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Investigating an outbreak of measles in Margibi County, Liberia, October 2015

Investigating an outbreak of measles in Margibi County, Liberia, October 2015

Joseph Asamoah Frimpong1,&, Maame Pokuah Amo-Addae1, Peter Adebayo Adewuyi1, Meeyoung Mattie Park2, Casey Daniel Hall2, Thomas Knue Nagbe3


1Liberia Field Epidemiology Training Program, Monrovia, Liberia, 2Rollins School of Public Health, Emory University, Atlanta, USA, 3Ministry of Health, Monrovia, Liberia



&Corresponding author
Joseph Asamoah Frimpong, Liberia Field Epidemiology Training Program, Monrovia, Liberia




The emergence and re-emergence of infectious diseases highlights the need to have well-trained field epidemiologists who will be at the forefront in the fight against these diseases, especially during an outbreak. Training for outbreak investigation is most effective when participants can develop their competencies in a practical exercise. To that end, this case study was based on a measles outbreak investigation conducted in Liberia during October 2015 by Liberia Frontline Field Epidemiology Training Program (FETP) residents, simulating steps to perform outbreak investigation in a real-life situation as a field epidemiologist. This case study is ideally suited to reinforce principles and skills already covered in a classroom lecture or in background reading by providing a practical training beyond the scope of theoretical learning. It is primarily intended for training novice public health practitioners who should be able to complete the exercises in approximately 3 hours.



How to use this case study    Down

General instructions: ideally, 1 to 2 instructors facilitate the case study for 8 to 20 students in a classroom or conference room. The instructor should direct participants to read a paragraph out loud, going around the room to give each participant a chance to read. When the participant reads a question, the instructor directs all participants to perform calculations, construct graphs, or engage in discussions. The instructor may split the class to play different roles or take different sides in answering a question. As a result, participants learn from each other, not just from the instructors. Specific instructor’s notes are included with each question in the instructor’s version of this case study.


Audience: residents in Frontline Field Epidemiology Training Programs (FETP-Frontline), Field Epidemiology and Laboratory Training Programs (FELTPs), and others who are interested in this topic.


Prerequisites: before using this case study, participants should have received lectures or other instruction in outbreak investigation.


Materials needed: laptop with Microsoft Excel or graph paper, flipchart or white board with markers


Level of training and associated public health activity: Novice - Outbreak investigation


Time required: approximately 3 hours


Language: English



Case study material Up    Down



Competing interests Up    Down

The authors declare no competing interest.



Acknowledgments Up    Down

We wish to thank African Field Epidemiology Network and Emory University for organising a case study development workshop through which this output was achieved. We acknowledge residents of the Liberia Field Epidemiology Training Program for allowing us to use their data for this case study. We also wish to acknowledge the following for their peer review during the case study development workshop: Doreen Tuhebwe, Mahmood Dalhat, Olufunmilayo Fawole, Jane Githuku, Notion Gombe and Gerald Shambira.



References Up    Down

  1. Maximore LS. Expanded Surveillance Report. Monrovia, Liberia. 2015.
  2. WHO/AFRO. Guidelines for Measles Surveillance. 2004 December; 1-38. Google Scholar

  3. CDC. Section 2: Steps of an Outbreak Investigation. In: Principles of Epidemiology in Public Health Practice [Internet]. 3rd ed. Atlanta, GA: CDC; 2012.