Impacts And Epidemiology Of The Disease

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Impacts And Epidemiology Of The Disease

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Question:
Describe the public health problem you have chosen. Include: i) the aetiology and epidemiology of the problem; and, ii) the impact (eg. The amount of disease in the community- the prevalence and incidence) of the problem on the population.

Answer:

According to Thomas, et al (2016), measles is a very communicable viral disease in children. The disease is however not limited to children since it can infect people of all ages. Not many cases of measles have worsened but there is likelihood of developing various complications. The main control method for this disease has been through vaccination as the disease readily spreads among people who have not had a measles vaccine. This paper will cover the etiology and epidemiology of measles, the risk factors, the role of the registered nurse and how the nursing roles can help improve the situation.
Etiology, impacts and epidemiology of the disease
Measles infects the respiratory system. The disease also causes a skin rash on the body of the infected person. In expectant mothers, the disease may also be prevalent and it may increase incidences of pre mature labor, giving birth to children of very low weight or even miscarriage. World statistics on infection rates indicate that the disease is mainly prevalent in children. In Singapore, cases of the infection have reduced since measles vaccination was made compulsory in 1981. Since then, children continue to receive the MMR vaccine from the age of 15 months up to 12 years. The MMR vaccine also vaccinates children against mumps, measles and rubella.
The causative agent of measles is a virus known as paramoxyvirus. It mainly affects people who have not been immunized against the disease. The main method of infection from the infected to a healthy person is through close contact. The main ways of spreading is through coughing, sneezing and having direct contact with surfaces that are contaminated with the virus. The incubation period of the disease takes 24-48 hours before any visible signs and symptoms of the disease. The skin rash may however delay up to a period of 4 days. The virus on the contaminated surfaces may carry the virus for several hours and still infect an individual after a period of several hours.

The main signs and symptoms of the disease may only begin to show after ten days of infection. However, minor signs develop before. These minor signs include; fever, colds, coughing and sneezing accompanied by a running nose, reddening of the eyes and occasional shedding of tears. The skin rash begins to develop as bluish white small spots often reddish at the bottom. As the spots continue to appear on the various body parts, skin rash then develops. The skin rash contains very has very red spots that are not always accompanied by itching. The skin rash mainly begins on areas near the face, on the face and neck and hen spreads to various body parts. The rash may then disappear after a while following the same procedure but it leaves an irritated skin in the victim (Ting, et al 2015).
In complicated cases, the infected person may have enlarged lymph nodes, stomach upsets, vomiting and diarrhea. The person may also develop a condition; conjuvities which affects the eyes making too much light sensitive. The effects of the disease are more extreme in adults than in small children. Death cases resulting from the disease are rare but not completely unavoidable. World statistics have proven that the death rate resulting from measles is about 0.05 percent. This means that 5 out of every 1000 people die of measles every year.th deaths mainly result from pneumonia and encephalitis Bassey, et al (2015).
Other severe conditions of measles include ear infection for relatively older people also known as Otitis Media. Pneumonia is mainly found in children and encephalitis which refers to the infection of the brain explains Vemula, et al (2016). Major signs and symptoms of encephalitis include seizures, commas and longer terms of mental impedance. Other organs that may be infected include the liver and the kidneys.
The prevalence rates of measles in Singapore cannot be said to have reached shocking levels (Berger, 2015). However, there are some outstanding situations that have lacked an elaborate explanation. One of these instances is where children before the age of 15 months have been infected with the disease. This is unusual since vaccination is done at 15 months because most of the infection affect children beyond this age. Such cases has elicited more emphasis on the immunization of expectant mothers so as to ensure the health of their children.
Since the implementation of the national childhood immunization programme, the infection rates in the Singapore health has decreased considerably year after year. Despite the continued efforts to eliminate endemic measles, sporadic measles continue to be a threat to Singapore health especially among the population that have not been vaccinated against the disease.

In the epidemiology report by Dorreh, & Heidary, (2015) more than half of the infections are nosocomial. The government of Singapore conducted an outbreak investigation in 2011 to identify the prevalence rates. The main methods used in the laboratory testing include molecular diagnostic and serological methods. After conducting the research, the hospital was then able to develop a policy that recommended for early identification diagnosis and treatment of infected individuals. In the policy, confinement of infected individuals after identification is also a safety practice. In addition, vaccination coverage of all health workers in the hospital is also a recommendation.
Relationship between current knowledge and geographical area data
The existing statistics in Singapore, more than 60% of measles cases are reported in children between the ages of one to six years. The center for disease control and prevention in the United States have argued that a sick person is likely to infect ten percent of the people around him. The fact that vaccination is done to children, many parents have continued to ignore calls for vaccination, some out of ignorance while others forget and skip some of the doses. In other health reports, 20% of cases are reported from foreigners. 34% of cases happen around the same period of the year and about 12% are reported from adults. Indicating cases of the spread of the disease. Some of these existing statistics around Singapore have called for herd immunity in the treatment and prevention of the disease (Trentini, et al 2017).
Herd immunity ensures that there is 96 – 98% control of the disease through controlling the symptoms of the disease by ensuring complete vaccination. The vaccine is not only significant in preventing the disease but it also decreases the period of infection in case someone gets infected. Statistics have also shown that few people go for the second vaccination MMR vaccine. This is considered a health risk since failure to completely take all the vaccines may result to delayed cognition and retardation problems such as autism argues Boucher, et al (2017).

