Measles: Examining Etiology, Epidemiology, and Nursing Interventions

This report comprehensively examines measles, a highly communicable viral disease, focusing on its etiology, epidemiology, and the crucial role of registered nurses in managing the disease, particularly in Singapore. It details the causative agent (paramoxyvirus), transmission methods (coughing, sneezing, direct contact), and the signs and symptoms, including fever, cough, and skin rash. The report highlights the importance of vaccination, especially the MMR vaccine, in controlling the spread of measles and discusses the role of community health nurses in identifying cases, advocating for treatment, and educating the community. Furthermore, it addresses the nursing roles at various stages of infection, from prevention through vaccination to palliative care in severe cases, emphasizing the importance of herd immunity and complete vaccination to prevent complications like pneumonia and encephalitis. The report concludes that measles is a controllable condition with proper prevention and management strategies.

Running head: Measles 1
Measles
Student’s name
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According to Thomas, et al (2016), measles is a very communicable viral disease in
children. The disease is however not limited to children since it can infect people of all ages. Not
many cases of measles have worsened but there is likelihood of developing various
complications. The main control method for this disease has been through vaccination as the
disease readily spreads among people who have not had a measles vaccine. This paper will cover
the etiology and epidemiology of measles, the risk factors, the role of the registered nurse and
how the nursing roles can help improve the situation.
Etiology, impacts and epidemiology of the disease
Measles infects the respiratory system. The disease also causes a skin rash on the body of
the infected person. In expectant mothers, the disease may also be prevalent and it may increase
incidences of pre mature labor, giving birth to children of very low weight or even miscarriage.
World statistics on infection rates indicate that the disease is mainly prevalent in children. In
Singapore, cases of the infection have reduced since measles vaccination was made compulsory
in 1981. Since then, children continue to receive the MMR vaccine from the age of 15 months up
to 12 years. The MMR vaccine also vaccinates children against mumps, measles and rubella.
The causative agent of measles is a virus known as paramoxyvirus. It mainly affects
people who have not been immunized against the disease. The main method of infection from the
infected to a healthy person is through close contact. The main ways of spreading is through
coughing, sneezing and having direct contact with surfaces that are contaminated with the virus.
The incubation period of the disease takes 24-48 hours before any visible signs and symptoms of
the disease. The skin rash may however delay up to a period of 4 days. The virus on the
contaminated surfaces may carry the virus for several hours and still infect an individual after a
period of several hours.

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The main signs and symptoms of the disease may only begin to show after ten days of
infection. However, minor signs develop before. These minor signs include; fever, colds,
coughing and sneezing accompanied by a running nose, reddening of the eyes and occasional
shedding of tears. The skin rash begins to develop as bluish white small spots often reddish at the
bottom. As the spots continue to appear on the various body parts, skin rash then develops. The
skin rash contains very has very red spots that are not always accompanied by itching. The skin
rash mainly begins on areas near the face, on the face and neck and hen spreads to various body
parts. The rash may then disappear after a while following the same procedure but it leaves an
irritated skin in the victim (Ting, et al 2015).
In complicated cases, the infected person may have enlarged lymph nodes, stomach
upsets, vomiting and diarrhea. The person may also develop a condition; conjuvities which
affects the eyes making too much light sensitive. The effects of the disease are more extreme in
adults than in small children. Death cases resulting from the disease are rare but not completely
unavoidable. World statistics have proven that the death rate resulting from measles is about 0.05
percent. This means that 5 out of every 1000 people die of measles every year.th deaths mainly
result from pneumonia and encephalitis Bassey, et al (2015).
Other severe conditions of measles include ear infection for relatively older people also
known as Otitis Media. Pneumonia is mainly found in children and encephalitis which refers to
the infection of the brain explains Vemula, et al (2016). Major signs and symptoms of
encephalitis include seizures, commas and longer terms of mental impedance. Other organs that
may be infected include the liver and the kidneys.
The prevalence rates of measles in Singapore cannot be said to have reached shocking
levels (Berger, 2015). However, there are some outstanding situations that have lacked an

