Operational Plan for the Prevention and Control of Dengue in the Republic of Mauritius

Objectives

Mauritius’s dengue operational plan seeks to reduce dengue-related morbidity, mortality, case fatality and community transmission through an integrated framework for prevention, surveillance, environmental management, vector control, community participation, clinical management and rapid outbreak response.[1][2][3][4]It addresses the year-round presence of Aedes albopictus, recurrent outbreaks, travel- and trade-associated risks, and the potential introduction of infected larvae through tyre shipments.[1][2]

• Strengthen early detection, epidemic forecasting and rapid response through surveillance of cases, laboratories and mosquito populations.[1][2][3]
• Reduce mosquito breeding and transmission through source reduction, environmental management, larval control between epidemics, and both larval and adult mosquito control during epidemics.[1][3]
• Improve prompt case management, isolation arrangements, triage and clinical guidance to reduce morbidity and mortality and to limit pressure on hospitals.[3][4]
• Increase public awareness, healthy behaviour and shared responsibility for container management, safe water storage, refuse disposal, environmental cleanliness and personal protection.[5][6][7]
• Build preparedness and emergency capacity through training, simulation exercises, clarified responsibilities, operational protocols, logistics and stockpiled investigation and control supplies.[1][7]
• Apply different priorities by epidemiological phase, concentrating on containment and mitigation during outbreaks and on early warning, surveillance and control during interepidemic periods.[2][7]

Implementation

The plan uses a coordinated, step-by-step preparedness and response model linking national leadership, regional health services, laboratories, vector-control teams, local authorities, other ministries, private-sector actors, civil society and communities.[2][8][9]The Communicable Diseases Control Unit coordinates outbreak operations, investigations, regional implementation, technical reporting, trend analysis, operational information and updated protocols, while an epidemiologist supports investigations, analysis, research and emergency-response functions.[8][10]

• Operate an early warning system that can trigger investigation and control from suspected cases, mosquito-incidence data, or increased laboratory requests or positivity.[3]
• Deploy regional Rapid Response Teams, led by hospital medical superintendents and comprising public-health, epidemiology, nursing, food and safety inspection, health surveillance, laboratory, and data-management or administrative capacities.[8][7]
• Coordinate health and non-health sectors through a ministerially chaired task force involving ministries responsible for environment, local government, agro-industry and food security, education, tourism and women’s rights, alongside private-sector representatives and other stakeholders.[8][9]
• Establish central and regional operation centres during outbreaks and maintain them during interepidemic preparedness, with communications equipment, computing facilities and designated operational staff.[11][7]
• Conduct multidisciplinary outbreak investigations, confirm that cases exceed the expected baseline, apply standard case definitions, obtain laboratory confirmation, collect minimum clinical and epidemiological data, and analyse cases by person, place and time.[11]
• Undertake active case searches around index cases through contact listing, mapping, tracing, interviews, acute blood-sample collection and seven-day observation, alongside passive surveillance through government facilities, private clinics and private practitioners.[4][7][12]
• Assign laboratory confirmation, viral-serotype monitoring and mosquito testing to the Central Health Laboratory’s Virology Unit, using polymerase chain reaction and enzyme-linked immunosorbent assay for initial suspected cases.[4][12][13]
• Conduct vector surveys within 24 hours of notification and within 300 metres of relevant locations, repeat surveys after interventions, map vector density, assess insecticide efficacy, and use ALBOMAURICE predictive modelling for Aedes albopictus.[6]
• Implement adult mosquito control through thermal fogging or ultra-low-volume aerosols within 300 metres of a case house, survey households in that radius for breeding sites, and undertake environmental surveys, larviciding and enforcement against persistent offenders.[10][9][6]
• Engage communities through talks, outreach, radio, television, newspapers, social and community media, influencers and trained regional officers who monitor rumours and misinformation.[9][5]
• Support prevention through intersectoral clean-up campaigns, waste management, temporary disposal sites for green waste and old tyres, wasteland inspection, workplace cleanliness, irrigation management and hotel-based case identification.[5]
• Strengthen border measures through surveillance at ports and airports, monitoring of passengers from dengue-endemic countries, passenger lists, home visits, referral of suspected cases and contact tracing.[12]
• Monitor mosquito populations using House, Breteau, Container, Pupal and adult-density indices, daily and sentinel-site surveys, predictive density maps, insecticide-resistance assessment and post-intervention surveys.[3][10][6]
• Report vector densities, larviciding, fogging, entomology and applications daily, maintain a daily outbreak-investigation database, issue regional and disease-trend reports, and use an evaluation committee to review technical reporting.[8][4][6]

