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Public Health Problem

Measles is said to be one of the most contagious viral disease in the world. This condition is spread by the measles virus, as infections start in the lungs and spread to the lymphatic cells in the body. Measles is an airborne disease, spreading through the sneezes and coughs of people. When this virus is in the air and atmosphere, it can survive at least one hour, infecting more people that come into contact with the contagious droplets of the virus 1. Measles express similar flu-like symptoms like cough, fever, headaches, as well as rashes. Although symptoms may seem common, if measles is left untreated or the infection escalates in the body, the patient can suffer from bronchitis, pneumonia (infection of the lungs) and encephalitis (swelling of the brain) 1. These conditions can lead to death or have a permanent effect on the body, such as brain damage, mental retardation or prolonging lung issues. Parties that are prone to measles include young children, the unvaccinated, travelers and those who cannot become vaccinated – children under one year old, pregnant women and people with immunocompromised conditions 3. Those who are immunocompromised have an impaired or weakened immune, such as people diagnosed with HIV/AIDS or cancer. Measles is to be seen as a global issue, not one that affects a certain community or certain parts of the world. Even though one country may have lower rates of the measles disease, immigration and traveling are factors that can change these rates in an instant. The United States is a country built on immigration and as people pour into this country, they may carry the measles virus with them from another country and infecting people when they arrive. Travelers who visit other countries for vacation can unknowingly become infected with the measles virus, and bring it back to the United States when they return. In common cases, most of the people infected are those who are unvaccinated. When there is a large community of people that are unvaccinated and become infected with measles, there is a greater chance of creating a measles outbreak.

How the Solve the Public Health Problem

The most common and well-known way to combat measles is with the MMR vaccine. It is recommended that children get the vaccine at two doses, once between 12 – 15 months of age and the second dose at 4-6 years old 1. According to a research, the effectiveness of one dose of the MMR vaccine is 95%, and for two doses it is 98% 2. The statistics show that vaccinations are an effective form of prevention and protection against the measles virus. However, according to data collected by the Center for Disease Control and Prevention (CDC), there were reports of 86 measles cases, in which 56% of the personnels involved were unvaccinated. Because of the measles outbreak at Disneyland in 2015, a bill is introduced to control the spread of measles and prevent such a big outbreak from recurring. The new bill, SB 277, states that it is necessary for all children to become immunized against various diseases which included measles, before enrolling in school or an educational organization 1. However, parents can still choose to not vaccinate their children based on personal beliefs or health conditions, if the paperwork is submitted to the government.
On February 6, 1981, a pediatric office in DeKalb County, GA was met with a measles outbreak, beginning with an infected 12 year old boy that is vaccinated against measles. Seven other children were exposed to measles due to being in the office during the same time frame or just a few hours after the boy left. However, he was only given one dose and hasn’t received the second dose of the MMR vaccine. When he visited the pediatric office, he was already showing symptoms such as coughing and rashes all over his body. He was administered for hospital care until recovery. The other seven children affected were tested for the disease and admitted to the hospital to be taken care of 6. Another incidence of a measles outbreak happened in San Diego, California. In January 2008, an unvaccinated 7 year old returned from vacationing in Switzerland, unconscious of the fact he was infected with the measles virus. As a result, there were 839 people that were exposed to measles, including infants who were too young to be vaccinated. Out of all the cases reported, approximately 75% were intentionally unvaccinated 5. All the infected patients were placed under a 21-day quarantine, monitored closely and given a post-exposure prophylaxis (PEP) known as immunoglobulin (IG) if the infection was in a 72 hour time frame after exposure 3. This main cause of this outbreak is the unwillingness of parents to vaccinate their children, fearing possible health complications, such as autism. However, there is no research evidence of negative health consequences of the MMR vaccine. The ignorance of parents who choose to leave their children unvaccinated affects surrounding people, risking exposure to measles.

Public Health in the Future

To prevent recurrences of a measles outbreak, there should be actions taken by every government globally. As long as there is a community exposed to measles, it cannot be completely eradicated due to the constant migration of people, as people move to different countries to settle or through vacationers visiting different countries. Anyone can become infected with this measles anywhere, and when they travel around, there is high rates of exposure to the surrounding people and areas. Vaccinations are highly effective at preventing the escalation of measles and controlling the spread of this disease. Many governments and organizations promote vaccination campaigns to raise awareness to vaccines. The President of Indonesia is launching a two year campaign focused on controlling the spread of measles within children. UNICEF has partnered up with the President and together, they aim to achieve 95% vaccination coverage with the possible elimination of measles by 2020. Efforts will be put into enforcing stricter immunization implementations at schools and health facilities to vaccinate roughly 40 million children. Governments and health foundations need to constantly promote the use of vaccinations, launching programs that visit schools or public health organizations to provide vaccinations at low prices.
Back in 1978, the Department of Health, Education and Welfare started a nationwide Measles Elimination Program. Great efforts and focus were put into surveillance and treatment of this disease, all while maintaining proper levels of immunity. This program was widely promoted, receiving great cooperation from the citizens, and as a result, 26,871 annually reported cases of measles greatly decreased to 1,479 cases by 1983 4.
In my opinion, vaccinations should be widely approved and used by everyone to ensure the safety to measles exposure and infection. Although there are many people unwilling to vaccinate their children or become vaccinated themselves, it is recommended to think of everyone else that is affected by your choice. There are infants and children dying because of measles because they are too young to be vaccinated. Although it is difficult, parents should be persuaded to get rid of the stigma that vaccinations cause health complications. There should be a greater government promotion that vaccinations are healthy and required. Another prevention method includes further research on Vitamin A and its effects in young children in reducing measles morbidity. In a study conducted by the Department of Pediatrics and Child Health in Durban, South Africa, Vitamin A supplementation greatly aided children through the recovery of measles symptoms. Data shows that children treated with Vitamin A recovered more quickly from pneumonia, diarrhea and fever compared to the placebo group of children 7. It also reduces the severity and recurrences of post-measles respiratory infections, especially in the lungs 2. When focusing on studying Vitamin A, researchers can find a method to help infants that are too young to be vaccinated fight against measles. Individuals with health conditions that prevent them from being vaccinated can also receive Vitamin A supplementation after exposure to the virus to help recover more quickly and controlling the virus from escalating in the body.

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