Short-term Outbreak Management Approaches

The degree of urgency and priority placed on outbreak control depends on several factors, including the incidence and severity of disease (morbidity and mortality), whether or not the outbreak is continuing or likely to recur, the degree of public concern, and the effectiveness or practicality of the control measures themselves. 

Control measures may be considered under three areas aimed at:

1. Outbreak source
2. Contaminated vehicles of infection transmission
3. Susceptible humans.

The choice of control measure within these three areas is dictated by factors such as whether the outbreak source is known, whether a suspected vehicle has been identified and whether a vaccine or prophylactic treatment is available for susceptible humans.

Examples of control measures aimed at the outbreak source

Outbreaks associated with food, water or environmental sources 

• Closure of premises or site of outbreak (e.g., food premises closure) 
• Modification of procedures (e.g., swimming pool filtration) 
• Cleaning or disinfecting contaminated equipment or fittings (e.g., cooling towers) 

Outbreaks associated with animal contact

• Removal from contact, treatment, isolation, immunization or destruction of animal reservoirs (e.g., immunization of cattle to prevent human leptospirosis) 

Outbreaks associated with human sources 

• Treatment of cases and carriers (e.g., treatment of individuals with tuberculosis disease or infection) 
• Exclusion or restriction of activities (e.g., temporary restrictions placed on food handlers or health care workers with gastroenteritis symptoms) 
• Isolation (e.g., use of universal precautions to manage hospital in-patients infected with or carrying MRSA) 
• Quarantine (e.g., people arriving in the country with viral hemorrhagic fever, close contacts of a confirmed case of measles) 
• Education (e.g., advising individuals with STIs to use condoms during sexual contact) 

Examples of control measures aimed at contaminated vehicles and vectors

Outbreaks associated with contaminated food or water

• Removal or recall of contaminated product (e.g., packaged food contaminated with Listeria) 
• Treatment, pasteurization or sterilization of contaminated material (e.g., use of boiled or treated water) 

Outbreaks associated with vectors

• Application of insecticides, setting traps, eliminating breeding habitats, improving management of solid waste (e.g., application of insecticide to breeding areas to control mosquito vectors) 

Examples of control measures aimed at susceptible humans

Outbreaks associated with food, water or environmental sources

• Education to change behavior associated with food preparation or hygiene (e.g., education to improve food safety, implementation of a food safety plan) 
• Instructions to treat or sterilize contaminated material (e.g., issuing ‘boil water’ notices) 
• Education to reduce contact with vectors (e.g., use of screens, bed nets, long-sleeved shirts and insect repellents to reduce risk of vector borne disease) 

Outbreaks associated with human sources

• Administration of chemo-prophylaxis (e.g., isoniazid for tuberculosis) 
• Administration of active and passive vaccines (e.g., immune globulin and vaccine for hepatitis A) 
• Advice on physical barriers (e.g., use of condoms to prevent STIs) 
• General improvement in host resistance (e.g., correct malnutrition or vitamin deficiency to reduce the effects of measles)