Monitoring & Evaluation

The plan establishes a surveillance and accountability framework centred on early warning, laboratory confirmation, vector monitoring, outbreak investigation, routine reporting and coordinated oversight by the Communicable Diseases Control Unit (CDCU), regional services and specialist units.[3][8]Surveillance is designed to support early detection, epidemic forecasting, containment during outbreaks and early warning during interepidemic periods.[1][2]

• Detect potential outbreaks through suspected-case reports, mosquito-incidence data, increases in laboratory testing requests and laboratory positivity.[3]Confirm an outbreak when positive cases exceed the expected baseline, applying the standard case definition and obtaining laboratory confirmation of index and linked cases.[11]
• Combine active case finding around index cases with passive surveillance through sentinel government facilities, private clinics and private practitioners.[4][7][12]Trace and observe immediate contacts of index cases for seven days.[12]
• Collect and analyse outbreak data by person, place and time, including age, gender, exposure, locality and geographical distribution, and map case patterns and hotspots.[11][4][6]Maintain a daily outbreak-investigation database and disseminate locality-level epidemic trends daily to interested parties.[11]
• Assign virological surveillance to the Virology Unit of the Central Health Laboratory, including rapid confirmation of suspected cases by polymerase chain reaction and enzyme-linked immunosorbent assay, monitoring of disease magnitude and viral serotypes, and daily reporting to central and regional public-health authorities.[4][6][12]
• Monitor mosquito populations using the House Index, Breteau Index, Container Index, Pupal Index, adult mosquito collections and predictive density maps for Aedes albopictus generated through the ALBOMAURICE model.[3]Apply Breteau Index thresholds of 5 and 0 to distinguish interepidemic and epidemic seasons.[3]
• Undertake daily mosquito surveys in at least two localities, monthly surveys in eight sentinel localities and monthly predictive mapping.[10]Screen field-collected Aedes albopictus mosquitoes for dengue using polymerase chain reaction, conduct at least 20 night-catch surveys annually, and undertake monthly surveys at seaports and airports for invasive mosquitoes, including Aedes aegypti.[10][9]
• Conduct mosquito surveys within 24 hours of notification and within a 300-metre radius of relevant locations, then repeat surveys after control interventions to assess their effect on vector populations.[6]Assess insecticide resistance annually and evaluate insecticide efficacy at procurement and whenever required.[10][9]
• Submit daily vector-density reports to the CDCU and relevant health offices, and report daily on larviciding, fogging, entomological activities and applications.[10][4][6]Require weekly Health Inspectorate reports to the central unit and Vector Biology Unit, alongside weekly disease-trend and operations bulletins.[8][10][9]
• Monitor implementation through the CDCU, which compiles reports; oversees larviciding, fogging, vector control and surveillance; analyses disease trends; and disseminates updated operational information and protocols.[8]Use an evaluation committee to examine technical reports from regional activities.[8]
• Support accountability through defined responsibilities for the CDCU, epidemiologist, regional public-health leadership, Rapid Response Teams, Vector Biology and Control Division, Health Inspectorate Cadre and laboratory services.[8][10][7]Coordinate multi-sectoral review through a ministerially chaired task force that reviews outbreak progress and advises government on control measures.[9]
• Monitor rumours and misinformation in media, social networks and communities through trained officers in every health region.[5]Notify senior health authorities, public-health leadership, the press attaché and regional Rapid Response Teams of potential outbreaks.[11]

The supplied material does not specify formal performance targets, comprehensive evaluation schedules or a broader results framework beyond the surveillance measures, reporting frequencies, technical review arrangements and assigned operational responsibilities described above.[7][12]

Costing & Financing

No monetary budget, expenditure estimate, financing source, funding gap, economic assumption or resource-mobilisation target is specified in the supplied sections.[3][8][4][6][7]Resource mobilisation is identified as an element of risk communication and community engagement, but without financial detail.[9]

• Provide operational resources for outbreak response, including additional workforce capacity, logistics, medical countermeasures, diagnostic tools, staff redeployment and advice to regional public-health leads.[11]
• Maintain central and regional operation centres with communication equipment, computers, printers and telephones.[7]
• Stockpile investigation and control supplies, and support preparedness through training, simulation exercises, revised protocols and standard operating procedures.[7]
• Support environmental control measures including temporary disposal sites for green waste and old tyres, wasteland management, larviciding and fogging.[5]

These resource requirements are described without costings, allocations, funding responsibilities or quantified financing needs.[5][11][7]