Infectious Disease Prevention and Control

Understand prevention measures and control strategies to reduce infection risks.

Understand prevention measures and control strategies to reduce infection risks.

Infectious diseases specialists diagnose and treat infections from bacteria, viruses, fungi, and parasites, focusing on fevers, antibiotics, and vaccines.

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Immunization Strategies and Public Health Defense

Measles prevention relies on keeping immunity high in the community. Since the virus only infects humans, it can’t survive if most people are immune. This is called herd immunity. At Liv Hospital, prevention focuses on strong vaccination programs, quick action after exposure, and careful monitoring.

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The Measles-Mumps-Rubella (MMR) Vaccine

Immunization Strategies and Public Health Defense

The cornerstone of prevention is the live-attenuated measles vaccine, typically administered as the combination MMR (Measles, Mumps, Rubella) or MMRV (including Varicella/Chickenpox) vaccine.

  • Efficacy: The vaccine is remarkably effective. A single dose is approximately 93% effective at preventing measles. Two doses are approximately 97% effective. This high efficacy is why the two-dose schedule is the global standard.
  • Schedule: The standard vaccination schedule involves the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age (before starting school). In outbreak scenarios or for international travel, the schedule may be accelerated for infants aged 6-11 months.
  • The vaccine uses a weakened form of the virus. It does not cause illness but helps the immune system make antibodies and memory cells. This prepares the body to quickly fight off the real measles virus if exposed in the future.
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Herd Immunity Thresholds

Herd Immunity Thresholds

Because measles spreads so easily, about 95% of people need to be vaccinated to stop outbreaks. If vaccination rates fall below this level—due to hesitancy, poor access, or health service problems—herd immunity is lost. The virus can then infect the small group of people who are not protected, causing large outbreaks. Public health teams work to find these gaps and run extra vaccination campaigns.

Post-Exposure Prophylaxis (PEP)

If a non-immune person is exposed to the measles virus, prevention is still possible if it is acted on immediately.

  • MMR Vaccine as PEP: If given within 72 hours after exposure, the vaccine can prevent measles or make the illness much milder.

Immune Globulin (IG): People who cannot get the live vaccine—like pregnant women, babies under 6 months, or those with weak immune systems—can receive immune globulin, which contains antibodies from donated blood. If given within 6 days of exposure, it can prevent or lessen the severity of measles.

Post-Exposure Prophylaxis (PEP)

Infection Control in Healthcare Settings

Hospitals are critical control points. Preventing nosocomial (hospital-acquired) transmission is a priority.

  • Triage and Isolation: Any patient presenting with fever and rash is immediately isolated in an Airborne Infection Isolation Room (AIIR) before entering common waiting areas.
  • Staff Immunity: All healthcare personnel must have documented proof of immunity to measles (two doses of vaccine or positive serology).

N95 Respirators: Standard masks are insufficient. Staff entering the room of a suspected measles patient must use fit-tested N95 respirators to filter out the aerosolized virus particles.

Managing Outbreaks and Surveillance

During an outbreak, control measures include “ring vaccination.” This means finding everyone who had contact with a confirmed case and making sure they are vaccinated. This forms a protective circle around the patient and stops the virus from spreading. Surveillance also means quickly reporting suspected cases to public health officials to track and control the outbreak.

Contraindications and Special Populations

While the vaccine is safe for the vast majority, there are specific groups who cannot receive the live vaccine and thus rely entirely on herd immunity for protection.

  • Pregnancy: The MMR vaccine is contraindicated during pregnancy due to theoretical risks to the fetus. Women of childbearing age should verify their immunity before becoming pregnant.
  • Immunocompromise: Individuals with severe immune deficiencies (e.g., undergoing chemotherapy, untreated HIV/AIDS) should not receive live vaccines.

Allergies: Severe allergic reaction (anaphylaxis) to a previous dose or vaccine component (like gelatin or neomycin) is a contraindication. Note: Egg allergy is not a contraindication for the measles vaccine.

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FREQUENTLY ASKED QUESTIONS

Why do children need two doses of the measles vaccine?

While the first dose of the measles vaccine is very effective, it fails to generate immunity in about 7% of children. The second dose is not a “booster” in the traditional sense; rather, it is a safety net intended to catch that 7% who did not respond to the first dose. After two doses, protection rises to about 97%, ensuring almost everyone is protected.

No. This is one of the most thoroughly investigated topics in medical science. Numerous large-scale studies involving millions of children across multiple countries have found absolutely no link between the MMR vaccine and autism. The original study that suggested a link was found to be fraudulent, was retracted, and the author lost his medical license. The vaccine is safe.

It is scarce, but possible. About 3 out of 100 people who get two doses of the measles vaccine might still get measles if exposed to the virus. However, these “breakthrough” cases are typically much milder than regular measles, and these individuals are less likely to spread the virus to others. The vaccine effectively prevents severe illness even in these rare cases.

If you are an adult and are unsure if you were vaccinated as a child, it is safe to get another dose of the MMR vaccine. There is no harm in getting an extra dose if you are already immune. Alternatively, a doctor can perform a simple blood test (titer) to check for measles antibodies to confirm if you are immune.

Measles was declared eliminated in many regions, but it is re-emerging primarily due to gaps in vaccination coverage. When vaccination rates dip below 95% due to misinformation, complacency, or access issues, the virus (often imported from other countries) can gain a foothold and spread rapidly through unimmunized pockets of the community.

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