The coronavirus disease 2019 (COVID-19) pandemic has provided a great lesson for the globe about the necessity and significance of pandemics-related preparedness in all settings. Public health emergency operation centers play critical roles in preparing for and responding to public health events and emergencies by coordinating and pooling resources. In this article, we aimed to share lessons learnt from the public health response to the louse-borne relapsing fever (LBRF) outbreak coordinated by the emergency operation center established to respond to the COVID-19 pandemic in Jimma, Ethiopia.

After the major waves of COVID-19 outbreaks in Ethiopia were over, Jimma University Medical Center (JUMC) reported clusters of louse-borne relapsing fever cases from Jimma Main Prison. Accordingly, Jimma Emergency Operation Center (JEOC) established for the COVID-19 pandemic was immediately alerted and effectively coordinated the overall response.

As a result, the outbreak was contained within the prison without spreading to the community and the outbreak ended within a shorter period compared to previous LBRF outbreaks in Ethiopia. This indicates the necessity of establishing and sustaining public health emergency operation centers to prepare for and combat potential future public health emergencies.

We present a detailed derivation and analysis of a model consisting of seven coupled delay differential equations for louse-borne relapsing fever (LBRF), a disease transmitted from human to human by the body louse Pediculus humanus humanus. Delays model the latency stages of LBRF in humans and lice, which vary in duration from individual to individual, and are therefore modelled using distributed delays with relatively general kernels. A particular feature of the transmission of LBRF to a human is that it involves the death of the louse, usually by crushing which has the effect of releasing the infected body fluids of the dead louse onto the hosts skin. Careful attention is paid to this aspect. We obtain results on existence, positivity, boundedness, linear and nonlinear stability, and persistence. We also derive a basic reproduction number R0 for the model and discuss its dependence on the model parameters. Our analysis of the model suggests that effective louse control without crushing should be the best strategy for LBRF eradication. We conclude that simple measures and precautions should, in general, be sufficient to facilitate disease eradication.