graphs, spot maps etc.)
  
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  ƒ Age distribution and vaccination status analysis
  
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  ƒ Analysis of Case Fatality Rate
  
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  ƒ Probable reasons of outbreak
  

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  ƒ Population at risk
  
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  ƒ Case management
  
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  ƒ Response to outbreak
  
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  ƒ Conclusions and recommendations
  

Send the outbreak investigation report to concerned district and state government officers (See Appendix 10.3).

STEP 8: GIVE FEEDBACK

Provide feedback to all levels (Community/ SC/PHC/CHC/District) on the outcomes of the VPD outbreak investigation, in order to ensure that all stakeholders are aware of the reasons for the outbreak, the actions initiated and the plan to prevent future outbreaks.

STEP 9: INITIATE ACTION

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CASE: Follow-up should be according to specific guidelines e.g. re-visit AFP cases after 60 days of Reporting

n all VPD outbreaks, effective case management and follow-up of cases is a priority. Thereafter, conduct activities for strengthening and raising awareness of routine immunization.