Interruption of transmission

Once a hypothesis of causation is made from the epidemiological investigation, a method of control is commenced. This can be done in three different phases:

• long-term prevention.

If the communicable disease is in epidemic form and threatening a large number of people, then emergency methods must be implemented as soon as possible. These are often non-specific and should commence before the detailed investigation has been finished. As an illustration of these three different strategies, an epidemic of dengue can be used. The emergency method would be a knock-down spray, such as fogging which kills all adult mosquitoes indiscriminately. This will control the immediate problem, but once the number of adult mosquitoes builds up again, the epidemic might recommence. The specific method would be a programme selectively against the Aedes mosquito vector by destroying all temporary breeding places and using larvicides in water containers. Long-term prevention would be by permanently altering breeding places, placing mosquito netting over water tanks, repairing broken guttering and all the techniques that are available for removing the mosquito permanently.

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