Measles: Eliminated or Epidemic?

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infection a difficult task. Trying to get a sense of the outbreak’s size and stop its spread was a challenge that took

Jacqueline Fletcher months to resolve reported Belluz (2015).

How a measles outbreak would affect my community. According to the Indiana Department of Health School Vaccine Coverage Assessment Data at the Kindergarten level 89.3% of the students meet the MMR vaccination requirement with 0.45% of these being medically exempt and 0.70% of them exempt for religious reasons. At the 6th grade level 95.8% of the students in New Albany Floyd County schools have the required MMR vaccination. I feel that if there were to be a local outbreak at the school system level our children would be fairly safe and the virus would be easy to stop due to the high vaccination rate in the area and the successfulness of the vaccination when given. It is said that two doses of MMR vaccine are about 97% effective at preventing measles; and one dose is about 93% effective (2015, March 31). It appears that Indiana’s policies have helped keep the unvaccinated rates pretty low in our area.

It has been proven in the past by a prior Indiana outbreak of measles that Indiana should function well at all levels should an outbreak occur. The Indiana department of health mentions a measles outbreak in 2005 from an unvaccinated girl that traveled to Romania on a mission trip. She returned and went to a church function shortly after only to expose many unvaccinated children at her church whose parents object to vaccinations and causing them to contract the illness. This resulted in 33 cases reported all with a close connection to the church. It is said on the Indiana Department of Health homepage on measles that the High vaccination levels in the surrounding Indiana communities and low rates of vaccine failure in Indiana averted a larger outbreak (n.d.). I believe the above information indicates that my community of Floyd County Indiana would react and handle a measles outbreak with little to no problems considering the high vaccination compliance rates in most all levels including local government, hospitals and business settings. The one thing that does concern me regarding a potential risk factor in my area if my state were to be exposed to a measles outbreak is the fact that according to A publication of the Indiana Business Research Center at IU’s Kelley School of Business titled Indiana’s Amish Population Indiana only trails Ohio and Pennsylvania in their number of Amish residents, being the home to 19 percent of Amish that reside in America (Manns). My concern is due to the fact that the Amish tend to vaccinate at a low rate due to many reasons including lack of understanding the importance of vaccinating, fear of the safety of immunizing, and the obvious hesitation regarding religious beliefs. This situation of course could be set up for an outbreak exactly like the one experienced in Ohio a couple of years ago.

Reporting Protocol for New Albany Indiana. Timely reporting, and investigation of measles is important due to the fact that the disease is so highly contagious and spreading of the disease can stop with early identification and vaccination of possible contacts. According to the Indiana State Department of Health Communicable Disease Reporting Rule, if a suspected case were to occur in my area prompt reporting within 24 hours must occur to the local health department and Indiana State Department of Health by physicians and or hospitals treating or testing the suspected victim. Laboratories must also report positive results to ISDH within 24 hours. Prior approval from a patient is not required before releasing this information to the local or state health department. A confidential report of communicable diseases form must be filled out and turned in to the ISDH as well. The ISDH then has 24 hours to report the case to the CDC with the name, address, date of birth, sex, race, birth county, reporting county, date 1st reported, and vaccination status. Clinical data must also be provided to the CDC such as the date symptoms began including the first sign of rash, length of presence of rash, max temperature, and any complications. Virus isolation labs must be reported as well as any epidemiological that can be obtained such as travel history and possible number of contacts. Outcome of disease is also required to be reported if possible (n.d.).

Strategies I would use to prevent a future outbreak of Measles in my Community. A strategy that I would use in my community to increase immunization compliance and prevent a future outbreak of measles would be to increase the likelihood of the lower income population being susceptible to the availability of immunizations. This could be done by somehow linking our WIC program to immunizations by possibly coming up with a new program requiring children of the recipients of WIC to be immunized by a certain period of time in order for benefits to continue. If Mothers are noncompliant the benefits will be forfeited for the non compliance. I would also make education available in these offices as to help those affected by the policy understand the importance of immunizations and hopefully decrease the fear that these vaccinations are potentially harmful. Another strategy that I would engage in would be to make sure that education was widely available in religious sects known for not immunizing their young. In these populations I think it is important to make them aware that immunizations are safe and extinguish their fears of autism, crib death, and brain damage occurring after vaccination In addition I think it is important to stress the fact that not immunizing against these diseases puts others at risk by potentially spreading the disease in a community due to the lack of immunity . I would very much stress the potential of vaccination in their community as a chance to serve and aid in the future health of their young and others exposed to their communities.

References

Belluz, J. (2015, January 29). How an Amish missionary caused 2014’s massive measles

outbreak. Retrieved from

http://www.vox.com/2015/1/29/7929791/measles-outbreak-2014

Indiana State Department of Health. (n.d.). Retrieved February 15, 2017, from

https://secure.in.gov/isdh/23849.htm

Indiana State Department of Health Communicable Disease Reporting Rule. (n.d.).

Retrieved February 17, 2017, from https://secure.in.gov/isdh/25366.htm

Jennifer Zipprich, PhD1, Kathleen Winter, MPH1, Jill Hacker, PhD1, Dongxiang Xia, MD, PhD1, James Watt, MD1, Kathleen