Wednesday, December 4, 2013

Public Health Experts on High Alert with Recent Rise in Spread of Infectious Diseases

A significant decline in immunization rates in the past few years has resulted in a dramatic increase in the number of documented cases of infectious diseases previously thought to be virtually eliminated in the United States has risen considerably. Falling immunization rates are attributed to fears that vaccinations can cause autism that are based on flawed studies that have been discredited.

Public health officials are seeing a rise in diseases such as measles and pertussis, commonly known as whooping cough. Measles was declared "eliminated" in the United States in 2000. This year alone there were 161 cases of measles reported across 16 states. While this increase does not suggest a widespread outbreak throughout the nation, it does present local and state public health systems with the new challenge of identifying and responding to a disease outbreak with shrinking budgets. 

Experts explain that the spread of measles in the US is generally traced to individuals who contract the disease outside the United States and then infects people exposed to the disease who were not vaccinated. For example, in Tuscon, Arizona a Swiss woman who had been traveling in Mexico arrived in an emergency room with measles. It took two days for her to be diagnosed and placed in isolation. During the two-day period before her isolation she infected an unvaccinated hospital staffer and an 11-month-old child who was too young to be vaccinated. The final count of infected individuals was 14 confirmed cases and 363 suspected cases that were a result of exposure to the Swiss traveler's measles. Seven of the 14 confirmed cases were contracted while the individuals were in the care of hospitals for other medical conditions. 

Preventing the Spread of Infectious Disease

  • Early Detection Systems 
    • The Department of Homeland Security recently announced plans to create a real-time disease outbreak alert system that would conduct hourly searches for reports of infectious diseases worldwide and send early warnings to at risk communities with low immunization rates. 
    • Biosurveillance automated monitoring systems could help with the early detection of natural disease outbreaks with modifications such as integrating primary-care physician data with emergency room data.

  • Establish Vaccination Policies
    • To reduce the risk of spreading contagious diseases and limit the numbers of isolations required, health systems should require all staff to be up-to-date with vaccinations of contagious diseases. 

  • Identification and Response
    • Early identification of infectious diseases should be a goal of all health systems. 
    • Once a case is discovered the health system should immediately alert public health officials and other community health systems to aid in rapid identification and limit exposure.
    • Employees should be familiar with the protocols for reporting the infectious disease to local public health officials and health systems. 

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