Measles outbreak highlights nurses’ role in prevention and control

RNL Editors |

Infectious disease is global concern.

The recent measles outbreak at a California theme park serves as a reminder of the important role that infection prevention and control (IPC) specialists play in preventing the spread of highly contagious viral infections such as measles.

“The potential for infectious disease outbreaks is something at the forefront of every IPC specialist’s thoughts and actions,” says Barbara Pate, PhD, MPH, RN, nursing faculty at American Sentinel University. “Infectious diseases can occur anywhere in the world and spread quickly to other regions through trade and travel. So it is important that we think globally and act locally when faced with the globalization of infectious diseases.”

Pate points out that IPCs wear their prevention hat every hour of every day. On some days, when an infectious disease such as measles re-emerges, they must also don their control hats. In this case, the single most important task that an IPC performs is to educate individuals, organizations, and communities on appropriate and timely prevention strategies and control measures to prevent the spread of this disease.

Transmission and diagnosis
Measles, also known as rubeola, spreads quickly because it’s a true airborne virus, capable of floating in the air for many hours after being expelled by the cough or sneeze of a sick person. Those infected can shed the virus silently before they develop symptoms and know they are ill. And 90 percent of those exposed will catch the disease if exposed to the virus and are not immune to it, either through vaccination or natural immunity from surviving the disease.

Despite this, immunization rates have dropped precariously in some communities, due to unfounded fears about vaccine side effects. This leaves babies under the age of one especially vulnerable because they are too young to receive the vaccine and have no natural immunity.

Pate believes that all direct care nurses on the front lines of health care must understand the signs, symptoms, and disease progression of measles. More importantly, they should search for evidence from credible sources, assess their environment, and seek the counsel of advanced practice nurses such as IPCs to identify the indicators for a potential outbreak.

Nurses are trained to perform a focused health assessment so when a patient presents with a fever, rash, and cough, coryza, and conjunctivitis—the "three C’s"—they should immediately consider the possibility of measles.

“The ability of nurses to quickly assess and diagnose patients for infectious diseases saves lives by reducing the potential spread of this highly communicable disease,” reports Pate.

Two immediate considerations exist when measles is diagnosed or strongly suspected. The first is that measles is a reportable disease. Both the CDC and state and local health departments track its incidence and engage in contact tracing whenever appropriate.

The next is isolation. According to the CDC, providers must implement isolation precautions immediately to limit the spread of the disease. Misdiagnosis, delayed reporting, and delayed contact precautions can all interfere with infection control measures and lead to a more widespread outbreak.

Role of IPCs
IPC nurses prepared at the graduate level play a critical role in leading preparedness initiatives in these kinds of outbreaks, managing appropriate response interventions and activities, and evaluating the effectiveness of the organization or community’s response tactics.

Pate points out that graduate-level IPCs are critical and analytic thinkers who possess higher-level problem-solving and strategic planning skills.

Specific prevention responsibilities of an IPC specialist include surveillance activities that identify risk factors and monitor the incidence of infectious diseases. This involves effective interdisciplinary collaboration with medical providers, microbiologists, pharmacists, informaticists, and statisticians to facilitate the development of risk estimates and predictive models for outbreaks.
Pate indicates that through education comes knowledge, and through knowledge comes the wisdom to practice safe and effective disease prevention and control.

“By combining the knowledge, strengths, and resources available within an organization, community, society, or system, the level of risk for an infectious disease can be managed and controlled,” she adds.

Nurses interested in planning, implementing, and evaluating infection prevention and control measures within a hospital or public health setting should consider making this in-demand field their career specialty.