Epidemiology-Measles
Epidemiology enables various stakeholders to obtain detailed information about various health conditions. It is dependent on accurate and unbiased data. Epidemiological data provide pertinent information about the distribution of cases. This paper discusses various aspects of measles. Do you need help with your assignment ? Contact us at eminencepapers.com.
The Chosen Communicable Disease
Measles is the chosen disease. This disease is caused by the measles virus (Misin et al., 2020). This is a ribonucleic acid virus whose genus and family are Morbillivirus and Paramyxoviridae, respectively (Misin et al., 2020). The disease is mainly transmitted via respiratory droplets (Misin et al., 2020). Individuals can also contract the disease by coming in contact with contaminated surfaces. Various factors predispose individuals to measles. They include recent travel to endemic areas and immunocompromised children (Misin et al., 2020). Cancer HIV/AIDS, and corticosteroids lower children’s immunity and increase the risk of measles (Misin et al., 2020). Furthermore, the severe form of the disease has been attributed to factors such as malnutrition, pregnancy, and nutritional deficiencies such as inadequate vitamin A (Misin et al., 2020).
Griffin (2020) reports that measles has an incubation period of approximately seven to fourteen days. Prodromal manifestations of the disease occur within two to four days (Griffin, 2020). Prodrome signs and symptoms include fever, loss of appetite, malaise, and coryza (Griffin, 2020). The other early manifestations include conjunctivitis, photophobia, coughing, and koplik spots (Griffin, 2020). Koplik spots are succeeded by the characteristic measles rash. This rash is characterized by macules and papules and lasts between five and six days (Griffin, 2020). This characteristic rash starts from the hairline and spreads to the face and neck (Griffin, 2020). The rash then spreads to other body parts. Measles-related complications occur because the virus compromises patients’ immunity. Common complications include pneumonia, pericarditis, pleural effusion, hepatitis, otitis media, hypocalcemia, encephalitis, and hepatosplenomegaly (Lo Vecchio et al., 2020). These complications are common in patients below five years and those above twenty years (Griffin, 2020).
The diagnosis of measles is dependent on the presenting signs and symptoms and laboratory tests. Examples of relevant laboratory tests include reverse transcriptase polymerase chain reaction to detect ribonucleic acid, antibody assays, and culture (Misin et al., 2020). Furthermore, chest radiography and lumbar puncture can detect complications associated with the disease (Griffin, 2020).
Various approaches can be adopted in the management of measles. Firstly, patients should receive comprehensive supportive care. In this context, patients are managed based on their manifestations and the presence of complications. For example, antipyretics are administered to manage fever, whereas antibiotics are administered to manage complications such as otitis media (Misin et al., 2020). Secondly, vitamin A should be administered because it reduces the morbidity and mortality rates associated with the disease by about 50 percent (Misin et al., 2020). Thirdly, patients who are not vaccinated should receive post-exposure prophylaxis. Fourthly, antiviral agents such as ribavirin can be used. However, these agents are not FDA-approved (Misin et al., 2020). Fifthly, immunoglobulins improve the prognosis of the disease in pregnant women, those with compromised immunity, and patients aged below one year (Griffin, 2020).
WHO (2019) reports that approximately 140,000 measles-related mortalities were recorded in 2018. Vaccination reduced mortalities recorded over the past two decades by about 73 percent (WHO, 2019). The pre-measles vaccine era was characterized by frequent epidemics that resulted in about 2.5 million mortalities annually (WHO, 2019). In the USA, the highest incidence over the past decade was recorded in 2019 (about 1270 cases) and 2014 (about 660 cases) (CDC, 2022). The number of cases reported in 2022, 2021, 2020, and 2018 is approximately 33, 48, 12, and 374, respectively (CDC, 2022). As such, the lowest disease incidence recorded over the past decade was reported in 2020. The high incidence in 2014 and 2019 is attributed to an unvaccinated population and recent travel to endemic areas.
Measles is a reportable disease. In the USA, immediate case reporting should be made to the CDC. Case reports should fulfill CDC’s criteria. The patient should have a rash that has persisted for at least three days, have a fever of at least 101oF, and present with conjunctivitis or cough (CDC, 2019). Additionally, rearing is categorized as suspected cases, probable cases, and confirmed cases. Suspected cases present with fever and rash (CDC, 2019). Probable cases fulfill the aforementioned CDC criteria but haven’t undergone any serological tests (CDC, 2019). Confirmed cases fulfilled CDC’s criteria and have been validated by a laboratory test (CDC, 2019).
