Measles Response and the Value of Public Health Preparedness
By Anthony S. Mangeri, MPA, CEM, EMT, faculty member, Emergency and Disaster Management Program at American Military University
Like emergency management, public health preparedness is a system designed to assess threats to the public and determine measures to mitigate those threats. Vaccinations are an example of mitigation measures designed to reduce risk and threat to the community as a whole.
The latest emerging or reemerging infectious disease that is putting communities at risk is the measles outbreak of 2015. This outbreak is actually four separate outbreaks, which have emerged in the past two months.
The Reemergence of Measles
The Centers for Disease Control and Prevention (CDC) is reporting more than 170 cases of measles in 17 states in the last two months. More than 74 percent of the reported cases are directly related to an exposure at the Disneyland theme park in Anaheim, Calif. There are also three unrelated and ongoing measles outbreaks in Illinois, Nevada, and Washington.
This is not the first outbreak of measles in the United States since it was classified as eliminated by the CDC in 2000. According to the CDC’s National Center for Immunization and Respiratory Diseases (NCIRD), 644 measles cases were reported by 27 states in 2014.
Measles is not uncommon in other parts of the world and remains present in Europe, Asia, and in Africa. Individuals traveling from these counties can bring the disease into the U.S. and potentially spread the disease among those who have not been vaccinated.
The Severity of Measles
Measles can be very serious and one of every four people who get the measles will need to be hospitalized. One in 1,000 people may develop encephalitis and as many as two in 1,000 may die, regardless of the quality of care.
The Measles Mumps and Rubella (MMR) vaccination is available and part of a child’s recommended immunization schedule. In the past, there was a belief that the MMR immunization shot might be connected with a child developing Autism Spectrum Disorder. However, many studies have disproved this theory.
Improving Training to Respond to Measles Outbreak
As with all community threats, public health surveillance and hospital preparedness systems must be integrated with emergency medical services (EMS). Public safety access point telecommunicators (9-1-1 operators) need to ask more questions when someone requests EMS for a medical emergency.
These operators must be trained to recognize the symptoms of measles. Measles generally present with a unique rash and a high fever, which may spike to 104 degrees. The rash appears as flat red spots on the face at the hairline and spreads down to the neck, torso, arms, legs and feet. Sometimes a small raised bump forms on top of the red spots. After a few days, the fever subsides and the rash fades. The more situational information operators can gather, the more responders can prepare for potentially infected patients.
As with any emergency operations strategy, flexibility and adaptability are essential for an effective response. Emergency management and public health preparedness professionals must openly discuss the risks and vulnerabilities from these health threats.
Just as with the Ebola pandemic, the recent outbreak of measles has shown the vulnerability of our society to reemerging infectious diseases. Public health officials and the medical community must continue working together to evaluate vulnerabilities and mitigate the threats of these public health risks.
About the Author: Anthony S. Mangeri has more than 30 years of experience in emergency management and public safety service. Currently, he is the Director of Strategic Relations for Fire Services and Emergency Services at American Public University System. Anthony also serves on the faculty in the School of Security and Global Studies at American Military University. He also serves on the Fire & Life Safety Council of ASIS International. Mangeri earned a Master of Public Administration from Rutgers University and is a Certified Public Manager and Certified Emergency Manager. He has completed a Fellowship in Public Health Leadership Initiative for Emergency Response sponsored by the Center for Public Health Preparedness.