At each encounter, we have the power to influence our patients' health choices. Preventive practices such as routine vaccinations can save the lives of our community members. In this issue, we take a look at the resurgence of measles—a disease that was considered eliminated in the US until recently (see page 26).
According to the CDC's June 27, 2019, report, there have been 1,095 individual cases of measles confirmed in 28 states in the US this year. Currently, the following states have reported measles outbreaks: Arizona, California, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Virginia, and Washington. It's essential that all nurses are familiar with the symptoms of measles and its incubation period (4 days before and after the classic maculopapular rash appears). When measles is suspected, we must report it to the CDC to minimize the spread of this disease within the community.
Educate patients and the community about measles, including how it's spread, complications, and its associated morbidity and mortality. Many patients will be surprised to learn that measles can thrive in the air or on contaminated surfaces for up to 2 hours after an infected person coughs or sneezes. Inform your patients that measles is highly contagious: When a person acquires measles, up to 90% of the unvaccinated individuals with whom he or she comes in contact will also acquire it. Once measles enters the community, it can quickly proliferate; unvaccinated children, older adults, and those with weakened immune systems are the most at risk.
Create an open dialogue with your patients to address the risks and benefits of vaccination. Nurses have a powerful voice that the community trusts. You can use your voice to dispel vaccine myths with the parents of young children. The measles-mumps-rubella (MMR) vaccine protects infants and children by providing an acquired immunity early in life before they encounter potentially life-threatening diseases such as measles. According to the World Health Organization, there were an estimated 110,000 deaths globally related to measles in 2017, mostly children younger than age 5, due to gaps in vaccination coverage.
If a patient is unvaccinated and planning to travel internationally, a two-dose preventive MMR vaccination 2 weeks before his or her travel date can help maintain health. According to the CDC, one dose of the MMR vaccine provides 93% immunity and the recommended two-dose vaccination provides 97% immunity.
By arming our patients and the community with knowledge about measles, including modes of transmission, the benefits of vaccination, and the urgency of medical assessment if symptoms arise, we can help eliminate this disease once more.