Kayla Redd, RN WGU VWT1 Student ID 339433 Task 2 The potential for global health crises is a real threat to community populations all over the world. Advancing technology and modes of travel allow populations that prior had no or little contact, now have the ability to interact. Despite the advances in technology, global health is still lacking in vaccinations and prevention of communicable diseases. Many diseases are preventable through vaccination. Vaccines, by definition, is a biological preparation that provides active acquired immunity to a particular disease . Vaccines typically are the most effective way to fight or eliminated infectious diseases. Vaccines have limitations due to various clinical factors like steroid use, chemotherapy, HIV, age or diabetes. For a vaccine to have optimal effect, a person needs to complete the scheduled vaccination regimen as well as obtain the appropriate boosters as scheduled. Vaccine efficacy is dependent on the disease, the vaccine strain, if the vaccination schedule has been adhered to, immune response to vaccination, and assorted factors such as ethnicity, age, or genetic predisposition. Some individuals are non­responders to certain vaccines, meaning that they do not generate antibodies despite being vaccinated correctly. “If a vaccinated individual does develop the disease vaccinated against, the disease is likely to be less virulent than in unvaccinated victims.” (Préziosi, 2003). There are multiple types of vaccine: inactivated, toxoid, attenuated, subunit, conjugate, experimental, valence, and heterotypic. Despite any limitations, “vaccination is ranked as one of the 10 greatest public health achievements of the last century and is the number one contribution to decreased global morbidity and mortality”. (Maldonado, 2002) Despite the scientific nature of vaccines, they continue to face opposition. Controversies over vaccine ingredients and side effects have disillusioned people to believe that vaccines might

be toxic due to incorrect internet data, celebrities, as well as misinterpreted and grossly bad science. Due to the belief that vaccines are harmful, a climate of fear has been created. The apprehension has led to decreased vaccination rates despite overwhelming scientific evidence supporting vaccine safety and their disassociation with autism, developmental disabilities or other medical disorders. According to the CDC, a person can exempt from obtaining vaccinations by medical exemption in all 50 states, religious exemption in 48 states and philosophical exemption in 19 states. On January 5, 2015, the California Department of Public Health received a report of an unvaccinated 11 year old male with the diagnosis of suspected measles. By January 7, there were seven confirmed cases of measles. The only common exposure location for all 7 confirmed cases was 2 Disney parks in California during December 17­20, 2014. The cases of measles rose to 135 cases by February 2015. Fifty­four individuals can be directly linked to the unknown person who was infected with measles that was at one or both Disney parks. The outbreak spread from California to Utah, Washington, Arizona, Colorado, Nebraska and Oregon, Mexico and Canada also had occurrences due to this outbreak. Thirty­four cases of measles were secondary infections due to exposure to sick close contacts. It is reported by the CDC that 88% of the 110 Californian patients were either unvaccinated or had unknown/undocumented vaccine status. Measles is a highly contagious airborne virus. The incubation period for measles is 7 to 21 days. Initial symptoms mimic common cold with a fever, runny nose, and cough. The characteristic flat, red rash develops on day 3­5. The incubation period for measles in 10­12 days and symptoms last 7­10 days. Measles can cause mild complications like ear infections to severe complications like brain inflammation. “Measles­related mortality is highest for infants, young children, and adults with decreased risk in older children and adolescents” (Stratton, 2012). There is no treatment for measles. Supportive care for symptoms and complications are implemented to help an individual cope until symptoms resolve. “The virus is highly

transmissible, and 90%–95% of the population must be immune to interrupt transmission” (Domínguez, 2008). The Department of Health and Environmental Services each year issues a list of reportable diseases. The diseases are classified into three categories; immediate reportable by phone, reportable by phone in 24 hours, and conditions that are to be reportable within 3 business days. According to the SCDHEC, measles is an immediate reportable disease by phone. DHEC has an extensive list of information that is required when reporting a suspicious diseases. If a person is suspected of having measles, the individual needs to be immediately placed into airborne isolation and notifications made to hospital personnel, primary doctor, infectious disease personnel, and the patient. The doctors and infection personnel will them make the notification to DHEC. A measles outbreak would affect the local school system, workforce, and community service personal by increasing absenteeism due the incubation period of the measles virus. This could decrease response time for emergency vehicles, decreased educational opportunities, and decreased revenue. An outbreak will cause local hospital to increase their airborne room and isolation areas. Nursing personnel will need to take special precautions to protect themselves and other patient populations in the hospital setting. Prevention is the number one to stop an outbreak. To prevent an outbreak, “the rate of vaccination coverage (with 2 doses of vaccine) must be maintained at >90%” (Domínguez, 2008). Hand hygiene is considered the most important way to prevent the transmission of disease. Registered nurses need to teach their patients to effectively wash their hands, maintain adequate immunizations, covering their mouth and nose when they cough and sneeze, and limiting their contact with health individual with they are sick.

 Citations Préziosi, M.; Halloran, M.E. (2003). "Effects of Pertussis Vaccination on Disease: Vaccine Efficacy in Reducing Clinical Severity" linical Infectious Diseases . C (Oxford Journals) (6): 37 772–779. : doi 10.1086/377270 . Maldonado, Y. (2002). Current Controversies in Vaccination: Vaccine Safety. JAMA: The Journal of the American Medical Association, (24), 3155­3158. 288 Measles Outbreak — California, December 2014–February 2015. (2015, February 20). Retrieved April 5, 2015, from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a5.htm?s_cid=mm6406a5_w Measles. (n.d.). Retrieved April 5, 2015, from http://en.wikipedia.org/wiki/Measles Stratton, K. (2012). 4 Measles, Mumps, and Rubella Vaccine. In Adverse effects of vaccines evidence and causality . Washington, D.C.: National Academies Press. South Carolina 2015 List of Reportable Conditions. (2015, February 1). Retrieved April 8, 2015, from http://www.scdhec.gov/Library/CR­009025.pdf Domínguez, A., Torner, N., Barrabeig, I., Rovira, A., Rius, C., Cayla, J., . . . Cabezas, C. (2008). Large Outbreak of Measles in a Community with High Vaccination Coverage: Implications for the Vaccination Schedule. Clinical Infectious Diseases, (9), 1143­1149. 47 Mathur, P. (2011). Hand hygiene: Back to the basics of infection control. The Indian Journal of Medical Research, (5), 611­611. 134