C228 Community Health Task 2 measles PDF

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Outbreak of Measles in Disneyland. 2014-2015 started by visitor to Philippines...

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C298 – KLP Task 2 – Community Outbreak

Karen Funk College of Health Professions, Western Governors University C298: Community Health Denise Edge September 3rd, 2021

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C298 – KLP Task 2 – Community Outbreak

Communicable Disease Measles is an infection caused by a virus that typically affects children. Once a person has been infected the virus incubates for the first 10-14 days and the person will be asymptomatic. Then for the next few days mild symptoms such as low-grade fever, inflamed eyes, cough, sore throat, and runny nose may appear. Next, the acute illness phase starts with a rash that consists of small red spots, some may be slightly raised in tight clusters that will give the skin a splotchy red appearance. The face breaks out first, then spreads down the arms and trunk, lastly over the thighs, lower legs and feet. At the same time, the fever rises sharply, often as high as 105.8 F. The rash gradually recedes in the order from which it appears (Mayo Clinic, 2020). Measles is so contagious that up to 90% of the people close to an infected person who are not immune will also become infected because it can live for up to two hours in an airspace after an infected person leaves. This virus lives in the mucus of the nose and throat of an infected person and spreads through coughing and sneezing. People become infected by breathing the contaminated air or touching an infected surface, then touching their eyes, nose, or mouth, and then spread measles to others from four days before through four days after the rash appears (CDC, 2020). Outbreak

3 In 2000 Measles were deemed eradicated from the United States. This means there had been no new cases for at least five years or longer. This is due to an extensive vaccination program that has protected children from the measles for the past fifty years. The World Health Organization estimates that between 2000 and 2013, measles vaccination prevented 15 million deaths around the world Miller, Jackie, 2020). Unfortunately, with declining vaccination rates, in December of 2014 another measles outbreak occurred at Disneyland in California. Approximately 75 people who had visited the park contracted measles. There are still many countries where measles outbreaks are more common, Europe, Africa, Asia and in this instance, there had been a recent outbreak in the Philippines. It is believed a traveler recently returned from the Philippines and unknowingly had been infected and when visiting Disneyland shed the virus to those who were susceptible to the disease. Then those people traveled back to their home states, increasing the spread of the virus to others. This outbreak in 2014-2015 it is considered one of the largest outbreaks of measles the U.S. had seen in decades. Though cases of measles are still considered rare it is now classified as a reemerging disease in the U.S. This means, a once eliminated disease has resurfaced in a population. With the increasing number of people who are not vaccinated, measles could potentially become a threat to public health in the United States. Epidemiology and Risk Factors The epidemiological determinant of measles has to do with exposure through traveling to countries where measles is still in large numbers. In Europe, Africa and Asia it is still being reported to having over 20 million cases each year. Also infected travelers coming into the U.S. and spreading the virus to those who are unvaccinated,

4 Being unvaccinated is one of the highest risk factors to catching this disease. Along with international travel and having a Vitamin A deficiency. Measles that are due to a vitamin A deficiency puts you at a higher risk of having more severe symptoms and complications. Some of the complications one with measles may have is an ear infection, respiratory or throat infections, pneumonia, encephalitis and or pregnancy problems. Impact on Community The community is impacted through increasing number of ER visits and hospitalizations. Premature death due to the disease. Families are impacted financially due to their children being sick and having to miss work. Schools may need to close down until the spread of measles in the community is under control. Reporting Protocol In 1912, measles became a nationally notifiable disease in the United States. All healthcare providers and laboratories in the U.S. were then required to report all diagnosed cases. In the first decade of reporting, an average of 6,000 measles-related deaths were reported each year (CDC, 2020). If a person contracts measles it is reported to the local Department of Health who then reports to the CDC. It is important to track where these diseases are contracted to attempt to understand them and eliminate them from our communities. It also can protect the community by informing them of highly communicable diseases that they need to protect themselves from. Prevention Strategies Before 1963, when the MMR vaccine became available, nearly all children got measles by the age of 15. Among the reported cases, an estimated 400 to 500 people died, 48,000 were

5 hospitalized, and 1,000 suffered encephalitis (swelling of the brain) from measles (Mayo Clinic, 2020). The Centers for Disease Control (CDC) recommends that children ages 12-15 months of age should be vaccinated with their first dose and the second dose between 4-6 years of age. Children may be able to receive the vaccine earlier if traveling abroad or if they are teens and have never been vaccinated, they can receive two doses four weeks apart. Adults who have not been vaccinated and are high risk such as travelling abroad, in college, working in healthcare environments may consider getting a titer (lab blood test to check immunity) checked or getting the vaccine. During an outbreak or if you have been around someone who is known to be infected it is important to isolate to protect those who are vulnerable, including those who are not vaccinated. Measles is highly contagious for up to four days prior to the rash appearing to four days after it appears. If you've already had measles, your body has built an immune response to fight the infection, and you can't get measles again. Since the introduction of the measles vaccine, measles has virtually been eliminated in the United States, even though not everyone has been vaccinated. This effect is called herd immunity. However, over the years vaccination rates have been dropping and herd immunity is weakening which has been seen in a rise of measles cases in the U.S. The drop in vaccination rates is likely due to a now dis-credited study in 1998 that linked the MMR vaccine to causing Autism. Increasing our vaccination rates is imperative to prevent larger outbreaks of measles. Bentonville Action Report Please see attached report with submission

6 References Center for Disease Control 2020. Accessed on 09/01/2021. https://www.cdc.gov/measles/about/index.html Mayo Clinic 2020. Accessed on 08/24/2021. https://www.mayoclinic.org/diseasesconditions/measles/symptoms-causes Miller, Jackie PhD. Education Development Center Inc. 2020 Accessed on 08/23/2021. http://infectiousdiseases.edc.org/content/article/measles...