Although none of the December Disneyland visitors expected to bring home a case of the measles as a souvenir, no one can deny a large, internationally-known theme park is the perfect arena for infectious diseases to propagate.  With swarms of internationally diverse people of all ages crowded together touching communal surfaces, sharing small enclosed areas, and walking through the same air space, venues such as theme parks are virtual petri dishes for a multitude of infectious diseases.
In fact, outbreaks have occurred at a variety of world events such as measles at the 2010 Vancouver Olympics, norovirus at the 2006 World Cup in Germany, and flu at the 2002 Salt Lake City Winter Olympics. Not to mention the possible outbreaks that were prevented by epidemic intelligence activities such as bird flu at the 2014 Winter Olympics in Sochi, Russia and dengue fever at the 2014 World Cup in Brazil. 
Outbreaks can also find their way into enclosed populations. It doesn’t need to be a world event for an outbreak to occur as demonstrated by the multitude of recent mumps cases that sidelined players and referees of the National Hockey League (NHL). In addition, while fans may not get close enough to players to risk exposure what about the guy in the seat next to you? Like Disneyland, sport fans are in close proximity to each other, share communal surfaces and breathe the same air.
What is the impact of an outbreak? In addition to the risk of the illness itself, an outbreak can have far-reaching repercussions. At last count, the number of Disneyland-related cases of measles has grown to 70 and has spread from California to Colorado, Oregon, Utah, Washington and Mexico. This number includes five Disneyland employees who were among those who contracted the disease. Several of those who were at the theme park in December have returned to their homes only to spread it on to others who had been nowhere near “the happiest place on earth.” Health officials in California are spending time and money tracking down those who may have been infected while working hard to stop the number of cases from rising further. In fact, Orange County health officials have banned unvaccinated students from a high school campus for 21 days after a recent measles exposure tied to the Disneyland outbreak. Health officials are also encouraging the unvaccinated to avoid the theme park for a while to prevent more cases.
The CDC indicates the United States experienced a record number of measles cases during 2014 with 644 cases reported in 23 outbreaks covering 27 states. Measles can linger in the air for hours, infecting people even after a sick person has left the area. Someone with measles can spread the virus for several days before the rash appears as well as after the rash clears up. Even though measles was declared eliminated in the U.S. in 2000, it is still prevalent in countries such as the Philippines, Vietnam as well as Europe and Asia. International travelers, or Americans traveling abroad, continually bring the disease into the U.S. while the growing number of unvaccinated individuals as well as those who are vaccinated but not immune help perpetuate it.
According to the National Conference of State Legislature, “All fifty states have legislation requiring specified vaccines for students. Although exemptions vary from state to state, all school immunization laws grant exemptions to children for medical reasons. Almost all states, except Mississippi and West Virginia, grant religious exemptions for people who have religious beliefs against immunizations. Nineteen states allow philosophical exemptions for those who object to immunizations because of personal, moral or other beliefs.” A growing number of parents are choosing not to vaccinate their children which make the chances of contracting a preventable infectious disease higher. In addition, those who are between the ages of 25 and 44 may find themselves not immune if they only received the required one childhood dose of MMR. A second dose of MMR was added in 1989 to bolster the low immunity levels of the previously recommended one dose.
Without a doubt, the best way to prevent outbreaks of any preventable infectious disease is vaccination.  However, since there will always be those who choose not to vaccinate both here and abroad, our best line of defense is vigilance. We must protect those who are most vulnerable such as patients in hospitals and other healthcare settings. With IntelliCentrics SEC3URE, healthcare organizations and other entities can credential and privilege every individual who enters their facility, ensuring that each person has gone through a thorough, but relevant, screening process based on their role.

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