Description of Chosen International Outbreak
The disease under consideration is measles, which is one of the highly contagious and acute viral conditions (Taylor, Burke, & Zhou, 2012). Although it was considered eliminated, local and even international measles outbreaks are still observed. One of the examples of an international measles outbreak was reported in 2011 (Taylor et al., 2012). It started in Malaysia, where a 16-year-old refugee from Burma became ill.
The first symptoms such as rash and fever appeared on 18 August. His other 15-year old relative developed a fever on 21 August and a rash on 22 August. They both were not vaccinated. They left Malaysia with their mother and one more child on 24 August and came to Los Angeles International Airport (Taylor et al., 2012). On 25 August, a 15-year-old child was admitted to the hospital, and the next day the Centers for Disease Control and Prevention (CDC) was informed about the possible case of measles. The tests proved the case of measles on 30 August. The following investigation provided by the CDC attempted to reveal secondary measles cases in the communities where the refugees who traveled the same flight were settled. In the period from 26 August to 12 September 2011, six cases of measles were reported in the United States (Taylor et al., 2012).
Epidemiological Determinants
The epidemiological determinants for measles comprise the complex of risk factors, observed in this or that community at a certain period of time as well as the ways of transmission. However, they will be discussed further in the paper. The other determinants relevant to the described outbreak are as follows. First of all, the infectivity of measles was an epidemiological determinant to consider. Measles is caused by a highly contagious virus and, therefore, is easily spread. As for virulence, it is also high in case of complications. Moreover, any person without immunity to measles (thus, all the people who are not vaccinated) can have measles.
Measles is spread both through contact and aerosol modes of transmission. Thus, a person can get infected from sneezing and coughing of another person with measles, or through close contact with infected secretions (World Health Organization, 2018). Climate should be considered as the epidemiologic determinant as well. For example, the measles virus is more active under warm temperatures and less active at lower temperatures. Therefore, in the case of the analyzed outbreak of measles, the disease was spreading quickly in the conditions of the equatorial climate of Malaysia, and there could have been more cases of measles in the country if the refugees had stayed there longer. Still, one of the primary epidemiological determinants was poor coverage with vaccination in Burma and generally low level of healthcare available in the area.
Route of Transmission
For the outbreak under consideration, the route of transmission was from person to person in the first infected individuals. They are relatives and were living together. Consequently, they could get infected from sneezing and coughing or through touching the infected surfaces. The further spread of the disease on the international level took place during the trip of refugees from Malaysia to the United States.
Risk Factors
The risk factors for measles include the following. First of all, the highest measles prevalence is observed among young children who are not vaccinated or did not receive a full vaccination (World Health Organization, 2018). For the outbreak case under analysis, the lack of vaccination became the major risk factor. Moreover, the origin of the infected individuals was important because measles is more spread in developing countries, in Africa and Asia in particular, and both Burma and Malaysia are located in Asia. Moreover, Burma is one of the poorest countries in the Asian region, which could contribute to the disease outbreak because low income per capita and poor healthcare infrastructure are also the risk factors for infectious diseases including measles.
How Outbreak Can Affect a Community
An outbreak of measles can have a negative effect on the community. My community, which is Saint Paul, Minnesota, is at high risk of this event. Thus, for the first half a year in 2017, there were 73 confirmed cases of measles in Minnesota compared to 70 across the United States in 2016 (Howard, 2017). In case of a more serious outbreak of measles, the whole community will be affected. First of all, all the community members who are not vaccinated will be at high risk of getting infected. Moreover, children under five years and adults older than 20 can experience serious complications. In case of a serious outbreak, the healthcare facilities will be overloaded with patients with measles thus leaving less space and time for other patients. Secondly, the community members can experience panic because the disease is easily spread and its consequences are not always predictable. Finally, the economic aspect should be considered. In case of a severe measles outbreak, the expenses on treatment will rapidly increase as well as the demand for vaccination. Moreover, there will be a need for financial support of the measles cases investigation throughout the community, which is time- and cost-consuming.
Reporting Protocol
On the national level, the confirmed cases of measles should be reported to corresponding authorities within 24 hours. In Saint Paul, the generally accepted rules for reporting communicable diseases in Minnesota are applied. The reporting protocol of the community defines persons required to report the disease. Thus, health care practitioners, health care facilities, medical laboratories, veterinarians, and veterinary medical laboratories are expected to report every case of communicable disease (“Minnesota administrative rules,” 2017). The protocol demands reporting the cases attended by health care practitioners, suspected cases, carriers, cases of death from any communicable diseases. Moreover, there are rules determining the urgency of reporting. For example, cases of botulism, brucellosis, cholera, measles, meningococcal disease, and other diseases (the list of 61 diseases is accepted) should be reported immediately by telephone to the commissioner (“Minnesota administrative rules,” 2017). Also, the clinical materials of the reported cases should be submitted.
Prevention Strategies
For every communicable disease, prevention is preferable to treatment. Prevention is usually cheaper than treatment and does not harm the health of a person. In the case of measles, the best prevention strategy which has proved effective is vaccination. This strategy combines routine vaccination as well as mass immunization in the regions with a high prevalence of this disease and high death rates (World Health Organization, 2018). Vaccination is provided with the help of two vaccines, MMR (measles, mumps, and rubella), and MMRV (measles, mumps, rubella, and varicella) (Gastanaduy et al., 2018). There is no single-components measles vaccine in the United States. Routine vaccination for measles prevention in children includes two doses of MMR vaccine. For adults exposed to a higher risk of getting this infection, two doses of MMR vaccine are used as well (Gastanaduy et al., 2018). The category of high-risk adults includes international travelers, students, and health care professionals. Another intervention that can be effective to prevent a measles outbreak, is the use of social media campaigns aimed at informing the community about the symptoms of the disease, focusing on the necessity to consults a physician in case of measles is suspected. Moreover, this intervention should attract the attention of international travelers who visit countries with a high risk of a measles outbreak and stimulate their vaccination.
Prevention is crucial for measles because another outbreak negatively affects many aspects of the community life. For example, schools are likely to suffer from a measles outbreak because children make the most vulnerable population group. Moreover, due to intensive communication within schools, the distribution of viruses will be fast. Consequently, the educational process will be interrupted in case there are many infected children. Local governments will be influenced in case of an outbreak as well. There will be an urgent need to prevent the spread of the disease and not to let a national-level outbreak. Also, local governments can be blamed for ineffective prevention and immunization work. What is more, businesses can face a negative impact of a measles outbreak, and the entertainment sphere in particular. The risk of epidemic makes people stay home thus creating unfavorable conditions for some businesses in the area. Finally, hospitals would feel the outcomes of the measles outbreak due to the increased workload and the necessity to control the epidemiologic situation in the area as well as report the new confirmed cases.
References
Gastanaduy, P. A., Redd, S. B., Clemmons, N. S., Lee, A. D., Hickman, C. J., Rota, P. A., & Patel, M. (2018). Chapter 7: Measles. Web.
Howard, J. (2017). Minnesota measles outbreak exceeds last year’s nationwide numbers.CNN Health. Web.
Minnesota administrative rules. (2017). Web.
Taylor, E. M., Burke, H., & Zhou, W. (2012). Crossing borders: One world, global health. Clinical Infectious Diseases, 55(3), v-vi.
World Health Organization. (2018). Measles. Web.