Narrator: In Springville, a new and strange disease began sweeping through the community. The town’s officials were alarmed, and epidemiologists ,Dr Kunene and Dr Singh and Dr van Rensburg from Hawkins University were called to investigate and relay the message to the mayor.
Dr Kunene: Good day mayor, as you know there is a new disease in town. We need to prepare for field work and gather as much information as possible about the affected individuals. This will help us understand whether we’re dealing with an outbreak.
Dr Singh: We've already begun collecting data from the three main hospitals. So far, we have 5890 cases in just 30 days out of a population of 62500 ,who present with similar symptoms. The next step is to visit homes, hospitals, and schools to ask people about their symptoms, travel history, and interactions. We need to gather data on where the disease may have started.
Mayor: Do you think this could be serious? We need to avoid the mayhem that happened during the Covid outbreak!
Dr van Rensburg: First, we need to verify the diagnosis. It's too early to tell ,we'll keep you informed once we gather enough data. We also need to create a more detailed contact form for the following interviews, which will have addresses of the relatives and their ages, so that we can be able to follow more of these cases
Dia: 2
Narrator: The researchers are doing fieldwork by going door to door and speaking to people in hospitals to interview patients and community members to learn more about their symptoms.
1) Dr Kunene: Hi there, may you please you describe your symptoms?
2) Community Member 1: I’ve had a high fever for the last few days, and now my throat is sore. I’m exhausted, and my eyes hurt whenever I’m in the light.
3) Dr Kunene, in deep thought, quickly connects the symptoms mentioned by Community Member 1—high fever, cough, etc.—with measles. She grows concerned, realizing it's highly contagious and action is needed urgently!
Dia: 3
3) Dr Kunene: That’s a key symptom to take note of Dr Singh. Let’s check for any rashes and follow up.
2) Community member 1: Yes, I noticed some white spots earlier today. The other symptoms started 3 weeks ago. when I went to Princeton which is outside of Springville.
1) Dr Singh: Do you notice any spots in your mouth and when did these symtoms start?
Dia: 4
1) Nurse: This child has a red, blotchy rash that started on the face and is spreading across the body. She’s also had a runny nose and a cough which started 2 weeks ago. when she left town to visit family
2) Dr Singh: We need to gather more data on when the symptoms started and whom she’s been in contact with.
Dia: 5
Dr van Rensburg: Hi, may you please tell me how you have been feeling?
Community member 2: I started feeling tired and had a cough. My kids have it too. We visited some relatives last week, and they had similar symptoms.
Dia: 6
2) Dr Kunene: We also need to track how the disease is spreading by person, place, and time. It seems like most of the people we interviewed got it from being in close proximity to individuals coughing and sneezing around them. They were with their relatives outside of Springville within a span of 2 to 3 weeks.
1) Dr van Rensburg: We’ve seen enough cases to confirm that this is an outbreak. The symptoms are consistent: high fever, cough, sore throat, red eyes, and eventually, a red rash that spreads across the body.
3) Dr Singh: Let’s define the case and perform a detailed case finding. We’ll need to analyse the data we’ve collected to pinpoint the common areas of transmission. So far it is clear that the disease came from outside of Springville.
Dia: 7
3- Dr Singh: Next, we’ll need to send nasopharyngeal, throat swabs , and urine specimens to the lab for confirmation.
2) Dr Kunene: Our hypothesis is that the measles outbreak originated in a community with low immunization coverage. It seems to be more severe on unvaccinated individuals.
1) Dr van Rensburg: We’ve tracked cases in various parts of Springville, especially in schools and households with young children. The disease seems to be spreading among those who haven’t been vaccinated for measles.
Dia: 8
Narrator: The researchers from Hawkins University are establishing research design to use for the outbreak.
2) Dr Singh: I agree with you, it will be much quicker and more cost effective to accommodate our limits budget.
1) Dr Kunene: We shall use the quantitative research design- cross sectional study to gather more information about this outbreak including the risk factors that might expose these infected individuals.
Dia: 9
Narrator: The researchers are meeting with the mayor to for a progress report
1) Dr Singh: Thank you for accommodating us in your busy schedule for this progress report meeting.
2) Mayor: My pleasure, our community is suffering from this disease and we need to work fast to come up with appropriate interventions.
3) Dr van Rensburg: Our hypothesis is that the outbreak is spreading rapidly among unvaccinated individuals, particularly in schools and households with young children less than years of age where people travelled outside of town. Lab results from the patient's specimen's confirmed the presence of the measles virus. Our next step is to conduct a mixed-methods study, gathering both qualitative and cross sectional study from the community to better understand the scope of the outbreak. This approach will be efficient and cost-effective.
4) Mayor: Thank you for your update and hard work to solve this matter. I will address the citizens of Springville tomorrow alongside our public health official.
Dia: 10
2) Dr Kunene: That confirms it. The measles outbreak is affecting mostly unvaccinated individuals. Now we need to refine our hypothesis and plan for the next steps.
