Measles is a highly contagious infection that is caused by the rubeola virus. Although elimination of the illness in the United States was declared in 2000, the country has reported several measles outbreak in recent years. According to the Centers for Disease Control and Prevention (CDC), most outbreaks result from importation of measles cases from countries where the infection is endemic (CDC, 2014a). Indeed, CDC notes that most outbreaks in the US are caused by unvaccinated Americans who travel to countries with high incidences of measles. In view of this, the current paper analyzes the 2014/2015 measles outbreak in Philippines and how this outbreak reached the US.
2014/2015 Measles Outbreak
The 2014/2015 measles outbreak in Philippines started late 2013. Immediately after the outbreak, the country’s department of health and the WHO launched a mass vaccination campaign that targeted non-vaccinated children. Despite these efforts, the outbreak became a disaster in 2014 with 58,000 cases reported – a figure that included 110 fatalities (CDC, 2015). The outbreak was officially announced to have reached the US the 29th of May, 2014 after the first case had been reported a month earlier. The first case directly connected with the outbreak in Philippines was reported in an Amish missionary who had just returned from the country. By the end of the year, 644 cases of measles had been reported in the US – the highest number since 1994.
Epidemiological Determinants of the Outbreak
At the national level, the outbreak was transmitted through interactions with infected persons while at the international level air transport was the route of transmission. Overall, vaccination was identified as a critical determinant of the outbreak. In the Philippines, regions with high numbers of unvaccinated children reported equally higher incidence rates compared to other regions. In this regard, it could be noted that children were affected by the outbreak more than other group. In the US, CDC reported that 90% of all measles cases confirmed between 01/01/2014 and 23/05/2014 were in unvaccinated people (CDC, 2014b). Travelling internationally could also be identified a risk factor involved in the outbreak. Indeed, geographical transmission of the disease to the US was facilitated by unvaccinated Americans travelling to the Philippines.
Potential Effects of the Outbreak at a Systems Level
The County of Fairfax would have been affected in a number of ways had the outbreak occurred in this community. Firstly, the outbreak would have had serious economic implications for this community especially considering the high cost of treating multiple cases. A measles outbreak might also necessitate diversion of resources from other important health priorities. This would adversely impair the efficiency with which health care facilities in this community operate. Depending on its magnitude, a measles outbreak in Fairfax may also disrupt learning in schools. Disruption of learning may result when students fail to attend school for fear of contracting the infection. Staff at hospitals and other health facilities located in Fairfax may also feel overwhelmed by the high number of patients expected during an outbreak and this may undermine quality of care. An outbreak may also limit social interactions in the community as people avoid social gatherings likely to promote spread of the disease.
Reporting Protocol during an Outbreak
In the event of a measles outbreak in Fairfax, health professionals would be required to report all new cases to the necessary departments in the involved health facility. Usually, the provider attending the affected patient would be expected to report the case to the following health officials: liaison officer, documentation officer, safety officer, and public information officer. From this point, a report would be prepared for the hospital’s operations chief who would in turn communicate the same to the local health jurisdiction as well as emergency response operations agencies operating in Fairfax. The local health jurisdiction would then notify the Virginia State Department of Health Communicable Disease Epidemiology. Overall, adherence to the reporting protocol is critical in fighting a measles outbreak. In addition to facilitating identification of new cases of measles, reporting helps to prevent spread of the outbreak through identification of populations at high risk.
Outbreak Prevention Strategies
There are several strategies that can help prevent an outbreak in the County of Fairfax. Among these strategies include measles vaccination for all unvaccinated children. With past studies indicating that vaccination has greatly reduced the global incidence of measles, this strategy could be described as among the most effective in regard to outbreak prevention. As highlighted earlier, unvaccinated persons are largely responsible for international distribution of the measles virus. Increasing the number of vaccinated people in Fairfax would therefore greatly reduce the likelihood of residents bringing the virus from other regions or countries.
Community education is an equally important prevention strategy as it provides an opportunity for improving the public’s understanding of the disease. Community education provides a platform for health officials to engage the public on the various dynamics of the disease such as symptoms and treatment plans available. Patient education can also be used to supplement community education. Among the patient education strategies to consider include traditional lectures, demonstration, and written material.
References
Centers for Disease Control and Prevention (CDC). (2015, April 10). Progress toward Measles Elimination – Philippines, 1998-2014. MMWR. Morbidity and Mortality Weekly Reports. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6413a5.htm
Centers for Disease Control and Prevention. (CDC). (2014b, May 29). Measles Cases in the United States reach 20-year High. Retrieved from http://www.cdc.gov/media/releases/2014/p0529-measles.html
Centers for Disease Control and Prevention (CDC). (2014a, June 6). Measles – United States, January 1-May 23, 2014. MMWR. Morbidity and Mortality Weekly Reports. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a4.htm?s_cid=mm6322a4_w
