Measles Virus: Policies and Solutions

Introduction/Statement of the problem

Rubella (measles) is a multisystem, human-exclusive virus that has been determined eradicated in the United States since the 1960s. Measles is highly contagious, dealt with public health officials vaccinating nearly the entire population. However, the virus is prevalent in developing and developed regions alike today. Rubeola is an enveloped, single-stranded, negative-sense RNA virus (sense” describing polarity to other nucleic acids” negativity meaning that it must convert to positive-sense before translation). Measles uses the lytic cycle to reproduce” it destroys the host after producing as many copies possible. The preferred host cells of rubeola are the tissues lining the back of the throat, the nasal cavity and lungs, and then move onto immune cells. Rubeola is transmitted through mucus and other respiratory fluids, either aerially or contractually. However, it can survive up to two hours on an infected surface, enhancing its contagion risk. Statistically, 90% of people in proximity to a diseased person will become infected. Although there are countries that haven’t had an isolated case in decades, regions like central and west Africa and India endure fatalities from lack of disease control. Only the Northern, Central and Southern Americans have eradicated measles because vaccinations are mandatory before a child can enter school. However, outbreaks by the hundreds as recent as 2017 have been occuring in Europe, New Zealand and Australia, all of which include hospitalizations, fatalities, and new vaccination campaigns. Measles has been called the “7-day virus”, although it conventionally last 10-14 days. It’s really hard to verify if you have a virus on your person or in your body before you travel. You can’t see the virions, and if you are infected, you are sometimes capable of spreading the virus to others without showing any symptoms yourself.

Now, consider the number of people traipsing across countries and continents on any given day. Passenger airlines have made it incredibly easy for humans to quickly traverse the world in less time than it takes for us to realize we are carrying a virus with us. We are often in cramped airplanes with poor circulation, ideal for transmitting pathogens to other others. This is enough of a problem on its own, but you also have to consider the transfer of cargo. Countless tons of goods are shipped around the world on any given day, and they are also capable of carrying countless many pathogens. This risk increases further when you are transferring live cargo, such as poultry, fish, etc. This isn’t accounting for stowaways on boats and planes (mice, rats, etc.) that are also capable of transmitting disease. The thing about globalization is that people and goods can move around the world faster than ever before, but it also means that pathogens can spread across the world equally rapidly, oftentimes before we are aware of their presence. In the case of measles, the virus is easily spread through respiratory inhalation, and primary viremia occurs 2–3 days after exposure. You could be on the other side of the planet by then, and actively exposing other people (who may not be immune!) to a highly infectious and deadly virus.

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Current Policies

Common symptoms include: acute fever, runny nose, cough, general discomfort, koplik’s spots in the mouth, full-body rash. The full-body rash and koplik’s spots combined are conclusive for diagnosis. Visible symptoms, like the rash, begin 3 days after infection, while the virus has already begun infecting others. The rash begins at hairline and ends at the feet. The rash is a bright, red color and , as the infection ends, it changes to brown then faces. As opposed to other viral rashes, lesions from measles do not contain fluids but are only raised areas of skin. The symptoms of measles diagnosis aren’t life-threatening, However, measles is especially dangerous because of its many severe complications, including blindness, hemolysis, pneumonia and encephalitis (swelling of the brain). Miscarriage and premature birth can come from infection during pregnancy.

Measles onset before the age of 1 or during infancy sometimes results in mental retardation or an extremely rare degenerative disease (subacute sclerosing panencephalitis) later on. The MMR vaccine (measles, mumps and rubella) is a 2 part injection beginning at age 1. The second at ages 4-5 if immunity has not developed by adulthood, more vaccinations are administered. The vaccine is a mixture of live attenuated viruses (weakened beyond symptom activation) that the immune system develops against. In this case, during childhood. Because of its rigorous updates, it is not popular globally. There is no definite treatment of measles, but if uncomplicated, rest and pain/fever medication (except aspirin) can be used to let the virus pass more comfortably.

Possible solutions/ Alternatives

Avoiding contact. Measles is extremely infectious. It is spread by droplets from coughing and sneezing. These can be directly inhaled or possibly picked up from contaminated surfaces. The initial stages are similar to most viral illnesses so keep away from any possible infection. Wash hands, wear a mask, don't eat or drink in public. This is impractical in many cases. Isolation. Infected persons are kept at home and not permitted to socialize especially with groups such as school church etc. Hopefully if the others at home are immunized they will be ok. This is necessary but very disruptive. Vaccination. Measles vaccine is very safe and very effective. The only way to stop the measles virus is to make sure that everyone is immunized. The people that deny their children from getting immunizations are risking their child’s lives because you cannot product which child will die from it. You also can easily spread measles from country to country by not immunizing your children, its happened a few times recently and put several children’s at very high risk. It is a very serious matter and everyone should be immunized.

