Communicable Diseases : Measles

Epidemiology
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Background
Measles is in the elimination status in the US, but there are still cases of highly contagious diseases. Therefore, preventing and controlling measles transmission is a public health concern, with vaccination and isolation the most common preventive measures. The paper focuses on the epidemiology of measles and provides insights into the most affected demographic groups, risk factors, and how the epidemiologic triangle explains measles transmission. There is also a focus on the role of the community health nurse and the role of the CDC in preventing and monitoring the disease.  
Description and Demographic of Interest
Measles (Rubeola) is a viral infection of the Morbillivirus genus and the Paramyxoviridae family (ECDC). The disease begins with fever, and there may be a persistent cough, runny nose, sneezing, sore throat, and watery or inflamed eyes. Over time, there are Koplik spots and rash, red spots. Measles mostly affects unvaccinated children, unvaccinated pregnant women, and other susceptible populations with a high burden of morbidity and mortality. However, even vaccinated in the past but failed to develop immunity are also at high risk of measles. People born before the 1950s tend to have natural immunity against measles since it is likely they were exposed to the disease.
According to the CDC (Centers for Disease Control and Prevention) (2021), roughly one in five people who are not vaccinated in the US and get measles are hospitalized. One in 20 children with measles gets pneumonia. The CDC (2019) further highlights that in the hospitalization in one out of four of those infected, there is encephalitis (inflammation of the brain) in one out of 1,000 of those infected and mortality of 1-2 per 1,000 cases. The severity of the symptoms is mostly in children under five years and adults above 20 years. There is also a high risk of complications in immunocompromised individuals. Besides pneumonia and encephalitis, children and immunosuppressed (immunocompromised) individuals and groups are at risk of otitis media (ear infection or inflammation), obstructive laryngitis, and occasionally acute diarrhea.
Determinants of Health 
Measles is a highly contagious acute viral disease that is preventable through the measles-mumps-rubella (MMR) vaccine. Early vaccination provides long-term protection, and susceptibility in a community decreases when there are high vaccination rates. Measles prevention measures focused on vaccination have led to a dramatic worldwide decline in the number of cases reported globally, but the virus is still infectious. The measles virus is spread through coughing and sneezing, intimate personal contact, or direct contact with nasal or throat secretions from infected people. The incubation period is around 11 to 12 days from exposure to the onset of fever or other nonspecific symptoms (CDC). The transmission period varies from four days before the appearance of the rash to four days after the appearance of the Maculopapular rash.
The seasonality of respiratory viral infections such as influenza and measles tend to affect unvaccinated communities when there are outbreaks disproportionatel...