Measles was previously a childhood disease that led to significant health problems and even death for multiple children annually. However, after the vaccine for it became mandatory, the incidence of the disease dropped significantly. Unfortunately, it is now returning as a disease as a result of parents who refuse to vaccinate their children. There have been several epidemics associated with the disease. The disease is highly communicable. While it was thought to be eliminated in the United States, an increase in epidemics have indicated that it is not. These epidemics tend to occur in communities that do not vaccinate. Overall, the herd immunity and vaccination rate in the United States is greater than 90%. However, small pockets of communities are at great risk (CDC, 2013).
As of September, there were 159 cases of measles in the United States in unvaccinated children and adults. This is the second greatest year for measles on record since the disease was eliminated in 2000. The disease has been imported into the country by individuals who are contagious. It is then spread to individuals who are not immune. Measles is highly communicable as a disease; as such it presents a significant risk to anyone who does not have proper immunity. The greatest outbreak this year occurred in New York City. The outbreak mainly occurred in the Orthodox Jewish communities in Brooklyn. Orthodox Jewish people do not vaccinate for religious reasons. The outbreak was traced to an unvaccinated adolescent who contracted the disease in London, England. The disease is spread by respiratory droplets; individuals are contagious four days prior to the onset of symptoms until approximately four days after the onset. Ninety percent of individuals who are not immune will develop the disease if exposed to it. The majority of the cases occurred in families. However, the disease spread through two neighborhoods in Brooklyn. Fortunately, there were no deaths associated with the outbreak (CDC, 2013).

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If the disease strikes in a community, it is important to immediately isolate the individual with the disease. It is also important to determine any individuals with whom the patient had recent contact. These individuals should be asked about their vaccination status. If they have not been vaccinated, they should be offered the vaccination. The benefits of the vaccination should be explained to them versus the risks. All family members of the infected individual should be asked about their vaccination status. If they have not been vaccinated, they should not be allowed contact with the individual. Unfortunately, for most communities, these actions are too late because of the communicability of the disease.

SARS is a disease of particular concern among international travelers. SARS stands for Severe Acute Respiratory Syndrome. There is no vaccination available for the disease. It is caused by a coronavirus. If it is believed that a local outbreak is occurring, it is crucial for a public health nurse or educator to follow the appropriate method of notifying the authorities. The local public health director should be immediately notified. He will be in charge of coordinating the local public health response. The disease has, fortunately, not been seen since 2004. For this reason, however, public officials need to immediately contain any potential outbreak. The local CDC should be notified immediately. They will contact the CDC in Atlanta. SARS is a notifiable disease, and as such must be reported by law. It is also a disease that must, by law, be reported immediately. In addition, if a person has any form of acute respiratory distress syndrome and has recent travel to Hong Kong, China or Taiwan, the local health department must be notified immediately (New York Department of Health, 2004).

Individuals with pre-existing respiratory conditions, such as asthma and COPD, are at significant risk for exacerbation during periods of poor air quality. As such, it is important to educate them about checking air quality. This is particularly true if they live in areas with smog concerns, such as Los Angeles. They should be told to check the air quality daily before leaving their home. News channels broadcast warnings on particularly bad ozone days. Asthmatics should be told to try to stay inside on bad quality days. In addition, they should ensure they have medications with them at all time. This is particularly true for emergency inhalers. Patients should also be advised to consider wearing an allergy mask if they need to go outside. This will reduce the amount of poor air they can inhale. If they do need to go outside, they should attempt to limit the time they are exposed to the outdoors. Furthermore, they should also be taught the importance of keeping hydrated and remembering to breathe correctly (Payne, 2010).

    References
  • CDC. (2013, September 13). Notes from the field: measles outbreak among members of a religious community — Brooklyn, New York, March–June 2013. Retrieved December 4, 2013, from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6236a5.htm
  • New York Department of Health (2004, February). Reporting potential SARS cases. Retrieved December 4, 2013, from: http://www.health.ny.gov
  • Payne, J. (2010, January 11). Air pollution and asthma. US News. Retrieved December 4, 2013, from: http://health.usnews.com
  • World Health Organization. (2013, November 11). Measles cases reported. Retrieved December 4, 2013, from: http://www.who.int/