Risks of a Measles Pandemic

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 COMMUNICABLE DISEASE

Measles, believed to have been erased by the year 2000 in the United States because of the measles vaccine efficiency (CDC. gov, 2017).  The movement of immigrants across vast areas globally increased the spread of the disease.  Added to the fact that not all countries utilize a universal practice of compliance with immunization contributes to the spread of disease across continents. This puts us at serious risk of a pandemic occurrence which I will explore in this report.

B. DESCRIPTION OF OUTBREAK 

●       Measles is a highly contagious virus that is usually known as a childhood disease. The countries involved are the Philippines and the United States.

●       There were 125 reported cases in California in the United States during a 45-day period from December 28, 2014 to February 11, 2015.

●       The first case was traced to the Disneyland Theme Parks. It was not proven but assumed that the disease had crossed international borders via travel from an already infected visitor from a foreign land visiting the travel destination mecca.

●       This Measle genotype strand B3 was traced to a massive outbreak that occurred in the Philippines in all of 2014 (Center for Disease Control and Prevention, 2015). This disease had a 9-fold increase compared to 2013 and was responsible for 58,010 cases in the Philippines during 2014.

 B1. EPIDEMIOLOGICAL DETERMINANTS AND RISK FACTORS

The symptoms appear approximately 10-14 after exposure (CDC.gov, 2017) and begin with a high fever, sore throat, dry cough, runny nose and watery eyes. A rash appears in 3-5 days covering the entire body. Adults can be at risk if not vaccinated or their immunity levels are too low. Some adults have received only one immunization versus the more commonly given two now. The incubation period of measles ranges between 7 and 18 days and patients are infectious from about 4 days before developing the rash until 4 days after rash. Complications of measles include viral and bacterial pneumonias and severe diarrhea. The disease can also lead to lifelong disabilities including brain damage, blindness and deafness. Measles are also known as Rubeola and is caused by the paramyxovirus.  It is most prevalent from winter to spring and this may be due to spending more time in close proximity with each other, such as in crowds. Measles kills more children than any other vaccine-preventable disease. Common complications are diarrhea and ear infections. Pneumonia and Encephalitis are the leading cause of death of those that contract the Measles. Before the widespread use of vaccine, 90% of children had contracted measles by the age of 10 years. An effective vaccine has been available since the 1960s, and all countries offer measles vaccine in their immunization programs. Measles is highly transmissible; almost all non-immune children contract measles if exposed to infection. Poorly nourished children and those whose immune systems have been weakened by HIV/AIDS or other diseases are at high risk of developing measles complications and death. Measles occurs worldwide and it is still a significant cause of childhood morbidity and mortality despite the existence of effective vaccine. Measles infection has its greatest incidence in children under 5 years of age and non-vaccinated people in most countries.

.B2. ROUTE OF TRANSMISSION

Measles spread human to human. Measles is a highly contagious respiratory infection that's caused by a virus that infects only humans.  It is transmitted by respiratory droplets and direct contact with nasal or throat secretions of infected persons. However, the virus can linger in the airspace up to two hours after the person has left the vicinity. One person can infect as many as 18 people. It lives in the gastrointestinal tract of humans. Just breathing the same air of an infected person or where an infectious person has been recently or touching a contaminated surface and then your mucus membranes can invite the virus in. The virus can remain airborne for two hours.

B3. IMPACT ON COMMUNITY

Due to the fact that Measles is a highly contagious disease and spreads so quickly from an infected host to a non-immunized person, it has a transmission rate >90%.  Even though, the United States had declared Measles eliminated from our country in 2000, they did not factor in the transient nature and the travel plans of others. At times, it is our non-immunized citizens traveling to other countries and sometimes it is in the reverse (Centers for Disease Control and Prevention, 2018). An outbreak in my community would close schools, shut down mass transit, overload our healthcare system. This would further have a domino effect on our food sources such as grocers who may be ill. Many people would have to stay home from work causing a strain on our economy. Most of our population is immunized but we do have some smaller groups within the community that are not immunized due to their religious, cultural, or personal beliefs. Such close contact in urban areas could be disastrous for rapid transmission. These factors all would greatly affect my community.

 B4. REPORTING PROTOCOL

In Missouri, if Measles are suspected, the local public health agency (LPHA) is to  immediately contact the District Communicable Disease Coordinator or the Missouri Department of Health. If a childcare facility is involved, the LPHA will also contact the Bureau of Environmental Health Services. If a long-term care facility, the LPHA must also notify the Section for Long Term Care. If a case is associated within a healthcare setting, the LPHA must also notify the Bureau of Health Services Regulation. The main purpose of these notifications is to investigate reports of possible Measle cases immediately, assess susceptibility of contacts. They also ensure exclusions of exposed, susceptible contacts from group activities, and provide information to people at risk and the general public informed (MO-dhss 4.0 Diseases and Condition, Measles Reference Manual, 2013). The purpose of these actions are containment and education.

B5. PREVENTION STRATEGIES

The strategies that I would recommend would be the promotion of educating the public in my community on the safety and efficiency of vaccines. Misinformation caused many people to believe that vaccines were responsible for Autism among other issues. Providing education would be related to my second strategy which is compliance of the actual vaccinations in my community. I believe if we each tackled our individual communities then maybe we could unite for a bigger cause. Measles are preventable and we can once again provide almost every American with immunity against this devastating and sometimes deadly virus. Making sure that all of our citizens are immunized, especially prior to travel outside of the United States, and requiring it of visitors for entry into our country would once again nearly eradicate this serious and deadly virus from the United States.

C.  SEE ATTACHED PDF

·       Influenza in Bentonville

·       Community Advocacy

·       Emergency Response·

        Communicable Disease

References

Center for Disease Control & Prevention. (2018) Measles chapter of the epidemiology and prevention of vaccine preventable diseases.

Retrieved from: https://www.cdc.gov/measles/transmission.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmeasles%2Fabout%2Ftransmission.html

Center for Disease Control & Prevention. (2018) Transmission of measles. Retrieved from: https://www.cdc.gov/measles/about/transmission/html

Center for Disease Control & Prevention. (2018) Measles history. Retrieved from: https://www.cdc.gov/measles/about/history.html

Center for Disease Control & Prevention. (2015). Morbidity & mortality weekly report.

Measles outbreak-California, December 2014-February 2015 Retrieved from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a5.html

Outbreak News Today. (2014) Philippines measles outbreak 2014: 58,010 cases, 110 deaths Retrieved from

http://outbreaknewstoday.com/philippines-measles-outbreak-2014-58010-cases-110-deaths-31292/

MO-dhss 4.0 Diseases and Condition, Measles Reference Manual (2013) Retrieved from

https://health.mo.gov/living/healthcondiseases/communicable/communicabledisease/cdmanual/pdf/Measles.pdf

 Center for Disease Control & Prevention. (2018) Measles data & statistics. Retrieved from

https://www.cdc.gov/measles/downloads/measlesdataandstatisticsslideset.pdf

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