Question 1
Description of the outbreak
Measles, a viral disease, has been established to be highly contagious mainly characterized by body rashes. The causative agent responsible for measles infects the mucous membrane then spreads out to other parts of the body. The condition can, however, be prevented by the use of vaccination. It is characterized by particular symptoms which include a runny nose, high fever, red eyes and coughs (WHO, 2016). The body rashes that usually develop on an individual who has contracted this disease begin with the head then move downwards to the body. The rashes usually appear after four days. It is essential that the condition is managed well since the complications which come out of this infection may have dire consequences for the patient.
The most pronounced complications are pneumonia, ear infections, severe diarrhea, the swelling of the brain and death in the worst case scenario. In most cases, this inflammation of the brain may require the patient to be hospitalized. These complications are more pronounced in children under the age of five years and adults who are above the age of twenty years compared to other members of the population (WHO, 2016). Diagnosing the condition is, however, a challenge because its trademark rashes usually appear after four days of infection. Also, the disease is highly contagious which means controlling it is quite a challenge. The mode of transmission of the condition is through making contact with an individual who is harboring the disease either through sneezing or coughing. The communicability period of the illness is eight days. The viruses usually remain viable in a particular location two hours after a measles patient has made contact with such a surface.
The outbreak that this paper will concentrate on is the California measles outbreak which lasted from December 2014 to February 2015. An unvaccinated eleven-year-old child was hospitalized on January 5th, 2015 with characteristic measles rashes. The rashes had first appeared on the boy on December 28th, 2014. His infection is likely to have been gotten from a visit to the Disney Land theme park in Orange County (CDC, 2015). The California department of health reported an additional four cases of the condition from persons who had visited the park between December 17th and 20th 2014. The cases had risen to 7 by January 2015 in California. 125 cases of the condition had been reported in the United States by February 11th of 2015, 110 of which were California residents. Out of the 110 patients reported to have contracted the disease in California, 39 of them had visited the Disney theme parks within the period that was deemed dangerous.
Thirty-four cases were established to have been caused by secondary causes which in this case were either through household contact or in a community setting. In addition to these two, 37 of the California cases were reported to have been caused by an unknown exposure. The other states where the condition spread to include Nebraska, Arizona, Oregon, Alaska, Washington, and Utah. This spread happened from December 17th, 2014 to February 28th, 2015 (CDC, 2015). 45% of the population diagnosed with the condition in California was established not to have been vaccinated against the condition. Five of them had received an earlier dosage of the vaccine while eight had received two. 47 patients had their vaccination status undocumented. Twelve infants had not attained the vaccination age in the infected population. In the unvaccinated group, twenty-eight of them were against vaccination due to personal beliefs while one had other prevention arrangements (CDC, 2015). The strain of the measles infection detected from the Disney land outbreak was measles genotype B3, which had also been reported in 14 other countries the Philippines being one of them.
Question 2
Epidemiological determinants
Route of transmission
Measles is a highly contagious condition based on the realization that it lives either in the throat, nose or mouth of the patient. The viruses are usually spread in the form of droplets when an already infected individual either coughs or sneezes. Studies have established that the virus can stay suspended in the air for up to two hours after an affected person has sneezed or coughed. Healthy individuals can be affected by the condition if they inhale the contaminated air or make contact with the surfaces which have been infected (CDC, 2016). The body parts through which the infection will enter the body include the nose, the eyes, and the mouth. The severity of this illness is such that in case one individual is affected by it in a particular locality, the chances are that close to ninety percent of persons who surround them will also be affected by it. The transmission period is eight days after an individual gets infected by the disease. In places where the condition has been satisfactorily contained, the disease can be spread by sick persons traveling to such territories.
Risk factors
The first risk factor related to the condition is being unvaccinated. As such, young infants carry the greatest danger as far as the contracting the condition is concerned. This group of persons is exposed to many complications including death. Additionally, an individual who is non-immune is also under the risk of developing the condition. Unvaccinated pregnant women also carry the danger of developing the condition which may also be passed down to their children (WHO, 2016). Secondly, traveling to countries where there is an outbreak of the condition also exposes one to the dangers of the condition. Thirdly, if an individual is deficient in vitamin A, they are likely to get affected by the condition. It has also been established that majority of measles complications have been reported in countries with poor health infrastructure and also low per capita income.
Question 3
According to the Forbes magazine, it is reported that the 2011 measles outbreak was responsible for an estimated treatment cost of between 2.7 to 5.3 million US Dollars (McGrady, 2015). These costs were directed at public health systems only. As such, the economic implications that such an outbreak has are enormous. Families and businesses also bear the brunt of such costs in most cases. To students, being infected with the condition means that they are will lose a lot of class hours making them lag behind regarding their academics (McGrady, 2015). Additionally, a student that has been affected by the condition will have to stay quarantined to prevent them from spreading the condition to others. Such a factor may have psychological impacts on the affected student. Public transport systems will also be affected by precautionary measures will be taken to avoid the spread of the condition to healthy persons. Hospitals also bear the brunt of taking care of the costs since a particular hospital has to trace and assess the condition if a patient is admitted to the emergency room.
Question 4
Protocol for reporting
According to the California code of regulations, healthcare providers who have got knowledge concerning parasitic and infectious diseases are obliged to report the facts of the disease to the local department of health by telephone (Orange County Public Health, 2015). Faster reporting of such diseases allows for faster epidemiological investigation of the condition. As such, there is the need for developing proper procedures which will be used in reporting the condition to the stakeholders responsible for ensuring the health of the locals. The methods that I will use to communicate the information will include making a call to the head of the California Department of health informing him of the condition. To schools and the community as a whole, I will create flyers, posters, and brochures which will be vital in passing the information around to ensure that then the condition is well contained.
Question 5
Prevention strategies
Keeping the condition at check plays a significant role in ensuring that the populations are prevented from any undesirable outcomes if an outbreak occurs. In this direction, therefore, I will organize for community and public sensitization programs which will play the role of educating people about how well to prevent the spread of the condition. These meet ups will see educational forums mainly focusing on mass immunizations for individuals who have not been given the right vaccination (WHO, 2016). Additionally, members of the public will be educated on the need for keeping a safe distance from an already infected individual to avoid making contact with them. These strategies are aimed at preventing the spread of the condition and in extension, eliminating the chances of any imminent outbreak.
References
CDC. (2015). Measles Outbreak — California, December 2014–February 2015. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a5.htm
CDC. (2016). Measles | Transmission | CDC. Retrieved from http://www.cdc.gov/measles/about/transmission.html
McGrady, V. (2015). Measles Outbreaks Cost Taxpayers Millions. Retrieved from http://www.forbes.com/sites/vanessamcgrady/2015/02/06/measles1/#5d236e3f3b0e
Orange County Public Health. (2015). Orange County, California - Reportable Disease Information. Retrieved from http://ochealthinfo.com/phs/about/dcepi/epi/physprov/report
WHO. (2016). WHO | Measles. Retrieved from http://www.who.int/mediacentre/factsheets/fs286/en/
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