Case Study: Measles

Introduction

The office space provides a conducive environment for the easy spread of infectious diseases. The high human traffic in office spaces is the primary reason why the office is a high-risk environment for the spread of contagions such as measles. The waiting area is a particularly critical point for the spread of infections to other occupants of the office (Li et al. 2019). Most interactions involving large numbers of people occur within the waiting area. Furthermore, most visitors and users of the office and other places within an organization go through the waiting area. This research paper seeks to analyze the management and prevention of a potential measles outbreak in the office.

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Managing the Situation

From the case, the source of the potential outbreak (the index case) is a child. Therefore, to understand and manage the situation correctly, it is imperative to consider the interaction patterns and social behaviors of children. Before the diagnosis, the child spent considerable time (30 minutes) in the waiting area, probably interacting directly with the people present in the area at the time. During the entire play and interaction, the child was already actively infected and was able to transmit the infection to those he was in direct contact with. Due to the possibility of a widespread infection from the child’s direct and indirect contacts within the office, active management of the situation must presume that every occupant of the office during the period in which the infected child was at the premises is already infected (Li et al. 2019).

Based on the presumption of infection of all office occupants, prompt isolation, symptom monitoring, and testing should be initiated for the office occupants. Such a strategy helps contain the possible outbreak hence curb the situation before escalating into a potential public health issue. The child's direct contacts should be accorded priority during the testing and isolation of possible cases. Following this cohort should be the direct contacts of the child’s direct contacts (that is, the child’s secondary contacts). This stepwise approach to situation mitigation ensures that those at the highest risk are identified and monitored. Measles is widely considered rare or eliminated in many countries due to mass immunization efforts (Perron et al. 2019). However, the isolation and monitoring of office staff and other occupants at the time of the child’s stay should be done regardless of individuals’ immunization status. This precautionary step is necessary since there have been cases of measles reemergence and infection of individuals who had received vaccination for the respiratory contagion (Li et al. 2019). The two classes of specimens utilized for measles testing include blood (serum samples and throat swabs).

Causes of Infection

Measles is a highly contagious viral respiratory infection caused by the measles morbillivirus. The morbillivirus belongs to the Paramyxovirus family of viruses (Perron et al. 2019). The measles symptoms include fever and sore throat, cough and runny nose, skin rash, and inflammation of the eyes. The symptoms appear after the virus's typical incubation period, ranging from about ten days to two weeks after infection (Perron et al. 2019). Measles primarily occurs in children under the age of five years. However, the disease can infect people of all age groups. Measles was a significant public health concern with thousands of annual infections and fatalities before the introduction of the measles vaccine in 1968.

The virus is transmitted through direct contact with respiratory fluids and discharges such as mucus from an infected person. The transmission of the measles virus can also be airborne through respiratory droplets when an infected person coughs or sneezes (Perron et al. 2019). The disease is primarily prevented through child and adult vaccination. Therefore, being unvaccinated is a significant predisposition to measles infection when exposed to the virus. Anti-vaccination social inclinations, like certain religious beliefs or activism, are among the significant behavioral causes of measles infection (Perron et al. 2019). Congestion, especially in a place experiencing a measles outbreak, also increases the risk of contracting the disease.

Preventive and Safety Measures

Due to the highly infectious nature of the measles virus, it is imperative to take precautionary safety and preventive measures to enhance the health and safety of all in the office. Such safety measures complement the initial management strategies to manage and contain the situation (Li et al. 2019). All users of the office should undergo post-exposure prophylaxis to prevent possible infection by the virus. The most common prophylactic measure is the immunoglobin PEP (Post-Exposure Prophylaxis). The immunoglobin PEP stimulates the body's immune system to recognize, fight, and eliminate the viral pathogen, preventing active infection. This strategy works similarly to vaccination. However, immunoglobin PEP only provides short-term protection against a single instance of exposure to the virus (Li et al. 2019). This preventive strategy helps provide rapid protection to those immediately exposed to the virus while bypassing the social criticisms of active vaccination like the anti-vaccination activists.

Measles is only preventable through active vaccination. Therefore, outbreak vaccination is recommended as a safety measure for those at the office. This is especially for those who are unvaccinated against the virus (Li et al. 2019). However, the vaccination should be voluntary to eliminate ethical issues such as the invasion of civil liberties. A combination of outbreak vaccination and the immunoglobin PEP ensures that all people at the office are safe from measles infection. As a respiratory infection, measles' transmission is faster in congested and poorly aerated environments (Perron et al. 2019). Therefore, the number of people at the office should be limited, and the aeration improved to reduce the probability of airborne transmission of the disease hence keep all at the office safe.

References

Li, Z., Zhang, Z., Wang, F., Wei, R., Zhao, J., & Liu, F. (2019). Measles outbreak in an office building in the crowded Metropolis of Beijing, China. BMC Infectious Diseases, 19(1), 1-6. https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4404-6

Perron, T., Larovere, H., Guerra, V., Kilfeather, K., Pare, N., & Park, J. (2019). Recent measles outbreaks in the United States: A look at the causes and responses. British Journal of School Nursing, 14(10), 491-496. https://www.magonlinelibrary.com/doi/full/10.12968/bjsn.2019.14.10.491