Introduction
Big cities are tourist attractions from all over the world. One of them is the City of Miami (ZIP code 33010-33299), which is a cultural, financial, and economic center of South Florida in the United States, located on the East Coast of the Atlantic Ocean with a population of almost 500,000 people (Open Data Portal, 2020). The location of the city attracts many travelers from other countries, which increases the chances of a pandemic happening.
Last year Centers for Disease Control and Prevention (CDC) received several community outbreaks, including Tuberculosis outbreak, Measles outbreak, and Hepatitis A outbreaks in Miami-Dade (Immunization and Infectious Diseases, 2020). The outbreaks happened in communities among unvaccinated populations, and measures for contamination and prevention of spreading were taken. However, the possibility of it happening again is remaining significantly high because of the large number of people who are not vaccinated and do not maintain proper personal hygiene.
Tuberculosis
Tuberculosis (TB) is an infectious disease that is caused by bacteria called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but they can attack any part of the body such as the kidney, spine, or brain. Not everyone who was infected with TB bacteria can become sick, so two conditions of TB exist latent TB infection (LTBI) and TB disease (Floyd, Raviglione & Glaziou, 2018). LTBI means that people were exposed to illness and have positive results for TB infection, but they do not show any symptoms, do not feel sick, and are not contagious. Usually, TB bacteria can live in their bodies for years and not cause any symptoms.
However, for some people, if they don’t get the treatment, it can develop into a TB disease (Floyd et al., 2018). So, one should do a routine scan and health check at least once a year to exclude the possibility of having any form of TB.
TB is spread through the air from person to person. When a sick person coughs, speaks, sings, or sneezes, it causes the bacteria to come up from the lungs to the throat, which gets those who are nearby being exposed to breathe it in. However, it is not spread through touching a sick person, shaking hands, sharing items, drinks, food, and even kissing (Floyd et al., 2018). When one breathes in TB bacteria, it goes down to the lungs and settles there.
From the lungs, it can move to other parts of the body: kidneys, spine, or brain, where it is not infectious. However, in the lungs or throat, TB is very contagious, and people who have close contact with a TB infected person are most likely to be exposed (Floyd et al., 2018). Therefore, one should avoid close contact with people showing the symptoms and visit a doctor if one suspects the exposure of TB disease.
The development of health systems and medications made it possible to stop the spreading of TB disease compared to the past. In 2018 there were 9,094 TB cases reported in the U.S., 591 cases in Florida, and 124 in Miami. In the city, it shows the rate of 4.4 per 100,000 populations (Tuberculosis (TB), 2018). However, even though it is controlled, the disease comes back once in a while because the health system is focused on treating the disease rather than stopping it completely (Tuberculosis (TB), 2018). So the public must be aware of its existence to reduce the risk of being exposed to it and minimize the possibility of causing panic among the population.
To contain the disease, a TB infection control plan was designed，which is supposed to ensure prompt detection of patients infected with TB, airborne precautions, and treatment of people who have suspected or confirmed TB disease. For this purpose, Administrative measures, Environmental Control, and Use of Respiratory Protective Equipment were developed. Administrative rules are meant to reduce the risk or exposure to people with TB disease.
It includes the following plan: assigning a responsible person for TB control; ensuring the availability of laboratory for processing and testing results, proper cleaning and disinfection of the equipment; educating and training personnel, reminding patient about coughing etiquette and respiratory hygiene; proper coordinating between local and state departments (Tuberculosis (TB), 2018).
Environmental Control includes controlling the source of infection by using local exhaust ventilation and removing contaminated air by using general ventilation and preventing the contamination of air by filtration or ultraviolet germicidal irradiation (Tuberculosis (TB), 2018). The use of Respiratory protecting equipment is supposed to reduce the risk of being exposed to TB bacteria by training health personnel on respiratory protection and educating patients on respiratory hygiene and cough etiquette.
Measles
Measles is an infectious disease that affects the immune system by suppressing it. It is a highly contagious disease and causes symptoms like fever, runny nose cough, red and watery eyes, and rush. Measles is highly infectious and has an incubation period of up to 21 days (Measles (Rubeola), 2019). The disease is also hazardous because it has serious health complications; it attacks immune cells, which causes immune suppression (Mina, Kula, Leng, Vries, Knip, Elledge, 2019, 599). It means that measles makes the immune system forget how to fight other diseases or infections, so people who had it are at constant risk of dying from other infectious illnesses.
Measles is transmitted from one person to another with droplets that are exposed to air when coughing, sneezing, speaking, etc. It is also very dangerous because the infection can live in the air for up to two hours, compared to other diseases that are not so survivable (Measles (Rubeola), 2019). The rate of contamination is significantly high since nine out of ten people get infected after close contact with a sick person (Measles (Rubeola), 2019). Before the age of vaccination, Measles disease was a cause of death for almost 1 million people per year (Measles (Rubeola), 2019). However, the development of technology, medicine, and vaccines reduced not only the death rate but also the rate of infected people. It was a great achievement for humanity that now is at risk because of the anti-vaccination movement.