1) Lab Technician: The tests came back positive for measles. The throat swabs and urine samples all show clear evidence of the measles virus.
3) Dr Singh: Let’s refine the data to identify the areas with the highest transmission rates and focus on containing the spread.
Dia: 11
2) Dr Singh: The interviews reveal that many parents in the villages did not know that vaccines are important.
1) Dr Kunene: We've completed our mixed-methods study. The quantitative data shows that 72% of the unvaccinated individuals are from low-income households, and nearly 60% live in rural areas with limited access to healthcare facilities. The vaccination rate in these rural areas is significantly lower than in urban regions. Most of the patients had gone to the nearby Eastern villages.
Dia: 12
Dr van Rensburg goes into deep thought - These systemic issues have left entire communities vulnerable, especially during outbreaks
Dr van Rensburg: Almost all the families in these eastern villages, depend fully on public healthcare yet they struggle to access services.
Dia: 13
Dr van Rensburg: We need the mayor’s support, relevant government departments, media and even the private sector to roll out a comprehensive vaccination campaign - to target rural, hard to reach and at-risk groups with mobile clinics and work with Community Health Workers, community leaders and gate-keepers among others. Education campaigns in local languages and community dialogues are critical to dispel myths and build trust in vaccination.
Dia: 14
Mayor: Thanks to your efforts, we have both the numbers and the personal stories that will help guide our vaccine campaign. This mixed-methods approach will allow us to tailor our response to meet the needs of the community.
Dr Kunene: By understanding both the data and the concerns of the public, we’re in a stronger position to prevent further outbreaks and ensure a successful vaccination drive.
Dia: 15
2) Public Health Official: We’ll need to implement quarantine measures in affected households and schools. We should also prepare to launch an immediate vaccination campaign targeting those who haven’t received the measles vaccine.
1) Dr Kunene: Now that we’ve confirmed the measles outbreak, we need to focus on control and prevention measures. Our data shows that schools are one of the main sources of transmission.
Dia: 16
Mayor: Let’s move quickly. The community is anxious, and we need to prevent further spread.
Dr Singh: We must increase awareness, provide accurate information, and ensure that vaccines are available and easily accessible, particularly for those in low-income and rural areas. We need to educate the public about the importance of the vaccinations for measles. We should also provide supportive care, including hydration and fever management, for those already infected.
Dia: 17
Mayor: Thanks to your efforts, we now have the data and strategy to contain this measles outbreak. We’ll continue to inform the public and provide the care they need.
Dr Kunene (Health Advocacy Lens): We need to improve service delivery to reach all citizens, particularly marginalized groups and rural areas. We propose mobile vaccination units for timely and equitable access to vaccines and rapid capacitation of community health workers and leaders for community-led awareness raising and catalysts for other behaviour change interventions.
Dia: 18
3) Dr van Rensburg: We will have to look at the age of individuals affected, vaccination history and other factors that may expose them to this disease. during the period of the previous month.
Dr Singh (Marxist Lens): Our data shows socio-economic inequalities are driving healthcare access disparities in our towns, villages and surrounding areas. To address these barriers, we must improve on service delivery at public hospitals and all clinics especially in the rural areas where most elderly live and are taking care of their grandchildren and orphans. We must serve everyone, not just those who may afford private health care.
Dia: 19
Dr van Rensburg: The vaccination campaign must be accessible to all. We'll set up sites in hospitals, schools, rural clinics, community halls and target low-income areas. Our public awareness efforts will use local languages to ensure everyone is informed and easily understands. We'll focus on quarantine measures, public education, and preventing further spread.
Dia: 20
1) Mayor: These strategies are now urgent and important. We must ensure equitable access, regardless of economic status. Let's move forward with transparency and clear communication to our communities to prevent panic and build public trust.
2) Dr Kunene: By combining data and community concerns, we can prevent further outbreaks and ensure successful vaccination drives.
Dia: 21
Mayor: Fellow citizens, we are facing a confirmed outbreak of measles. Our public health experts have developed a plan to contain the spread. If you or your loved ones are experiencing symptoms such as high fever, sore throat, red eyes, or a rash, please seek medical attention.
Public Health Official: We will be rolling out a vaccination campaign starting tomorrow .Vaccination is our most powerful tool in preventing the further spread of measles. We urge those who haven’t received the vaccine to get vaccinated immediately.
Dia: 22
Dr van Rensburg: Supportive care is available for those already infected. Rest assured, our team is working tirelessly to prevent more cases and bring this outbreak under control.
Dia: 23
.
Narrator: Health advocacy and recognition of structural inqualities must be addressed at the same time. Addressing both socio-economic barriers and improving service delivery ensures equitable health outcomes, laying the groundwork for a more inclusive and effective healthcare system. Only by addressing the science and human concerns can we build trust and protect communities.