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Description of Measles Outbreak

Measles, also referred to as rubella, is a highly infectious viral disease of the respiratory system. The specific virus associated with measles is known as the paramyxovirus, which belongs to genus morbilliviruss (Arias, 2000). Within 4 to 6 days, patients present with cough, conjunctivitis, itchy rash, and anorexia. The infection is highly contagious and is transmitted when one comes in contact with secretions of an infected person or when stays close to a sneezing or coughing patient.

Infection of measles occurs all over the world. Major outbreaks of measles are experienced in either two to three cycles every year. Outbreaks mainly occur in winter and spring, while small scale outbreaks are experienced during the off-year. However, the outbreaks are rarely experienced in babies of about eight mothers due to congenital immunity. Being an extremely contagious disease, outbreaks of measles mainly occur in areas with dense population and low vaccination coverage.



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Epidemiological Indicator of Measles

Primary epidemiologic indicators of measles are prevalence and incidence. Prevalence of measles refers to the approximated population that is managing measles at a given period. Incidence of measles refers to the yearly rate of diagnosis and the number of cases diagnosed (Ward et al, 2012). Incidence of measles is very low in countries and areas where there is high vaccination coverage. Globally, it is approximated that 20 million cases and 164000 deaths occur every year.

There are various epidemiological indicators of measles such as rate of morbidity and mortality. The level of case fatality within an affected population is another indictor. It is perceived that case fatality is high when it occurs above five percent in a given population. The amount of vaccination coverage within a population serves as another epidemiologic indicator. This is particularly so in children below the age of five years. Other indicators include vaccination campaign surveillance and security.

Analysis of Epidemiological Data of Measles

In 2011, deaths resulting from measles were estimated to be 164000. In developed countries mortality was estimated to be one 1 out of 1000. On the other hand, mortality was estimated to be 10 percent in sub-Saharan Africa. However, a portion of patients with complication mortality rose to about 20 to 30 percent. Consequently, about 400 people die every day due to measles.

According to WHO, measles vaccine helps reduce childhood mortality. Worldwide, the number of deaths due to measles has declined from 873000 deaths to 34500 from the year 1999 to 2005 respectively. This decline was attributed to vaccination programs that were put in place by American Red Cross, CDC, UNICEF, measles initiative, and the WHO. By the year 2008, the number of deaths had reduced to 16400. In 2005, delegates at the world health assembly set a global target to reduce measles by 95 percent by the year 2015.

Route of Transmission of Measles

Being a respiratory infection, measles is transmitted via the respiratory route. Transmission occurs when one comes in contact with secretions from the nose or mouth of an infected person (Griffin & Old Stone, 2009). One may come in contact with these fluids directly, for instance when kissing, or indirectly via aerosol, when next to a sneezing patient. One is most likely to transmit this infection when sharing living space with an individual without immunity.

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Patients with measles have fever, red eyes, running nose, and cough. Running nose and coughing are the most critical symptoms that elevate the rate of transmission. Other symptoms associated with measles include erythematous or maculopapular and rash. Therefore, measles is transmitted through the respiratory route, and this occurs from the inhalation of the fluid containing the virus through the nose, which is an external link of the respiratory system to the environment. Secondly, transition can occur via the oral route, where the virus finds its way into the respiratory system.Below is a graphical representation of the outbreak’s international pattern of the movement or possible movement:

Effects of Measles to the Community

Presence of measles in the community has several negative effects associated with it. For instance, measles can result in death. This is one of the limiting factors to community development because communities have lost vital and skilled personnel that would take part in the development of a community. Secondly, measles has imposed a strain on local limited funds. Management and eradication of measles has been associated with high costs. This has undermined the improvement of community status. High costs incurred due to vaccination and associated campaigns, research, and medication led to a decline in resources that would have been used to improve community's infrastructure development.

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Measles has also affected other important programs in the community such as education. A lot of students and teaching personnel have been affected by measles. Moreover, agriculture and other economic activities have been affected since labor and fund have been diverted to combating measles rather promoting development programs in the community.

A) Protocol of Reporting Possible SARS Outbreak

The protocol of reporting severe Acute Respiratory Syndrome is based on the level of action globally. The protocols are classified into two: absence of global transmission of SARS Corona virus and presence of global transmission of SARS Corona virus (Gootnick  & Heinrich, 2010). Health providers required to promptly report any probable cases of SARS to the local department of health.

In case of absence of worldwide transmission of the SARS Corona virus. Health provider needs to ask patients to undertake hospital admission. This should happen especially with patients having a radiographic evidence of either pneumonia or acute respiratory distress syndrome of unidentified cause that is linked to recent travel, occupation history, or contact with a recently ill person with pneumonia diagnosis. The health service provider should immediately report any patient that meets these clinical and epidemiological conditions to the local health department (Gootnick & Heinrich, 2010).

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When there is presence of worldwide transmission of SARS Corona virus,  health providers need to take history for patients with clinical symptoms such as fever or respiratory syndrome. These should include recent travels and exposure to any person with SARS. The health provider needs to immediately report any patient having these symptoms to the local health department.

When reporting patients that meet the SARS reporting criteria to the local health department, health providers should do so immediately by phone. Consequently, providers should implement mechanisms and regular contacts with both state and local health department. They should also report to health departments in case of SARS activity and information of exposed visitors. Providers are supposed to develop a plan of daily updates of SARS activity in the community to the local health department. The plan should include flow and release of data connected to SARS Corona virus spread in the health facility or patient care.

B) Discuss how You would Modify the Care to Address the Increased Risk due to Poor Quality Air Index

Air quality index is referred to the national uniform index for reporting and forecasting daily quality of air (Harver, 2010). In case of poor air quality, index patients should be provided with allergy masks whenever they are doing outdoor chores. Allergy masks limit the level of exposure to allergens. Secondly, patients should be advised to breathe properly and stay hydrated. Patients need to try breathing through the nose and not the mouth to ensure proper filtration, thermoregulation, and hydration of air (Harver, 2010). The health provider should instruct and ensure that patients keep their medication such as Advair or Flovent at hand. They should have their inhaler next o them in case of an asthmatic attack.

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Healthcare workers should try and ensure that their patients remain indoors on the ozone alert days. They should be advised to avoid strenuous outdoor activities during these days. They need to keep their windows closed so as to avoid exposure to smog. Patients should be provided with air quality index and also encouraged to regularly check their air quality index by checking the website of environment and climate change. Patients should also be assisted to understand that modification of their behavior can help minimize exposure to allergens.


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