Environmental and Global Health Issues Case Study

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Environmental and Global Health Issues

Environmental & Global Health Issues

Communicable disease outbreak: Measles

Until recently, it was thought that measles had been entirely eradicated in the United States, thanks to the success of the national vaccination program. According to the CDC, "measles was declared eliminated from the United States in 2000" (Measles outbreaks, 2012, CDC). However, that proud statement has been amended, as cases of measles have once again begun to reassert themselves slowly within our nation's borders. On average, every year 60 people in the United States contracts the measles. In 2011, that figure skyrocketed to 222. 40% of these cases originated outside the U.S. "They brought the disease to the United States and spread it to others. This caused 17 measles outbreaks in various U.S. communities" (Measles outbreaks, 2012, CDC). Of the countries implicated in the spread of the illness, France, Italy, Romania, Spain, and Germany were responsible for 90% of the transmissions. To be classified as a case of measles, the patient must exhibit the classic rash for three days or more, a temperature above 101F and a cough or have a laboratory confirmation of measles (McLean 2011).

Thus, there is an alarming trend as measles has reasserted itself as a communicable illness thanks to continued fears about childhood vaccinations. 86% of the patients that contracted the measles were unvaccinated or had unknown vaccination status. (A small percentage of vaccinated persons can still contract the disease). A "drop in MMR vaccination coverage in a community can increase the risk for large, sustained measles outbreaks, as experienced recently in Canada and France, or reestablishment of endemic transmission, as experienced in the United Kingdom," which means the illness no longer needs to be 'imported' from abroad to be transmitted from person to person (McLean 2011).

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The 'imported' nature of the measles outbreak can be seen in the following graphic illustration, in which there are small, concentrated pockets of import-associated measles scattered throughout the United States, without a clear trail of transmission.

Source of graphic: McLean 2011, CDC website

Measles is an extremely contagious disease and spreads rapidly from person to person. It can also be deadly, a fact often forgotten because of the successful vaccination campaign that nearly eliminated the disease in the 20th century. Worldwide, the disease causes the death of up to 200,000 persons every year out of approximately 20 million cases. It can also cause miscarriages and premature births (Measles, 2012, CDC Overview). The disease can be especially dangerous for children, leading to ear infections, pneumonia, or encephalitis. One or two children of every thousand that contracts measles die (Measles, 2012, CDC Overview). While fears about vaccinations have been shown to be largely unsubstantiated, the risks of not vaccinating are very clear. Some parents have been hoping to rely upon 'herd immunity' for their unvaccinated children but recent epidemiological trends illustrate the unwise nature of their actions.

Q2. Protocol for reporting SARS for healthcare professionals

In the event of a suspected or confirmed outbreak of SARS, all healthcare professionals should report the cases to the state or local health department. Examples of 'red flags' include "all persons requiring hospitalization for radiographically confirmed….....

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