---
title: "Measles - just when we thought they were \"wiped\" away!"
description: "Measles - just when we thought they were \"wiped\" away!"
---

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## Measles - just when we thought they were "wiped" away!

<http://static1.squarespace.com/static/595689fc9de4bbc892200518/t/59568acb5fd63b5f29287847/1498845447964//img.jpg.com/static/595689fc9de4bbc892200518/t/59568acb5fd63b5f29287847/1498843851809/1000w/>

You may be thinking that vaccinations and disinfection  
 really do not have much in common.  If  
 you'll pardon my pun, vaccinations and disinfection both "[wipe](https://www.google.ca/search?q=definition+of+wipe&oq=definition+of+wipe&aqs=chrome..69i57j0l5.2507j0j7&sourceid=chrome&espv=210&es_sm=93&ie=UTF-8)" germs  
 away and both directly work toward the prevention of outbreaks.   Why then, with a disease such as [Measles](http://www.cdc.gov/measles/)  
 which most would say we've conquered are we seeing increased reporting of  
 outbreaks?  What impact does this have on  
 society not only in terms of illness and deaths, but the economic burden to our  
 healthcare infrastructure? 

Yesterday, [Ottawa Public Health](http://ottawa.ca/en/news/confirmed-case-measles-ottawa) announced their first  
 lab-confirmed case of measles since 2011 and the [European Centre for Disease Control](http://ecdc.europa.eu/en/press/news/_layouts/forms/News_DispForm.aspx?List=8db7286c-fe2d-476c-9133-18ff4cb1b568&ID=964) (ECDC) confirmed there has been a measles outbreak onboard a cruise  
 ship that had travelled between Spain and Italy.   If you didn't already know, **measles is  
 considered one of the MOST contagious infectious diseases**.  In fact it is one of the leading causes of  
 death among young children even though there is a safe and cost effective  
 vaccine available.  Prior to widespread  
 vaccination in the 1980's measles caused 2.6 million deaths each year (based on  
 my age, I could have been one of the unlucky children...).  To give an idea of the significance of  
 measles from a cost perspective,   
Massachusetts reported that in 2011 there were 107 confirmed cases  
 in their state which **cost local and state officials between $2.7 million and  
 $5.3 million! **

Measles has a long incubation period - anywhere from 7 -  
 18 days.  A person is considered  
 infectious from about 4 days before the rash starts to 4 days after the rash  
 appears.  The virus itself is transmitted  
 by airborne droplets or direct contact with nasal or throat secretions, but can  
 also spread through contact with surfaces or fomites that have been  
 contaminated with nasal and throat secretions.    No wonder it's so contagious!  You have 4 days to walk around infecting  
 people before you know you're sick, a perfect storm not just onboard cruise  
 ships, but any public setting!

As we know, there is no singular step, process or  
 intervention that can stop the spread of germs.   PREVENTION is our best line of defense.  The use of [vaccinations](http://www.phac-aspc.gc.ca/im/vpd-mev/index-eng.php) certainly play a very  
 important role in preventing outbreaks. [Hand Hygiene ](http://www.cdc.gov/handhygiene/)as we know plays probably the single most important role in  
 preventing transmission of germs not just in healthcare settings, but all  
 community settings.  [Cleaning and Disinfection](http://www.cdc.gov/hicpac/pubs.html) as we have mentioned in numerous blogs plays an important part in  
 not just the prevention of transmission, but intervention of outbreaks that do  
 occur.

When talking about infection prevention programs, cost is  
 often a road block to implementation.     
In the US, a cost-benefit analysis showed that every dollar invested in  
 a vaccine dose saves $2 to $27 in health costs which equates to cost savings of  
 millions upon millions of dollars.  We  
 also know that every day, about 1 in every 20 hospitalized patients will get an  
 infection caused by receiving medical care which relates to an overall direct  
 cost of **HAIs in hospitals ranging from US$28 billion to 45 billion**.

When it comes to hand hygiene, studies have shown a  
 linear relationship exists between hand hygiene compliance and HAI rates. For  
 each 1% increase in hand hygiene compliance, there is a 0.6% decline in the  
 prevalence rate of Methicillin-Resistant Staphylococcus Aureus (MRSA).  
 Increasing hand hygiene compliance can save hospitals big money by avoiding HAI  
 related costs and freeing up beds. As an example, a hospital that improves its  
 compliance rate from 40% to 80% could experience a 24% decline in  
 infections.  A hospital with a history of  
 50 HAIs per year means they can prevent 12 HAIs and if we assume an average  
 cost of $43,000 per infection, **the hospital would save $516,000 per year in HAI  
 related costs**.

Similarly, there are studies to support that improved  
 Environmental Hygiene programs can directly impact HAIs.   The contribution to reducing HAIs varies,  
 but from work I have reviewed a 20% reduction from improved cleaning and  
 disinfection programs is reasonable.   
This would mean a prevention of 10 HAIs (remember the hospital has  
 50/yr) - a savings of $430,000 per year!

The savings add up!   
What would our healthcare system look like if we had 100% vaccination  
 rates, 100% hand hygiene compliance and environmental hygiene programs that  
 have sufficient staff and allow sufficient time to cleaning and  
 disinfect......NIRVANA!

*Bugging Off! *

Nicole

 

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