© 1973 Oxford University Press
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Active Search Operations for Smallpox-An Ethiopian Experience
1WHO Epidemiologist
2WHO Senior Adviser
3Peace Corps Volunteer, Former Assessment Officer
Smallpox Eradication Programme, c/o W.H.O. Representative, P. O. Box 3069, Addis Ababa, Ethiopia
Requests for reprints may be addressed to Dr. C. A. de Quadros.
In little more than 2 years, the smallpox eradication programme in Ethiopia has succeeded in reducing smallpox incidence from a rate of over 100 per 100,000 inhabitants (1971) to the point in March, 1972, where 9 of 14 provinces were free of smallpox and the complete interruption of transmission could be foreseen within a year's time. Because of the size of the country, dispersed population, difficult communications and limited staff, programme strategy has necessarily focussed on case detection and containment of outbreaks rather than on systematic mass vaccination. A continuing active search for cases has been an important activity. Inquiries at schools and market places about cases of smallpox have been remarkably effective in detecting outbreaks. In a special study of the method, a 2-man team in 14 days conducted an active search in a 48,000 square kilometre area in which resided 275,000 persons. Two related outbreaks, one of eight cases and one of two cases were detected and containment measures taken. Although the infection had been imported only 8 weeks previously, information about the outbreak was obtained at 6 different schools and markets located 3 to 9 hours' walk distant from the principal focus. Approaches such as this should prove useful to both endemic and non-endemic areas throughout the world.
Received 17 March 1973