Social Determinants of Health (SDOH)
According to Healthy People 2030, SDOHs are classified broadly into five categories. Firstly, economic stability enables people to access quality healthcare services, adequate nutrition, and proper housing (Health.gov, n.d.). Individuals with low socioeconomic status are unlikely to access quality healthcare services. Secondly, access to quality education equips people with relevant information regarding healthy living, health prevention, and promotion (Health.gov, n.d.). Thirdly, access to quality healthcare services allows people to get the best treatment options hence better outcomes (Health.gov, n.d.). Individuals who cannot access quality healthcare services are likely to have poorly managed conditions and low quality of life. Fourthly, the neighborhood and environment impact health by determining the quality of water, and air and the risk of violence (Health.gov, n.d.). Fifthly, social and communal factors impact health. In this context, a society and community that offers social support and adopts a nondiscriminatory approach improves an individual’s quality of life (Health.gov, n.d.).
SDOH impacts the development of measles. Regarding economic stability, people with low socioeconomic status cannot afford quality healthcare services. Lack of quality healthcare can worsen and prognosis of measles and increase the risk of complications (Griffin, 2020). Regarding access to quality education, healthcare providers should educate patients and the public about measles. Quality education will equip patients with key information about measles to facilitate prompt case reporting and timely access to healthcare services.
Consistently, regarding access to quality healthcare, timely and quality healthcare improves the prognosis of the disease (Lo Vecchio et al., 2020). As such, the risk of measles-associated complications is reduced, and better patient safety is achieved. Regarding social and communal factors, individuals from marginalized areas are likely to be discriminated against and lack social support groups. This population is at a high risk of having poorly managed measles and developing complications.
The Epidemiologic Triangle
Findings indicate that human beings are the natural reservoirs of measles. The disease is mainly transmitted via respiratory droplets produced by a cough or a sneeze (Misin et al., 2020). The disease can affect individuals across all lifetimes. However, it is common among children who are not vaccinated and those who are immunocompromised (Misin et al., 2020). The disease does not have an ethnic predilection. Additionally, it affects both males and females. As aforementioned, in the USA, the highest incidence over the past decade was recorded in 2019 (about 1270 cases) and 2014 (about 660 cases) (CDC, 2022). The number of cases reported in 2022, 2021, 2020, and 2018 is approximately 33, 48, 12, and 374, respectively (CDC, 2022). As such, the lowest disease incidence recorded over the past decade was reported in 2020. Furthermore, findings from the WHO indicate that approximately 140,000 measles-related mortalities were recorded in 2018 (WHO, 2019). The pre-measles vaccine era was characterized by frequent epidemics that resulted in about 2.5 million mortalities annually (WHO, 2019).
The measles virus causes measles a ribonucleic acid virus whose genus and families are Morbillivirus and Paramyxoviridae, respectively (Misin et al., 2020). The virus has an incubation period of between seven and fourteen weeks (Misin et al., 2020). Furthermore, its prodrome develops within two to four days after infection (Misin et al., 2020). Poorly managed measles increases the risk of complications.
Various environmental factors affect the development of measles. Notably, the SDOH impacts the development of measles. As stated earlier, people with a low socioeconomic status cannot afford quality healthcare services (Health.gov, n.d.). Lack of quality healthcare can worsen and prognosis of measles and increase the risk of complications. Furthermore, a low socioeconomic status increases the risk of malnutrition, a key risk factor for developing the severe form of the disease (Misin et al., 2020). Quality education will equip patients with key information about measles to facilitate prompt case reporting and timely access to healthcare services. Additionally, timely and quality healthcare improves the prognosis of the disease and lowers the risk of complications (Griffin, 2020).
Role of the Community Health Nurse (CHN)
CHNs provide healthcare services for diverse members of the community. They play a significant role in the timely identification of healthcare problems of concern and in providing cost-effective services to patients (EveryNurse.org, 2022). To accomplish this, CHNs formulate evidence-based care plans for the target population (EveryNurse.org, 2022). In the context of measles, CHNs play various roles. Firstly, they are involved in case finding. They achieve this by conducting regular health assessments and screening of the public. Secondly, they are involved in case reporting. This is done based on CDC’s criteria. As such, they report the cases as suspected, probable, or confirmed. Thirdly, they perform data collection and analysis. Data collection is dependent on case findings and case reports. They collect data on the incidence and prevalence of measles, the risk factors, and the response to treatment. Afterward, they analyze the data and disseminate the findings to the community and other stakeholders. CHNs are also involved in patient follow-up. In this context, they monitor patients’ progress and provide pertinent education. Follow-up enables them to evaluate the prognosis of the disease.
Demographic data impacts the community’s health. Regarding measles, relevant demographic data addresses aspects such as incidence, prevalence, morbidity, and mortality rates. This data forms the basis for community education and the formulation of evidence-based strategies for preventing the transmission of measles. For example, an increase in the prevalence of measles can be attributed to an increase in the unvaccinated population or travel to endemic areas (CDC, 2022). As such, the community is educated on the importance of vaccination and protective measures when they visit endemic areas (CDC, 2022).