Action Plan

Promote education concerning the need for routine immunization against measles. If the problem is getting worse over a period of time, then public health officials may have to declare mandatory vaccination of all children. Need better education system based around vaccinations. Illnesses such as this are a problem because of a growing anti-vaccination community. We require all students in public schools to be vaccinated. The measles virus is already disseminated worldwide. Countries which do not mandate immunizations or have multiple reasons to defer or object to immunization have higher rates of transmission. In the United States certain populations have higher numbers of anti-vax parents and have been the source of outbreaks; example is a community just outside Portland Oregon. Vaccines work — they are not the problem. The childhood diseases vaccines protect against are the problem — they kill and cripple Antri-Vaxers are a problem—-they continue to spread misinformation, falsehoods and rely on discredited pseudoscience to convince gullible parents to ignore real science and real evidence to not vaccinate their children Too many states have passed laws needlessly and foolishly giving credence to anti-vaxers by allowing almost unlimited right to “conscientious objections” to vaccines and continue to allow those kids to attend school.

The federal government should take the lead using policy and financial carrots and sticks to reverse this trend and require parents to vaccinate children in order to attend school, day care, sports activities, etc. Vaccinated children not only protect the individual but form a vaccinated herd that reduces the risk to those rare few who are medically unable to be administered one or more vaccines. We need to stop researching vaccine safety. We need to start researching risks and repercussions of childhood diseases such as Measles, Mumps, Rubella, and Polio. Any laws should make sure that doctors at least personally examine any children for whom they provide exemptions. Medical boards need to review exemption for signs of fraud and gaming, with a proper appeals process. The border patrols of any country should interview people coming from regions with measles cases (Ukraine, Madagascar, Texas) and check vaccination status and current health. When the swine flu was infecting people in the US, countries in South America did this. They didn’t keep you from entering unless you were sick. This isn’t a bad idea generally. I know that people are contagious during the prodrome, and may not fall ill until they have already entered a country, but this would catch some active cases of infectious disease. Social media should stop publishing anti-vax propaganda.

Conclusion

Measles uses the lytic cycle to reproduce it destroys the host after producing as many copies as possible. However, it can survive up to two hours on an infected surface, enhancing its contagion risk. Common symptoms include: acute fever, runny nose, cough, general discomfort, koplik’s spots in mouth, and full-body rash. The MMR vaccine (measles, mumps and rubella) is a 2 part injection beginning at age 1. These can be directly inhaled or possibly picked up from contaminated surfaces. The initial stages are similar to most viral illnesses so keep away from any possible infection. Medical boards need to review exemptions for signs of fraud and gaming, with a proper appeals process. When the swine flu was infecting people in the US, countries in South America did this.

Works cited

1. NHS Choices. Accessed February 22, 2019. https://www.nhs.uk/conditions/measles/treatment/#.
2. 'Measles (Rubeola).' Centers for Disease Control and Prevention. February 20, 2015. Accessed February 22, 2019. https://www.cdc.gov/measles/about/index.html.
3. Orenstein, Walter A., Perry, Robert T., Halsey, and Neal A. 'Clinical Significance of Measles: A Review.' OUP Academic. May 01, 2004. Accessed February 22, 2019. https://academic.oup.com/jid/article/189/Supplement_1/S4/823958.
4. Public Health Agency of Canada. 'Measles.' Canada.ca. February 05, 2019. Accessed February 22, 2019. https://www.canada.ca/en/public-health/services/diseases/measles.html.
5. 'The Problem.' Measles & Rubella Initiative. Accessed February 22, 2019. https://measlesrubellainitiative.org/learn/the-problem/.
6. Young, Leslie. ''This Is a Serious Disease': Why We Should Worry That Measles Is Making a Comeback.' Global News. February 17, 2019. Accessed February 22, 2019. https://globalnews.ca/news/4967561/measles-danger-deaths/.
7. 'Measles Deaths in the 21st Century.' VAXOPEDIA. January 27, 2019. Accessed March 17, 2019. https://vaxopedia.org/2017/04/22/measles-deaths-in-the-21st-century/.
8. https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/meas.pdf
9. http://www.globalization101.org/uploads/File/Health/health.pdf