COMMUNITY ASSESSMENT TASK 2

Measles is a virus that is spread by droplets through coughing and sneezing or by contact on surfaces. People infected with measles are contagious up to four days before and after the measles rash appears. Measles is highly contagious, 9 out of 10 people that come in contact with the measles virus will contract it. The highly contagious nature of measles makes widespread infection a very real threat to those who are not vaccinated (Transmission of Measles, 2014). Measles is fatal in about one case in 1,000. As with chickenpox, once an individual has had the measles, they have lifelong immunity (Facts About the Measles Outbreak, 2015). Signs and symptoms of measles include cough, runny nose, conjunctivitis and a high fever. Koplik spots in the mouth appear two to three days after the first symptoms and the measles rash appears three to five days after the first symptoms. The fever may spike with the appearance of the rash. Symptoms will then begin to subside and the rash will slowly disappear (Signs and Symptoms, 2015).
A measles outbreak occurred in California between December 2014 and February 2015. The first patient was reported to be an unvaccinated 11-year-old who had recently visited Disney in Orange County, California. Several more cases were reported in California and in Utah. The common factor between these patients was the visit to Disney between December 17th and 20th. Between December 2014 and February 2015 there were 125 confirmed cases of measles in the United States from this outbreak. Most of the victims were California residents but there were some cases in Arizona, Colorado, Nebraska, Oregon, Utah, Washington as well as Mexico and Canada. Not all victims visited Disney, 34 were secondary victims, exposed to those exposed at Disney. The source of the exposure at Disney was never identified but specimens that were genotyped matched specimens from an outbreak that had recently occurred in the Philippines. No deaths were reported from this outbreak (Measles Outbreak, 2015).
A measles outbreak in _________ could be quite similar to the outbreak at Disney in California. A measles outbreak would be a serious concern to residents. Schools may close to prevent exposure if there has been exposure in a specific school district. Citizens may be advised to make sure that their children’s vaccinations are up to date and schools may need to verify vaccination records. Local government would need to inform residents of the risks of measles and encourage residents to be cautious in public, encourage handwashing and seek treatment for measles symptoms including fever, runny nose, conjunctivitis and of course, the measles rash (Signs and Symptoms, 2015). Hospitals would need to prepare for potential measles admissions, have staff on call if an outbreak was to become widespread and review isolation precautions and protocols with all staff. The Health Department may issue an advisory to remind parents to have their children vaccinated if they have not been vaccinated already. In the event of a measles outbreak in _________ County, businesses may suffer as people stay close to home to avoid exposure. Restaurants and the food industry would need to put a high priority on cleanliness, hand washing and safe food handling practices being that the measles virus can live up to two hours on surfaces (Facts About the Measles Outbreak, 2015).
The reporting protocol in _______________ Department of Health. When a case of measles is suspected it must be reported immediately to the __________ Department of Health by phone. Measles need only be suspected not confirmed to report immediately. As a nurse at ______________________, the protocol for reporting would be to inform the charge nurse and nursing supervisor. The nursing supervisor would report the suspected measles using the _______ Department of Health disease reporting telephone number ___________________(Infectious Disease Services, 2015). There is a protocol checklist on the _______ Department of Health website for practitioners to follow, including interviewing the patient or family members to try to determine when the exposure occurred, travel history, vaccination record, when symptoms began, and who the patient has been in contact with to determine exposure of others (Measles (Rubeola) Protocol Checklist, 2012).
The main strategy to prevent a measles outbreak in _____________________is vaccination. Vaccination rates need to be above 95% to effectively protect a community (Haberman, 2015). The ____________________ County Health Department offers free vaccination to all children. According to the Centers for Disease Control, children should be vaccinated for measles with two doses of the MMR vaccine. The first dose is recommended to be administered at 12 to 15 months old and the second dose can be given as soon as four weeks later but can be given before the start of kindergarten at age four to six (Measles Vaccination, 2013). The State of ________ School Entry Immunization Requirements for 2015-2016 follow the CDC’s recommendations, requiring one dose of MMR for Pre-K and the second dose to enter kindergarten up to 6th grade (Student Services, 2015). There is a movement of parents in the United States that are choosing not to vaccinate their children because of the feared link between vaccinations and autism. This link has since been proven to be false and can lead to disaster when children are infected with measles (Haberman, 2015).
The __________--County Health Department, community leaders, the ___________ County School District, local area hospitals, physicians and nurses must educate patients on the risks of measles, which does include the chance of death. Vaccination clinics can be held throughout the county to make vaccination convenient to all residents. Through community communication and education, all children can be vaccinated to prevent a measles as outbreak like the one that occurred in California.

References

Measles Outbreak — California, December 2014–February 2015. (2015, February 20). http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a5.htm

Measles Vaccination. (2013, February 7). http://www.cdc.gov/vaccines/vpd-vac/measles/default.htm#vacc Signs and Symptoms. (2015, February 17). http://www.cdc.gov/measles/about/signs-symptoms.html Transmission of Measles. (2015, March 31).
http://www.cdc.gov/measles/about/transmission.html