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Communicable Disease: Measles
Although measles has been almost completely eradicated from the Americas, dozens of cases still occur each year in the United States due in large part to transmissions of the disease from travelers returning from abroad. Because it is highly contagious, outbreaks of measles must be addressed as quickly as possible. This paper provides a review of the relevant peer-reviewed and scholarly literature to describe a communicable disease outbreak of measles, and the epidemiological indicators associated with the disease. An analysis of the epidemiological data on the outbreak is followed by a discussion of the route of transmission of the disease causing the outbreak and how the attack could affect the community. Finally, an explanation concerning the appropriate protocol for reporting a possible outbreak is followed by an assessment of a community health nurse's role in modifying care of patients with asthma and other respiratory diseases when the air quality index is poor. A summary of the research and important findings are presented in the conclusion.
Review and Discussion
Measles is a severe, but vaccine-preventable disease that is capable of causing extensive morbidity and mortality on a global basis (Warrener, Slibinskas, Chua et al., 2011). The measles virus (MV) is described by Warrener et al. As "an enveloped RNA virus classified in the family Paramyxoviridae, genus Morbillivirus [which] is the most transmissible virus known in humans" (2011, p. 675). Notwithstanding the enormous amount of resources that have been devoted to vaccination programs in many countries, the measles virus continue to represent a serious public health threat on a global level, especially in developing countries (Warrener et al., 2011).
In spite of aggressive measures to counter the disease through the widespread use of measles vaccine (whether as a single antigen vaccine or as a constituent ingredient in the triple vaccine against measles, mumps and rubella (MMR), there were still 278,358 reported cases of measles and approximately 164,000 fatalities caused by measles worldwide in 2008 alone (Warrener et al., 2011).
Although measles has largely been eliminated from the Americas, vaccine coverage is highly variable between World Health Organization (WHO) global regions and measles continues to be endemic in the African and Southeast Asia regions, where vaccine coverage is currently less than 80% (Warrener et al., 2011). Although measles has been virtually eradicated from the Americas, as of early August, more than 180 cases of measles in the United States had been reported to the Centers for Disease Control and Prevention in 2011; this total was the largest number of measles cases reported since 1996 and was fully twice the number of cases reported in all of 2008 when the disease reached its last spike (Johnson, 2011). The majority of cases have been brought into the United States by travelers and spread to others who lack immunity to the illness (Johnson, 2011).
Currently, Africa and Southeast Asia account for the vast majority (94%) of all global measles deaths; however, outbreaks continue to take place in other parts of the world (Warrener et al., 2011). These incidence of these outbreaks in other parts of the world is expected to increase in the future as a result of the measles virus being introduced into areas where vaccine coverage has slipped below optimal levels and an susceptible population has developed (Warrener et al., 2011). According to Warrener and his associates, "Most regions have elimination goals and elimination strategies based on the maintenance of high vaccination coverage, for which political commitment is required. A key component of elimination plans is surveillance to monitor impact" (2011, p. 676). This point is also made by Johnson (2011) who emphasizes, "Maintaining high immunization rates with the mumps-measles-rubella, or MMR, vaccine is the cornerstone of outbreak prevention. The vaccine is recommended routinely for all children at age 12 months to 15 months, with a second dose at ages 4 to 6" (p. 2).
Prior to the introduction of the first measles vaccine in 1963, nearly all children got measles before their 15th birthday. The virus caused pain and suffering, including as many as 500 deaths each year and 48,000 hospitalizations. According to the National Network for Immunization Information, the vaccine has led to a 99% reduction in the incidence of measles in the United States (Johnson, 2011).
It is important for clinicians to secure confirmation of a measles diagnosis through…[continue]
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