Current Response Goals:
1) Slow spread in Ebeye and Majuro; & prevent spread to outer atolls, 2) Assure excellent clinical care to minimize deaths. Surveillance:
• Surveillance system with daily updates in place for Ebeye, Majuro, and Outer Islands
Community Engagement & Vector Control:

• Vigorous community engagement, ongoing with help from partners- Red Cross, WUTMI, Kalgov, Malgov. Ebeye complete for community clean-up and spraying of hospital, schools, and churches. Community awareness by mass phone texts, radio, posters, and public seminars.

• Vector Control: 54/54 churches completed; 22/22 schools completed in Majuro. As of Sept. 24, 59% of rainwater tanks (3500) repaired with screens.

• Health Education: 54/54/churches completed; 19/22 schools completed in Majuro.

• Rain catchment tanks on Ebeye and Majuro not yet screened or treated (due to the absence of screening materials & larvicide. Majuro: Trash and large item pickup completed in Ebeye and in

  about 1⁄2 of Majuro (from Rita-Rairok villages). Four Illegal dumps in Majuro found (but not yet addressed). Clinical capacity:

  • Dengue 101 clinical seminars completed in Ebeye: 100% of doctors & 100% clinical nurses and Majuro: 100% of doctors, 100% NPs, 100% triage & ward nurses. Fast track outpatient

    dengue clinic using NPs in Majuro Hospital was stopped in Week 8 due to a decreasing number of Dengue Fever seen.

  • Surge Capacity Team completed and passed the CDC DF Module Post Test week of Sept 16-23.

  • Ebeye & Majuro was fully functional for dengue care. Preparation for outer atolls:

  • Dengue 101 training to health assistants is still ongoing; Community cleanup initiated in 3 outer atolls but most still pending; Shipments of dengue-related supplies to go to some atolls

    this week.

  • A total of 6 Health Assistants for Jabor Jaluit, Kaven Maleolap, Tokewa Mili, Wormej Wotje and 2 from Majuro were trained in DF, management of DF Category A, B, and C; Surveillance

    forms, Active Surveillance, and OI response plan for prevention of DF with the traditional and Govt leaders, Churches, NGOs, etc..

  • Travel restrictions for Ebeye & Majuro outer atolls in place since Aug 23.

    Rongrong: On Oct. 11, 2019, OI protocol was activated in RongRong and Jelter: 2 NPI, lab tech and 1 health assistant will be deployed to RongRong to manage DF patients and stabilizing patients that need medivac. House to house visit was carried out. Mosquito nets and repellents were distributed to every Dengue Like Illness cases, households, pregnant women and disabled patients. Vector breeding sites surveillance was carried out by the NPs. Vector Control and WASH Team continued to fumigate the whole Majuro villages with the highest attack rate including Rongrong and Uliga. Aside from fumigation, mosquito dunks were distributed to the wells and water catchments.

    Utrik: With 1 admitted case and 2 suspected cases from Utrik Atoll, OI Dengue Response team immediately deployed to Utrik on October 19, 2019. Response measures have done: Fumigation of the whole island, case investigations, and other clinical measures. 177 Health Care Program chartered the plane and notified the Utrik community. Logistics prepared Medical Counter Measures and other supplies. 53 houses were fumigated, 16 water wells, 40 plastic water catchments, 5 abandoned concrete water catchments were treated with mosquito dunks. Mosquito control education was delivered on house to house visits. Adult mosquito and larvae were collected for testing.
    Plan for Aur Dengue Response: 1) Risk assessment, 2) Epidemiology investigation, 3) set up a station on Aur and Tobal, 4) Vector control and surveillance