Epidemiology of Communicable Diseases: Measles

Epidemiology: Measles
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Introduction
Measles ranks among the most contagious communicable diseases alongside Flu, HIV, Tuberculosis, Hepatitis A and B, Ebola, and others. Measles was a major cause of high mortality rates among children and adults before 1963. Even with the introduction and licensure of the measles vaccine in 1963, measles remained a major threat, especially to children aged five and below. However, the adoption of the vaccine and distribution across the globe throughout the 1960s to early 2000 led to a significant decline in measles-related mortalities. The numbers further declined from 2000 to 2016 but slightly in 2018 and 2019. WHO reports that there were 869,770 new measles cases in 2019, the highest number of cases since 1996 and around 200,000 deaths globally. In 2020, the number of cases had slightly increased, mainly due to the disturbances caused by Covid-19 in vaccine rollout, especially in Asia and Africa. To this date, however, the measles vaccine, Measles, Mumps, Rubella (MMR), remains the most successful and effective strategy of preventing and reducing measles-related mortalities. Through the MMR vaccine, over 23.2 million deaths have been prevented between 2000-2020. This means that the measles vaccine reduced global death by approximately 73%, that is, from an estimated 536,000 deaths in 2000, the figures declined to about 142,000 deaths in 2018. As a highly infectious and contagious disease of the respiratory system, measles is attributed to a single-stranded, enveloped virus with a 1 serotype. Measles falls under the Morbillivirus class and the Paramyxoviridae family (Hashiguchi et al., 2011). Measles causes a condition called encephalitis, and its onset is marked with symptoms such as fever and rash. The only formally approved medical prevention plan as of 2021 is the MMR vaccine. Even with the rollout of vaccines across the globe, measles still contributes to over 100,000 deaths annually, the majority of whom are children aged five years and below. This paper explores the epidemiologic triangle related to measles, uncover the roles of the community health nurse, present national and global agencies working in measles reporting and surveillance, examine global implications of the disease, medical prevention, and identify familiar sources of the virus in the community.
Demographic of Interest
With the introduction of the measles vaccine, it has become scientifically clear that the majority of people recover from measles. However, one out of every four people will be hospitalized, and one out of every 1,000 will die (Patel et al., 2019). According to WHO, the measles death rate has been a decline in the last century. While there were about 630,000 deaths in 1990, the figures have drastically declined to slightly above 100,000 as of 2020. In developed nations such as US and UK, fewer than two deaths are due to measles in 1,000 people (WHO, 2011). In developing nations, especially Africa and Asia, the measles mortality rate has declined by 84% since 2000, with less than 100,000 cases recorded in these continents annually. In most cases, where mortality cases rise, the rate of vaccination is considered to be low. Outbreaks of measles have happened over the years, often hitting areas with the least vaccination rate the hardest (WHO 2021).
Signs, Symptoms, and Complications of Measles
Measles only affects human beings, and on contractions, one takes around 10 to 14 days for signs and symptoms to appear. WHO organization reports few common symptoms and normally begin between 10 to 12 days after disease exposure. Other signs and symptoms include having a running nose, running nose, conjunctivitis, high fever that can rise up to 104° Fahrenheit, cough, and small white spots that often develop inside the cheeks. Rashes erupt several days later in both the face and the upper neck. Rashes spread to other parts of the body in about three days but fade in roughly four days (Gastanaduy et al., 2018). Over 90% of measle deaths are a result of related complications and which normally affect young children the most. While measles poses serious threats to all age groups, including adults, some groups are more likely to be affected the most when exposed to the virus. These include young children below five years, adults above 20 years, pregnant women, and people living with already compromised immune systems such as those suffering from diseases such as HIV/AIDS and leukemia. When exposed to the virus, these groups of people are more likely to develop complications which range from encephalitis (brain swelling), severe respiratory infection (pneumonia), severe diarrhea, blindness, encephalitis, and dehydration. WHO reports that 1 out of every 20 people who get measles develops severe pneumonia. Encephalitis is not common as only 1 out of 1000 children who get measles develop brain swelling, leading to deafness or intellectual disability.
Also, there are long-term effects of measles and include the development of Subacute sclerosing panencephalitis (SSPE), a nervous system disease that leads to progressive, disabling, and deadly brain disorder. While it is a rare occurrence, its effects on an individual are fatal. Measles hardly causes brain damage, but an abnormal immune response can occur in some people, causing brain inflammation that lasts for many years. SSPE often affects mostly children who contract measles before age 2. In most cases, one can appear normal or recover only for the disease to strike later on in life. In most cases, measles affects malnourished children, especially those with poor immune systems and vitamin A deficiency. WHO reports that regions with a high rate of malnutrition and lack adequate health care facilities result in about 10% deaths in all measles reported cases (WHO 2018).
Causes, Mode of Transmission, Risk Factors, and Diagnoses of Measles
As a contagious disease, measles is caused by a virus replicating in an infected person’s nose or throat. It spreads through the air, especially when someone with measles coughs or sneezes. Coughing or sneezing releases infectious particles into the air and can be inhaled by others who then become infected (Wakefield et al., 2019). Normally, infected particles last in the air for several hours, and one can get exposed by simply touching contaminated surfaces and rubbing hands on the nose, eyes, or mouth. One has over 90% chance of contracting the virus and developing signs and symptoms a few days later on exposure.
There are many risk factors for contracting the measles virus. First, being unvaccinated is a major risk factor that causes over 70% of deaths, especially among children.  Most regions that record high mortality rates due to measles repo...