In all settings, close coordination between the laboratory, surveillance, and Expanded Programme on Immunization (EPI) staff at the national, regional, district, and local levels is essential once the outbreak is confirmed. Preparedness plans should be implemented that include increasing the capacity of the laboratory and case-based surveillance systems.
In humanitarian settings or areas with access constraints, enhanced community-based or event-based surveillance includes identifying local focal points to notify suspected cases, even before formal case definitions can be applied or lab confirmation is feasible. In these settings, predefined outbreak trigger thresholds should be adapted to the realities of access and risk.