Measles was the first disease to be controlled by vaccination (Mina et al., 2019, 599). Today, people who are exposed to it are mostly those who have not received the vaccine. Last year, Florida experienced the worst measles outbreak since the 1990s, almost 1200 cases were confirmed, and lots of them were in the City of Miami (Measles (Rubeola), 2019). It is a significant number because, with the existing vaccine, the disease was supposed to be demolished by now.
The location of South Florida also puts it at risk of exposure since many people travel through it every day, and the possibility of someone bringing the disease to the U.S. from other places where outbreaks happened is exceptionally high (Measles (Rubeola), 2019). It means that the government should always be on high alert to another outbreak and be prepared to contain it.
Hepatitis A
Hepatitis A is a liver infection caused by the hepatitis A virus. It affects liver function and causes inflammation and can be contaminated from contact with a sick person, sharing food, drink, or personal items. Most people who were exposed to it recover without liver damage and some mild cases don’t even require treatment (Hui, 2018). One of the best ways to prevent Hepatitis A is maintaining good personal hygiene, like washing hands.
The symptoms usually don’t appear until a few weeks after exposure and include fatigue, vomiting, and runny nose, loss of weight and appetite, yellow skin. It is advised to see a doctor if one developed such symptoms or has been in close contact with people diagnosed with Hepatitis A or ate in the restaurant that reported a Hepatitis A outbreak (Hepatitis A Outbreaks in the United States, 2019). Timely received diagnosis and treatment can minimize the risk of further development of the disease and health complications.
At most dangers to exposure to Hepatitis A and developing complications are people with the weak immune system; homeless people who live in the streets; drug-users, patients with pre-existing conditions (such as chronic liver disease, hepatitis B, hepatitis C); and men who have sex with men (Hepatitis A Outbreaks in the United States, 2019). Those people should receive a vaccine for Hepatitis A during the outbreak or when traveling to the places where the outbreak recently happened since promptly, vaccination is the most reliable existing way to prevent spreading the disease.
Last year there were up to 5000 cases of Hepatitis A reported in Florida, with almost 3000 cases hospitalized (Vaccine-Preventable Diseases, 2020). As a response to the outbreak, the CDC provides epidemiology and laboratory support, vaccine supply, and vaccine development. A possible increase of Hepatitis A cases is continuously monitored and assessed to reduce the risk of community outbreaks among the population (Vaccine-Preventable Diseases, 2020). However, the best measure for the prevention of Hepatitis A contamination remains vaccination and maintaining proper personal hygiene such as washing hands and following the coughing etiquette.
Conclusion
Many years of human history show that an infectious disease outbreak can happen anywhere and anytime. There are always places, like Miami, that, due to its location, are at most risk of exposure to epidemics. Governments and national disease control centers must do everything possible to prevent the infectious disease from spreading or take necessary measures for containing them if the outbreaks happen. Most of the existing contagious diseases like Measles or Hepatitis A can be prevented by vaccinating. Right now, it is one of the biggest problems for healthcare workers. Therefore, it is essential that the public is aware of such a measure and understands its importance.
Receiving timely treatment is also essential to contain the infectious disease. If one experiences symptoms such as long-term coughing, vomiting and runny nose, fatigue, or weight loss, it is crucial to visit a doctor promptly. It is not only to prevent further development of the disease but also to stop spreading it to other people and reduce the risk of causing the outbreak. It mainly considers people who recently traveled to countries where the outbreaks happened. Moreover, one should maintain one’s body in good health by eating properly, exercising, and completing a health check at least once a year.
References
Floyd, K., Raviglione, M., & Glaziou, P. (2018). Global Epidemiology of Tuberculosis. Seminars in Respiratory and Critical Care Medicine, 39(03), 271–285. Web.
Hepatitis A Outbreaks in the United States. (2019). Web.
Hui, Y. H. (2018). Foodborne Disease Handbook, Second Edition Volume Ii: Viruses, Parasites, Pathogens, and Haccp. Milton: CRC Press.
Immunization and Infectious Diseases. Web.
Measles (Rubeola). (2019). Web.
Mina, M. J., Kula, T., Leng, Y., Li, M., Vries, R. D. D., Knip, M., … Elledge, S. J. (2019). Measles virus infection diminishes pre-existing antibodies that offer protection from other pathogens. Science, 366(6465), 599–606. Web.
Open Data Portal: Miami FL: Open Data Portal. Web.
Tuberculosis (TB). (2018). Web.
Vaccine Preventable Diseases. Web.