Community/Public Health Nursing ( Epidemology paper) Health Essay

Community/Public Health Nursing Epidemiology Paper on Measles
Student’s Name
Institutional Affiliation
Community/Public Health Nursing Epidemiology on Measles
Introduction
Measles, also known as rubeola, is one of the highly contagious viral diseases globally. It often commences its pathogenic process in the respiratory system. The health systems have created elaborate response frameworks aimed at managing infectious diseases like measles. Despite the presence of a powerful control system encompassing deploying a safe and efficacious vaccine, measles continues to pose a substantial health threat globally due to significant mortalities that are associated with this disease.
Causes of Measles
Measles is one of the most contagious infectious diseases occasioned by the measles virus. This measle virus is called Measles morbillivirus (MeV). It is a single-stranded ribonucleic acid (RNA), negative-sense (negative polarity), enveloped, and non-segmented RNA virus. It belongs to the genus Morbillivirus, which falls in the family Paramyxoviridae and of the order Mononegavirales (M'garrech et al., 2012: Leung et al., 2018). The measles virus is spherically shaped, with a diameter ranging from 100 to 200 nm, and depicts pleomorphism. The non-segmented genome has about 16 000 nucleotides in length and contains six genes for eight viral proteins (Leung et al., 2018). It comprises six structural and two non-structural proteins. The six structural proteins include haemagglutinin protein, fusion protein, nucleocapsid protein, phosphoprotein, matrix protein, and large protein, where the haemagglutinin protein binds to cellular receptors, thereby allowing the virus to attach itself to host cells. The fusion protein permits fusion of the viral envelope with the host cell, plasma membranes. Such fusion allows the entry of viral ribonucleoproteins into the cytoplasm of the host cell. The two non-structural proteins, including V protein and C protein, show little role in maintaining viral structure. However, they act as virulence factors by suppressing the host’s innate immune response through their influence in limiting interferon production and encouraging viral replication (Leung et al., 2018).
Measles Mode of Transmission
Humans are the only known hosts of the measles virus. The virus is often transmitted by inhalation of virus-laden airborne droplets. Besides, the micro-particle aerosols suspended in the air, direct contact with infected secretions, and contact with contaminated fomites are some of the ways that constitute critical approaches to measles transmission (Leung et al., 2018). However, the authors note that measles infection transmission via contaminated fomites is less observed. The measles virus can survive in the air and on fomites for up to 2 hours (Leung et al., 2018). Thus, measles transmission may occur in the absence of direct contact with an infected person. Measles is a highly contagious virus residing in the nose and throat mucus of an infected person. Thus, it is frequently spread to others via coughing and sneezing. People get infected by breathing in contaminated air, touching contaminated services, and subsequently touching eyes, nostrils or mouths with such contaminated hands after getting the measles virus from a contaminated surface.
Symptoms
A spectrum of symptoms often manifests measles. The illness mostly starts with fever, runny nose, cough, and pathognomonic enanthem (Koplik spots) followed by an erythematous maculopapular rash (Leung et al., 2018). The rash typically starts on the face and presumes more confluency as it progresses cephalocaudally.
The phases of infection and disease progression in light symptoms may revolve around infection and incubation period, nonspecific signs and mild symptoms, acute illness and rash, and infectious period. The measles symptoms emerge as a result of infection and associated immunological response. The virus can enter the human body via mouth, nose, or eyes and spread to various body parts, eliciting a cascade of immunological responses after invading immune cells. Due to invasion and immunological responses, the viral particles are carried to various regions. For instance, the measles virus within the skin can cause inflammatory responses within the capillaries leading to skin rashes. Measles mostly affects young patients and evolves via four stages: incubation, invasion, eruption, and desquamation (M'garrech et al., 2012).
According to the Centers for Disease Control and Prevention (CDC), measles symptoms begin to appear about 7-14 days after infection. The CDC cites high fever, which can even exceed 104°F, dry cough, runny nose (coryza), and red, sore throat, watery eyes, or conjunctivitis, as the most critical measles-defining features or symptoms. Ophthalmic manifestations, especially conjunctivitis, though often asymptomatic, appear during the invasive and eruptive phases. Measles keratitis is the most worrying symptom due to the risk of corneal ulcer, bacterial superinfection, and corneal perforation (M'garrech et al., 2012).
During measles pathogenesis, Koplik's spots and skin rash appear. The Koplik's spots are micro-white spots marked by bluish-white centers found on red background within inner linings of the cheek in the mouth. The Koplik’s spots often emerge 2-3 days after the measles symptoms manifestation (Centers for Disease Control and Prevention). The skin rashes comprise large, flat blotches. These rashes occur 3-5 days after the appearance of symptoms where they appear as flat red spots on the face, especially at the hairline, and advance downwards towards the neck, trunk, legs, arms, and feet (Centers for Disease Control and Prevention). The small raised bumps can also emerge at the apex of flat red spots. The spots can also merge as their spread continues from the head to the rest of the body. More often, there is fever exacerbation upon the appearance of rashes. Other manifestations that can accompany measles infection include body aches, convulsions, drowsiness, confusion, hemoptysis, chest pains, sneezing, and breathing problems. Most persons infected by measles recover uneventfully after about one week of illness marked by a spectrum of symptoms comprising fever, malaise, coryza, conjunctivitis, cough, and a maculopapular rash (Paules, Marston & Fauci, 2019).
Complications associated with Measles Infection
Measles is a life-threatening disease when it is not adequately controlled.  Measles is a highly contagious viral infection with severe complications (Bester, 2016). Children less than five years and adults older than 20 years are at risk of increased measles complications due to infection (Centers for Disease Control and Prevention). The most frequent complications are observed in secondary infections linked to measles-induced immunosuppression, otitis media, pneumonia, diarrhoea, keratoconjunctivitis (Paules, Marston & Fauci, 2019). The authors observe keratoconjunctivitis can cause blindness, especially amongst the vitamin-A-deficient population.
According to the CDC, the most frequent complication associated with measles includes ear infections and diarrhoea, and severe complications revolve around pneumonia and encephalitis. Severe complications such as pneumonia and encephalitis need hospitalization to prevent death. One in 20 of the children with measles gets pneumonia, which underpins significant causes of mortality. Measle-infected children can also develop a severe complication, especially encephalitis, leading to convulsions, child deafness, and intellectual derangement. Substantial mortalities resulting from measles infections occur due to neurologic and respiratory complications. Ear infections occur in approximately 10 % of children infected with measles, and diarrhoea present in less than 10 % of patients with measles. The respiratory tract complications are many, and they can include otitis media, sensorineural hearing loss, otosclerosis, tonsillitis, sinusitis, laryngotracheobronchitis, bronchitis, and aggravation of tuberculosis (Leung et al., 2018). The authors also noted gastrointestinal complications such as gastroenteritis, gingivostomatitis, and pericoronitis. Others included mesenteric lymphadenitis, hepatitis, pancreatitis, and appendicitis.
. In about 1 in 1000, cases of measles, severe and fatal neurologic complications, including acute disseminated enc...