Risk Assessment: Tools, Techniques, and Their Applications

20.10 Example of Measles, Mumps, and Rubella

These are classically grouped together, as the features of these diseases are somewhat similar. Measles is caused by Morbillivirus, which is contagious and spread through aerosolized droplets. It is the fifth leading cause of childhood mortality worldwide, with less than 1% occurring in the United States because of the relatively widespread use of the measles vaccine. Symptoms include 2 days of upper respiratory disease followed by a fever >105 F, which then leads to the classic morbilliform rash, which includes the palms and soles. The measles vaccine is a live attenuated virus given at 1 year of age.

Rubella or German measles is caused by Rubella virus of the genus Rubivirus (6). The vaccine was introduced in 1969 with the last pandemic occurring in 1964. It spreads via respiratory droplets and is most severe when acquired by pregnant women. Intrauterine rubella can lead to mental retardation, deafness, and heart disorders among other complications. Maternal infection during the first trimester of pregnancy will have an incidence of 50% transmission to the fetus resulting in more severe malformations than infection during subsequent trimesters of pregnancy.

Mumps is caused by paramyxovirus (6). The vaccine was introduced in 1967. The disease can also be transmitted by respiratory droplets. Rarely fatal after introduction of the vaccine, the incidence in the United States was reduced to approximately 200 annually.