Measles is a highly contagious childhood infection caused by virus in the paramyxovirus family and Morbillivirus genus. It has the highest mortality cases among children globally. In its first stages, it is presented by; very high fevers, cough, sore eyes, diarrhea, and vomiting. Small white spots are observed inside the cheeks. At about fourteen days after infection, a rash appears on the upper face and hands. This rash lasts for about 5 to 6 days. If left untreated, measles can result in serious complications such as; blindness, severe diarrhea and related dehydration, bronchitis and croup, and encephalitis.Measles is more common among malnourished and immune-compromised children such as children with HIV/AIDS.Unvaccinated young children and pregnant mothers are at higher risk of acquiring measles.

Epidemiological determinants

Measles is a major notifiable disease globally. Beforethe introduction of Measles, Mumps, Rubella (MMR) vaccine, mortality of children due to measles was very high. Miller (1985) states that, “between 1970 and 1983, more than half of the acute measles deaths that occurred were in previously healthy children who had not been immunized” P. 443. The MMR vaccine was introduced in October 1986 (Gay, et al. 1995, P. 140). Measles outbreak among secondary school children were experienced in England and Wales in 1993 (Ramsay, et al. 1994, P. 143). To halt transmission and reduce mortality due to measles, a two-dose MMR vaccination schedule was started. Second dose is a booster vaccine, if one is unresponsive to the first dose. According to Plotkin& Orenstein (2004), the United States started administering the two-dose schedule in 1989 and reported significant reduction in endemic transmission of measles in 2000. Strict adherence to the immunization schedule reduces prevalence of measles significantly.

Route of transmission

The Morbillivirus, that causes measles, is transmitted through respiratory droplets released into the air by cough or sneeze. It is also transmitted through direct contact with infected throat secretions. When a person inhales secretions containing the virus, it infects the oropharynx and multiplies in the respiratory epithelium. The virus then spreads to the regional lymph nodes and blood streams, spreading to other organs. The virus is shed during coughing and sneezing.

Risk factors

Risk factors for measles include; being unvaccinated, traveling internationally especially to developing countries and being vitamin A deficient.

Effect on the community

Measles being a highly contagious infection, isolation is vital to preventing the spread of infection in cases of an outbreak. Organizing quarantine in case of an outbreak interferes with school programs and community activities. When one person gets infected at the work place, measles disease will spread so fast to other employees increasing sick-offs thus reducing productivity. The local government will, therefore, have to organize campaigns for health education on measles and mass immunizations to the at-risk population.

Reporting protocol

Measles being a notifiable disease, one should report it as soon as it occurs, most preferably within 24 hours. Each state has guidelines governing reporting protocols of measles outbreak. Specific persons are responsible for reporting of measles cases occurring in various institutions such as schools, health facilities, and community set ups.

While reporting an outbreak to the various stakeholders in my community, I would first collect the following data; demographic information such as name, date of birth, address, age, sex, ethnicity, race and country of birth. Reporting source that is county and the date first reported; clinical data such as signs and symptoms, their onset, duration, presentation and complications; outcome, that is whether the case survived or died; date of death, results of post-mortem exam if done and death diagnoses. The health provider should report thelaboratory test results, vaccination status of infected persons and the transmission of the disease.

Prevention strategies

Measles being a highly contagious disease, prevention is key to ensuring there are no outbreaks experienced in the community. There is various prevention strategies used to prevent outbreak of measles. These include; isolation of infected persons four days before up to four days after appearance of the rash, vaccination with the Measles, Mumps and Rubella (MMR) vaccine to all at-risk persons. Persons without evidence of MMR vaccination should get post exposure prophylaxis incase they come into direct contact with an infected person. Most importantly, carrying out timely assessment to all people exposed to infected persons.

Health education to community members is very important. Health educationfocuses on proper respiratory etiquette and used of face masks by infected persons to prevent transmission of the virus. It should also emphasize on adherence to the immunization schedule and vitamin A supplementation by young children.

Conclusion

In conclusion, this essay has described measles disease outbreak, epidemiological determinants route of transmission and the risk factors. It has also discussed, effects of the disease outbreak on the community, reporting protocol, plan to reporting to the various stakeholders and the strategies to prevent disease outbreak.