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elaborate explanation. One of these instances is where children before the age of 15 months have
been infected with the disease. This is unusual since vaccination is done at 15 months because
most of the infection affect children beyond this age. Such cases has elicited more emphasis on
the immunization of expectant mothers so as to ensure the health of their children.
Since the implementation of the national childhood immunization programme, the
infection rates in the Singapore health has decreased considerably year after year. Despite the
continued efforts to eliminate endemic measles, sporadic measles continue to be a threat to
Singapore health especially among the population that have not been vaccinated against the
disease.
In the epidemiology report by Dorreh, & Heidary, (2015) more than half of the infections
are nosocomial. The government of Singapore conducted an outbreak investigation in 2011 to
identify the prevalence rates. The main methods used in the laboratory testing include molecular
diagnostic and serological methods. After conducting the research, the hospital was then able to
develop a policy that recommended for early identification diagnosis and treatment of infected
individuals. In the policy, confinement of infected individuals after identification is also a safety
practice. In addition, vaccination coverage of all health workers in the hospital is also a
recommendation.
Relationship between current knowledge and geographical area data
The existing statistics in Singapore, more than 60% of measles cases are reported in
children between the ages of one to six years. The center for disease control and prevention in
the United States have argued that a sick person is likely to infect ten percent of the people
around him. The fact that vaccination is done to children, many parents have continued to ignore

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calls for vaccination, some out of ignorance while others forget and skip some of the doses. In
other health reports, 20% of cases are reported from foreigners. 34% of cases happen around the
same period of the year and about 12% are reported from adults. Indicating cases of the spread of
the disease. Some of these existing statistics around Singapore have called for herd immunity in
the treatment and prevention of the disease (Trentini, et al 2017).
Herd immunity ensures that there is 96 - 98% control of the disease through controlling
the symptoms of the disease by ensuring complete vaccination. The vaccine is not only
significant in preventing the disease but it also decreases the period of infection in case someone
gets infected. Statistics have also shown that few people go for the second vaccination MMR
vaccine. This is considered a health risk since failure to completely take all the vaccines may
result to delayed cognition and retardation problems such as autism argues Boucher, et al (2017).
Role of the community health nurse
It is among the roles of the community health nurse to identify cases of measles in the
society and provide mechanisms and directions geared towards fighting the disease. Among
these activities include routine vaccination, advocating for screening treatment of the disease,
identification of the risk factors and the comorbidities that heighten the risk of infection of the
disease and providing the society with various measures that can be used to control the disease
and the risk factors of the disease.
According to Thompson, & Odahowski, (2016) the community health nurse also acts as
an advocate between the patients and their significant others. The help to give both emotional
and psychosocial support to the affected families. The nurse also explain the necessary action to
be taken to treat the disease. The community health nurse is also charged with the role of

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communication such as educating the community. The nurses represent the ministry of health
and the government in explaining the various policies such as the 1981 compulsory
immunization policy in Singapore. In addition the nurses also collect ethical information from
the patients and social cultural values and beliefs that influence how people perceive the disease
and how the disease impacts in their lives.
How nursing roles can deal with various stages of infection
According to Ward, (2016) the nursing roles are significant in every step of the way. For
instance, nurses help to advocate for measures that will help those who are not infected to remain
healthy. These measures include recommending vaccination for all children since children are
the most vulnerable. Healthy eating and healthy living is also a valuable recommendation by the
nurses. According to the social cultural societal beliefs, the nurse is able to advise the society on
various measures that will prevent spread of the disease in the society.
For instance, sometime back this year, the Auckland regional public health service
recommended the vaccination of passengers aboard a Singapore plane. The public health
department argued that the passengers might have been exposed to measles and recommended of
measles screening for the passengers where they were to be checked for signs and symptoms of
measles upon landing at Singapore. The public health officials also recommended for
vaccination of passengers boarding the planes to reduce the risk of infection. In addition, since
the risk of prevalence is very high, the airport workers were also recommended to be vaccinated
against the same.
When a person is already infected, the role of nurses is to advocate for treatment. The
nurses may also explain the complications that may follow if the patients neglect care. The nurse

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also highlights the various ways the disease can be spread to other members of the family and
therefore cautions the people with measles patients. The nurses also provide the government and
other policy makers in information that helps in the formulation of policies that helps to control
the disease (Evans, Coutsaftiki, & Fathers, 2017).
In very terminal and complicated cases, the nurse may offer palliative care and
psychosocial support to the patients and their families to help control the disease and improve the
quality of life of the patient if the disease has reached incurable levels. The nurses also help to
advocate for safety measures such as ensuring that people take plenty of water, this helps to
replace any water lost through fever. Increasing immunity against the disease and other
opportunistic infection by eating plenty of vitamins. Caring for the eyes since measles makes the
eyes more sensitive to light. This can be done by using sunglasses or ensuring one stays in a
dimly lit environment. Finally, plentiful rest is also advised for the patients to also help improve
the quality of their lives.
In conclusion, it is clear to indicate that measles is a controllable condition and therefore
it should not get to uncontrollable levels. The disease is mainly prevalent in children but it can
also affect adults. The normal signs and symptoms include fever, vomiting, diarrhea, coughing
and sneezing. The mild complications include eye and ear infection, brain infection and death. In
young children the complications may include pneumonia. The community health nurse aids in
prevention, treatment and control of the condition.

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