In the year 2000 measles was considered eliminated in the United States, which means it is no longer a prevalent disease in this country. According the Centers for Disease Control and Prevention (CDC) approximately 60 people each year are diagnosed with the measles. However, this year, in 2013 there were 159 cases reported from January to August. ” This is the second largest number of cases in the U.S. since measles was eliminated in 2000.” (“Centers for Disease Control,” 2013) In ¼ of these cases, the person infected with measles contracted the disease while traveling to other countries.
This year one case of measles lead to one of the largest outbreaks since 1996. “On March 13, 2013, an intentionally unvaccinated adolescent aged 17 years returned to New York City from London, United Kingdom, while infectious with measles.” (Arciuolo et al., 2013) According to Arcuiolo et al., 2013, the outbreaks were contained within two neighborhoods in Brooklyn, both Jewish orthodox communities. In over half of the cases the person was infected by a family member. 21% of the cases were in infants younger than 12 months, in which case they were too young to receive the vaccination. The rest of the people infected refused to receive their vaccinations. The outbreak lasted approximately 3 months and due to the high percentage of vaccinations among the rest of the community, the spread of the disease was limited.
The number one risk factor for contracting measles is lack of immunizations. In all cases immunizations were either refused or delayed. People at highest risk are people who are not immunized with the MMR vaccination and are traveling to another country. When traveling to other countries, it is extremely important to have up to date immunizations. People are also at high risk if they have non-immunized family members who travel and they themselves are not immunized either. In these types of circumstances it is very beneficial for the community to be educated about immunizations and plan for health services.
Route of Transmission
Measles is extremely contagious. The window when it can be spread is 4 days before and 4 days after the classic rash appears. The virus can be spread through droplets of saliva. When a person sneezes or coughs, the droplets are dispersed into the air where people can breathe them in. The droplets can also land on surfaces or objects. The virus can live up to 2 hours on these surfaces therefore, if someone were to touch the surface they could pick up the virus and infect themselves by touching their eyes or eating something without washing their hands.
Effect on Community An outbreak of measles in the local community of Lane County could be significantly dangerous to the children of this community. Only 70 percent of the children ages 2-3 years old are fully immunized. This puts not only this population of the community at risk for measles, but also older adults who have declined vaccinations. The last outbreak in the community was in 2007. There was a young man who had recently been to Japan who was the source of the outbreak. Luckily, the source was identified early and prevention of the spread of the disease was successful.
Severe acute respiratory syndrome (SARS) suddenly broke out in 2002 in China. There were over 8,000 cases total with nearly 800 deaths caused by the virus. There have not been any new cases of SARS since 2004. SARS was considered a global threat so government organization such as the CDC, created a checklist for healthcare facilities to follow if another case is discovered. It was revealed by the Centers of Disease Control and Prevention (2013) that healthcare settings were most prevalent place of contagion.
Therefore, it is important to have preparedness plan and the ability to report cases for all healthcare facilities if there is another breakout of this highly contagious and deathly virus. The CDC has created a 12 page form to complete if a SARS case is discovered. The form can be found on the CDC website. The information to be provided consists of the patient’s general background information, then moves on to clinical information such as what type of symptoms does the patient have and when the symptoms started. It also asks how severe the symptoms are and if the patient was admitted to ICU or needed mechanical ventilation. Other information required for this form is the patient’s occupation, if they have travelled recently including dates and destinations which help track the virus.
The forms also evaluate what type of testing used to determine the patient is positive for the Corona virus, including the source of the test and the specimens. As a healthcare worker, if you suspect that a patient has SARS, you would contact the CDC public response hotline number that they provide on their website. The 12 page form also provided by the CDC would be filled out and sent to the CDC contact person. In the meantime, the patient and others that had been exposed would need to put in personal protection equipment and protocols for prevention of the spread of the virus would be used.
Modification of Care
People with asthma and other respiratory diseases are more at risk during poor air quality days. One way to help alleviate symptoms and a possible admit to the emergency room or urgent care would be to stay indoors. It is important for these people to watch their local air quality and abstain from doing any outdoor activities especially any strenuous exercising. If the person must go outside, they should be instructed to use an allergy mask to help minimize the bad air they breathe in. It is also very important to keep medications on hand, especially inhalers. Inhalers should be used as prescribed. The inhalers should also be checked frequently to be certain that they are not expired and that they are working properly.
Poor air quality days are very important days not to skip or forget to take any preventative medications as well. Preventive medications will help maintain and stable baseline and hopefully ward off any impending attacks that may be caused by poor air quality. Prevention is also important indoors, particularly during bad air quality days. Keeping all window and doors closed as to keep the bad air out. Using air filters such and a hepa filter is also beneficial. Exposure to first hand or second hand smoke is a huge potential hazard for anyone with asthma or respiratory problems. Keeping a clean indoor environment by vacuuming and dusting will also help alleviate triggers.