Saving Lives and Protecting Communities: Rapid response teams in Pakistan move us closer to a world safe from infectious disease threats

Murk at her home in Karim Bux Jamali, Pakistan after being treated for diphtheria. Credit: JSI/USAID Integrated Health Systems Strengthening and Service Delivery Activity

On September 3, 2024, a rapid response team at the disease surveillance and response unit in Badin, Pakistan, received an alarming report. A young girl in the nearby village of Karim Bux Jamali was showing symptoms of diphtheria. The team responded immediately and, within a day, arrived in the village to find the girl, Murk, suffering from fever, swelling in the neck, and difficulty eating. She needed immediate medical attention.

The team quickly transported Murk to a hospital in the provincial capital of Karachi, where she received treatment. After five days, doctors declared her diphtheria-free, and she returned home to her village, where members of the response team had been hard at work.

Investigating the Outbreak and Conducting Active Case Finding

While Murk was receiving care at the hospital, the team had been working to prevent a potential diphtheria outbreak in her village. Murk lives in a household with eight other family members, including five other children. The team screened each member of the household for signs and symptoms of diphtheria and were relieved to find them all symptom-free. In addition, the team went door-to-door in the surrounding community to conduct active case finding and, when identifying a suspected case, confirmatory testing. Thankfully, after a thorough outbreak investigation, they determined that there were no other potential diphtheria cases in the village.

Preventing Future Outbreaks

Before leaving Karim Bux Jamali, the rapid response team took measures to protect the community from future outbreaks. They vaccinated 56 children under the age of 12 with the Penta combination vaccine, offering them protection against diphtheria, tetanus, whooping cough (pertussis,) hepatitis B, and Haemophilus influenza type B. Village residents over 12 received vaccination against tetanus and diphtheria. The team vaccinated 120 people total.

Diphtheria is a vaccine-preventable disease, yet it has been on the rise in Pakistan since the COVID-19 pandemic entered the country in 2020. According to the Pakistan Demographic and Health Survey, 2017-18, only 46 percent of the children aged 12-23 months living in rural Sindh—where the investigation took place—had received the DPT3 (diphtheria-pertussis-tetanus) vaccine, compared to 75 percent overall in Pakistan.

The team also shared information about vaccination with the community, disseminating messages in line with the global Expanded Programme on Immunization. They provided counseling on essential vaccinations, including polio and measles, and the importance of completing the full course of vaccination. A critical component of the response was coordinating with Lady Health Workers—key agents of change in the health care workforce in Pakistan—to reach and children in the community with information and immunization.

The team’s quick action and multi-faceted response saved Murk’s life and prevented future disease outbreaks in Karim Bux Jamali. This rapid response team had received training, resources, and technical assistance from the USAID Integrated Health Systems Strengthening and Service Delivery (IHSS-SD) Activity, implemented by JSI in partnership with the Government of Pakistan. With support from the IHSS-SD Activity, the team had completed an internationally recognized Field Epidemiology Training program to strengthen their ability to identify and respond to disease outbreaks and make fast, effective decisions during a public health emergency in line with international protocols. They were also equipped with vehicles provided by the IHSS-SD Activity.

The IHSS-SD Activity is working at national, provincial, and district levels to develop and implement Pakistan’s national action plan for global health security. In addition to training a cadre of rapid response teams to quickly and effectively identify, respond to, and stop emerging infectious disease outbreaks, the Activity is standardizing reporting mechanisms, strengthening district and provincial Disease Surveillance Response Units across the country, and establishing a digital health infrastructure and an integrated reporting system to support evidence-based decision-making.

Looking Ahead

Murk, her family, and their community are better protected from future disease outbreaks thanks to the rapid response team trained by the USAID IHSS-SD Activity. In the event of another suspected outbreak, residents of the village can rest assured that there is a team nearby with the knowledge, skills, and resources to act quickly to save lives, prevent the spread of disease, and move us closer to a world secure from the threat of infectious diseases.