National Agency or Organization
The Pan American Health Organization is an example of an organization involved in the management and prevention of measles. The organization serves various countries in North America and South America (PAHO.org, n.d.). The organization has formulated three objectives to address measles. Firstly, it aims to achieve a national 90 percent vaccination rate and at least an 80 percent vaccination rate in every state or district (PAHO.org, n.d.). Secondly, it aims to minimize annual cases to about five incidences in every one million people (PAHO.org, n.d.). Thirdly, it aims at lowering the mortality rate by about 95 percent (PAHO.org, n.d.). The organization is also involved in surveillance and public education.
CDC is the other agency involved in the management and prevention of measles. The CDC allows healthcare practitioners to perform case reporting (CDC, 2019). Additionally, it has developed elaborate criteria to enable the healthcare provider to define various cases. The CDC also provides a surveillance manual for all stakeholders involved in the management of measles (CDC, 2019). This surveillance manual equips healthcare providers and the public with pertinent information about measles. This enables them to manage and prevent diseases effectively.
Global Implication
Globally, measles is prevented via vaccination. Findings indicate that vaccination prevented approximately 23 million mortalities globally (WHO, 2019). Furthermore, vaccination reduced global mortality by approximately 73 percent over the past two decades (WHO, 2019). Data from 2018 demonstrates that approximately 140,000 measles-related mortalities were recorded globally (WHO, 2019). Measles is endemic to various countries in Africa and Asia. Data from 2022 indicates that the highest incidence of the disease has been reported in Nigeria (about 9,300 cases), India (about 9,000 cases), Liberia (about 4800 cases), and Ethiopia (about 3, 400 cases) respectively (CDC, 2022-b). The other countries with significant cases of measles include Pakistan (about 3,000 cases), Afghanistan (about 2,900 cases), DR Congo (about 1,500 cases), and Cameroon (about 1,400 cases) (CDC, 2022-b). All stakeholders should emphasize vaccination to reduce the global prevalence and incidence of measles. Additionally, all countries should adopt a comprehensive surveillance system to detect and report measles cases.
Conclusion
Measles is a viral disease caused by the measles virus. It is mainly transmitted via respiratory droplets produced via a cough or a sneeze. Individuals can also contract the disease by coming in contact with contaminated surfaces. The prodrome of the disease lasts between two to four days. Examples of SDOH that impact the management of measles include access to healthcare and economic stability. CHNs play a key role in the management and prevention of measles. The Pan American Health Organization and the CDC are examples of organizations involved in the management of measles.
References
CDC. (2019). Chapter 7: Measles. https://www.cdc.gov/vaccines/pubs/surv-manual/chpt07-measles.html
CDC. (2022-a). Measles Cases and Outbreaks. https://www.cdc.gov/measles/cases-outbreaks.html
CDC. (2022-b). Global Measles Outbreaks. https://www.cdc.gov/globalhealth/measles/data/global-measles-outbreaks.html
EveryNurse.org. (2022). Community Health Nurse. https://everynurse.org/careers/community-health-nurse/
Griffin, D. E. (2020). Measles virus persistence and its consequences. Current Opinion in Virology, 41, 46–51. https://doi.org/10.1016/j.coviro.2020.03.003
Lo Vecchio, A., Krzysztofiak, A., Montagnani, C., Valentini, P., Rossi, N., Garazzino, S., Raffaldi, I., Di Gangi, M., Esposito, S., Vecchi, B., Melzi, M. L., Lanari, M., Zavarise, G., Bosis, S., Valenzise, M., Cazzato, S., Sacco, M., Govoni, M. R., Mozzo, E., … Galli, L. (2020). Complications and risk factors for severe outcome in children with measles. Archives of Disease in Childhood, 105(9), 896–899. https://doi.org/10.1136/archdischild-2018-315290
Misin, A., Antonello, R. M., Di Bella, S., Campisciano, G., Zanotta, N., Giacobbe, D. R., Comar, M., & Luzzati, R. (2020). Measles: An overview of a re-emerging disease in children and immunocompromised patients. Microorganisms, 8(2), 1–16. https://doi.org/10.3390/microorganisms8020276
PAHO. (n.d.). Measles. https://www.paho.org/en/topics/measles
WHO. (2019). Measles. https://www.who.int/news-room/fact-sheets/detail/measles
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Question 
Assessment Description
Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.
Epidemiology-Measles
Communicable Disease Selection
Chickenpox
Tuberculosis
Influenza
Mononucleosis
Hepatitis B
HIV
Ebola
Measles
Polio
Influenza
Epidemiology Paper Requirements
Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
Describe the social determinants of health and explain how those factors contribute to the development of this disease.
Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?
Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.
Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.
A minimum of three peer-reviewed or professional references is required.