In July 2015, an elderly woman being treated for several health issues attended a local health clinic. The medications for her chronic diseases placed her in an immunocompromised status. While waiting to be seen by her primary care physician, a child came in with his mother, sneezing and coughing. Nothing more was thought of it until the woman died from pneumonia—caused by measles. This was the first death in the United States from measles in 12 years.
Discussion Questions
What are the facts of this case?
What would have been the potential impact on the woman if the child had the following diseases: pertussis, polio, influenza, or Ebola?
What are the management implications of this case? Should there be separate waiting rooms for people with an immunocompromised status?
What are the legal and ethical obligations of the parent of the unvaccinated child?
What are the legal and ethical obligations the clinic has to its patients and how do they apply to this case? Should the woman’s family seek legal remedies?
An RN who works at the clinic refuses to have an influenza vaccination. She does not have allergies, nor does she have religious objections. She just “doesn’t believe in them.” Create a script for a conversation with this employee, urging her to reconsider, and detailing the consequences of her continued refusal.
Full Answer Section
Pertussis (Whooping Cough):
- Pertussis is a highly contagious respiratory infection that causes severe coughing fits, especially in infants and young children.
- For an immunocompromised elderly woman, contracting pertussis could lead to severe complications, including pneumonia, respiratory failure, and even death.
- The woman's weakened immune system would be less able to fight off the pertussis bacteria, increasing her risk of serious consequences.
Polio:
- Polio is a highly contagious viral disease that can cause paralysis.
- While polio has been eradicated in the United States, it is still endemic in parts of the world.
- If the elderly woman had been exposed to polio, her immunocompromised state would have heightened her susceptibility to the virus.
- Contracting polio could have resulted in paralysis, respiratory problems, and even death.
Influenza:
- Influenza is a respiratory illness caused by influenza viruses that circulate annually.
- While most people recover from influenza within a week or two, it can be severe for older adults, especially those with underlying health conditions.
- For the immunocompromised elderly woman, influenza could have triggered severe complications, such as pneumonia, bronchitis, and even death.
- Her weakened immune system would have made it more difficult to fight off the influenza virus, increasing the risk of serious consequences.
Ebola:
- Ebola is a rare and deadly viral disease that causes severe hemorrhagic fever.
- Exposure to Ebola, even in its early stages, can be life-threatening, especially for individuals with compromised immune systems.
- For the elderly woman, contracting Ebola would have been catastrophic, with a high probability of fatal complications.
- The woman's weakened immune system would have been overwhelmed by the Ebola virus, leading to severe organ failure, bleeding, and death.
Conclusion:
The case of the elderly woman who died from measles highlights the importance of vaccination and the risks posed by infectious diseases to immunocompromised individuals. Vaccinating children against measles and other preventable diseases is crucial to protect vulnerable populations from potentially deadly infections. Additionally, healthcare facilities should implement strict infection control measures to minimize the spread of contagious diseases.