Background 

Outbreaks of vaccine preventable diseases including pertussis remain a significant health challenge, particularly to small island health systems with limited surveillance and response capacity. In 2025, Shefa province, Vanuatu, experienced a pertussis outbreak. We evaluated outbreak response performance using the 7-1-7 framework. It sets targets of detection within 7 days, notification within 1 day, and initiating early response within 7 days; it also facilitates identifying opportunities for system strengthening.  

Method 

Using the 7-1-7 framework, we recorded milestone dates from case emergence through early response actions. Timeliness was calculated against the 7-1-7 targets. Bottlenecks and enablers were documented, and corrective actions were proposed for both immediate implementation and long-term planning.  

Results  

Detection occurred within 7 days, meeting target. Notification was delayed by 2 days due to the absence of weekend surveillance coverage, failing the 1-day target. Early response actions including laboratory confirmation, case management, risk communication, and initiation of public health countermeasures were completed within 3 days, meeting the 7-day target. Bottlenecks included a lack of immediate pertussis testing protocols, unclear pharmacy responsibilities, and communication delays. Enablers included trained staff, available laboratory capacity, and effective communication channels. Immediate corrective actions included clinician reminders regarding urgent notification requirements and clarifying pharmacy roles. Longer-term recommendations included establishing weekend surveillance coverage, developing outbreak response standard operating procedures, and conducting simulation exercises to strengthen coordination.  

Conclusion 

The 7-1-7 assessment of the Shefa province pertussis outbreak highlighted systematic gaps and actionable solutions to strengthen outbreak detection and response. This case study demonstrates that structured performance assessments are valuable in small island contexts to ensure timely outbreak detection, notification, and response. Systematic use of the 7-1-7 framework should strengthen small island health systems, ultimately reducing the impact of vaccine preventable disease outbreaks.