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Contact tracing 

Contact tracing is a disease management tool used to control outbreaks.  Following the confirmation of a Lassa fever case, contact tracers try to identify and follow up anyone whom that person has been in contact with. Contact tracing is viewed as a critical strategy required for timely prevention and control of Lassa fever. However these imposed forms of external surveillance can be rejected because people feel stigmatised or policed and are unwilling to undergo quarantine or other supervision measures during the incubation period of the virus. In some countries, case investigation, contact tracing and searches for infected animals are conducted at the same time.  This provides an opportunity to share information with community members about Lassa fever. Recent Lassa fever outbreaks have shown that primary transmission from rodent to human can be ongoing. Therefore, rodent control should be encouraged during contact tracing activities. Social science research can help us understand the barriers for Lassa surveillance and control as well as the ways in which disease control activities can be politicised, or the ways in which local political/economic history might create mistrust between communities and contact tracing teams. Social scientists can also help to identify ways to improve trust and information sharing between communities and contact tracing or active case finding teams.

Policy-relevant findings:

  • Quarantine should be avoided if there are other reasonable methods of monitoring contacts.
  • When quarantine is necessary this should come with adequate support  including food supplies and compensation for those who, for example, lost their jobs during the period of quarantine.  

Resources

The politics of fear: Médecins Sans Frontières and the West African Ebola epidemic

This book provides a primary documentary resource for recounting and learning from the Ebola epidemic. Comprising eleven topic-based chapters and four eyewitness vignettes from both MSF- and non-MSF-affiliated contributors, it aims to provide a politically agnostic account of the defining health event of the 21st century so far to inform current opinions and future responses.

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Social consequences of Ebola containment measures in Liberia

This study of quarantine during the Ebola epidemic in Liberia also shows that state-enforced quarantine, with a mandatory prohibition of movement, raised condemnation, strengthened stigmatization and created serious socio-economic distress.

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Nigeria Centre for Disease Control (NCDC): Contact tracing, national guidelines for Lassa fever case management

The national guidelines for contact tracing and case management of Lassa fever as outlined by the Nigeria Centre for Disease Control.

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