Role of the community health nurse
It is among the roles of the community health nurse to identify cases of measles in the society and provide mechanisms and directions geared towards fighting the disease. Among these activities include routine vaccination, advocating for screening treatment of the disease, identification of the risk factors and the comorbidities that heighten the risk of infection of the disease and providing the society with various measures that can be used to control the disease and the risk factors of the disease.
According to Thompson, & Odahowski, (2016) the community health nurse also acts as an advocate between the patients and their significant others. The help to give both emotional and psychosocial support to the affected families. The nurse also explain the necessary action to be taken to treat the disease. The community health nurse is also charged with the role of communication such as educating the community. The nurses represent the ministry of health and the government in explaining the various policies such as the 1981 compulsory immunization policy in Singapore. In addition the nurses also collect ethical information from the patients and social cultural values and beliefs that influence how people perceive the disease and how the disease impacts in their lives.
How nursing roles can deal with various stages of infection
According to Ward, (2016) the nursing roles are significant in every step of the way. For instance, nurses help to advocate for measures that will help those who are not infected to remain healthy. These measures include recommending vaccination for all children since children are the most vulnerable. Healthy eating and healthy living is also a valuable recommendation by the nurses. According to the social cultural societal beliefs, the nurse is able to advise the society on various measures that will prevent spread of the disease in the society.
For instance, sometime back this year, the Auckland regional public health service recommended the vaccination of passengers aboard a Singapore plane. The public health department argued that the passengers might have been exposed to measles and recommended of measles screening for the passengers where they were to be checked for signs and symptoms of measles upon landing at Singapore. The public health officials also recommended for vaccination of passengers boarding the planes to reduce the risk of infection. In addition, since the risk of prevalence is very high, the airport workers were also recommended to be vaccinated against the same.
When a person is already infected, the role of nurses is to advocate for treatment. The nurses may also explain the complications that may follow if the patients neglect care. The nurse also highlights the various ways the disease can be spread to other members of the family and therefore cautions the people with measles patients. The nurses also provide the government and other policy makers in information that helps in the formulation of policies that helps to control the disease (Evans, Coutsaftiki, & Fathers, 2017).

In very terminal and complicated cases, the nurse may offer palliative care and psychosocial support to the patients and their families to help control the disease and improve the quality of life of the patient if the disease has reached incurable levels. The nurses also help to advocate for safety measures such as ensuring that people take plenty of water, this helps to replace any water lost through fever. Increasing immunity against the disease and other opportunistic infection by eating plenty of vitamins. Caring for the eyes since measles makes the eyes more sensitive to light. This can be done by using sunglasses or ensuring one stays in a dimly lit environment. Finally, plentiful rest is also advised for the patients to also help improve the quality of their lives.
In conclusion, it is clear to indicate that measles is a controllable condition and therefore it should not get to uncontrollable levels. The disease is mainly prevalent in children but it can also affect adults. The normal signs and symptoms include fever, vomiting, diarrhea, coughing and sneezing. The mild complications include eye and ear infection, brain infection and death. In young children the complications may include pneumonia. The community health nurse aids in prevention, treatment and control of the condition.

References
Bassey, B. E., Gasasira, A., Weldegbriel, G., Sylvester, M. T., Richard, K. I., Thompson, I., … & Akpan, G. U. (2015). Impact of a Nationwide Measles Immunization Campaign and Routine Immunization in Nigeria, 2006-2010: A Critical Review of South-South, Nigeria. Science, 3(5), 693-698.
Berger, S. (2015). Infectious Diseases of Singapore. GIDEON Informatics Inc.
Boucher, A., Herrmann, J. L., Morand, P., Buzele, R., Crabol, Y., Stahl, J. P., & Mailles, A. (2017). Epidemiology of infectious encephalitis causes in 2016. Medecine et maladies infectieuses, 47(3), 221-235.
Dorreh, F., & Heidary, M. (2015). Adverse Events Associated with Measles-mumps-rubella Vaccines in Arak. Clinical Research, 1(1), 6-10.
Evans, D., Coutsaftiki, D., & Fathers, C. P. (2017). Health Promotion and Public Health for Nursing Students. Learning Matters.
Thomas, J. S., Ong, S. E., Chia, K. S., & Lee, H. P. (2016). A Brief History of Public Health in Singapore. In Singapore’s Health Care System: What 50 Years Have Achieved (pp. 33-56).
Thompson, K. M., & Odahowski, C. L. (2016). The costs and valuation of health impacts of measles and rubella risk management policies. Risk Analysis, 36(7), 1357-1382.
Ting, C. Y., Tee, N. W. S., & Thoon, K. C. (2015). Could a fever and rash after the measles, mumps and rubella vaccination indicate wild?type measles?. Acta Paediatrica, 104(5), e232-e234.
Trentini, F., Poletti, P., Merler, S., & Melegaro, A. (2017). Measles immunity gaps and the progress towards elimination: a multi-country modelling analysis. The Lancet Infectious Diseases, 17(10), 1089-1097.
Trentini, F., Poletti, P., Merler, S., & Melegaro, A. (2017). Measles immunity gaps and the progress towards elimination: a multi-country modelling analysis. The Lancet Infectious Diseases, 17(10), 1089-1097.
Vemula, V. N., Li, L., Thoon, K. C., Chong, C. Y., Tee, N. W. S., Maiwald, M., & Tan, N. W. H. (2016). Risk factors and clinical profile of measles infection in children in Singapore. Infection, Disease & Health, 21(4), 192-196.
Ward, D. (2016). Microbiology and Infection Prevention and Control for Nursing Students. Learning Matters.

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