A proactive approach to local and international disease threats is an essential safeguard to business productivity. Human capital is arguably worth more to a business than tangible assets because it is often the key competitive advantage that distinguishes a business in the marketplace.
Infectious diseases are a constant threat to productivity since they erode and diminish human capital. However, businesses who monitor infectious disease threats and couple this with a proactive healthcare approach are often able to avoid such threats to productivity.
Vaccinations and Herd Immunity
While vaccinations are important to protect individual human capital, they are critical for broader, continued corporate productivity. Vaccinations have a direct effect on individuals by providing them with a defense, or immunity, against disease.
Yet, vaccinations also have an indirect protective effect on other individuals in the corporate setting. For example, when a high proportion of employees are vaccinated, they potentially prevent the spread of disease within the workplace by establishing a protective barrier around those who are not vaccinated and/or have not built up sufficient defenses against disease.
In the science community, we call this concept herd immunity. The modern corporate workplace is threatened by local and international infectious diseases. Local disease outbreaks have the potential to expose a high proportion of employees to an infectious disease; therefore, herd immunity is extremely important for maintaining a corporate protective barrier against outbreaks.
Corporate health is equally jeopardized by international disease threats when unprotected individual employees travel abroad. Upon return, those employees can threaten productivity by exposing others to the imported infectious agent.
Case Study: Pertussis Activity in the United States
Pertussis, also known as whooping cough or the "100-day cough," is a highly contagious bacterial infection. Most adults with pertussis misdiagnose themselves as having a cold. A local disease outbreak of pertussis has the potential to greatly impact employee productivity due to the employee being sick and/or an employee needing to take care of a sick child or family member.
Pertussis activity peaks in the United States about every three to five During 2014, the United States Center for Disease Control reported over 32,970 pertussis cases countrywide which is a 15 percent increase compared to the roughly 28,640 reported during 2013.(1) At present, officials in the U.S. customarily recommend that young children receive the pertussis vaccination. Yet, it has been observed that defenses built up by the pertussis vaccine tend to diminish after five to 10 years.
Thus, any employee who received pertussis vaccination more than five to 10 years ago may be at risk for contracting the disease. During a local disease outbreak, employees will be exposed to pertussis through contact with droplets from a cough or sneeze of a contagious community member. If an exposed employee is not vaccinated or lacks the necessary protection, he or she can contract the disease, become contagious, and spread pertussis to other employees.
Although symptoms of pertussis usually do not occur until seven to 10 days after initial exposure, infected individuals become contagious shortly before symptoms begin, and thus a contiguous and undetectably ill employee can unknowingly expose co-workers and the workplace to pertussis for several days.
If the workplace lacks herd immunity-the protective barrier-the potential for a corporate-wide outbreak is very high. According to officials, 92 to 94 percent of people in a community need to be vaccinated against pertussis to benefit from herd immunity.
Case Study: Measles and International Travelers
Measles is a highly contagious international disease threat that causes individuals to become extremely sick for about one week. Since measles is a potential threat to all employees who travel abroad, most healthcare officials recommend that all international travelers receive the MMR (measles, mumps, and rubella) vaccine or undergo a blood test to ensure they have adequate protection against the disease.
Not only will these proactive measures protect the health of the individual employee, they will also prevent importation of the disease into the workplace. Measles was officially eradicated in the U.S. in 2000 after the country went 12 months without reporting any measles infections. Elimination was achieved by maintaining high vaccination coverage.
However, sporadic outbreaks have been reported in the U.S. due to imported measles cases and low immunization rates. In 2014, over 660 measles cases were reported in the U.S. from 27 states. This was the greatest number of cases reported since 2000. According to the U.S. CDC, many of the cases were linked to infected international travelers from the Philippines.(2)
Similar to pertussis, employees who travel abroad can be exposed to measles through contact with droplets from a cough or sneeze of a contagious person. If an exposed employee is not vaccinated or lacks the necessary protection, that person could spread the disease to susceptible co-workers upon return to the workplace.
A contiguous employee can unknowingly expose co-workers and the workplace to measles because infected individuals become contagious as many as four days before the most obvious symptom-a rash-appears at 7 to 21 days after initial exposure.
International Travelers & Vaccinations
International travelers regardless of their destination should ensure that they are up to date on the vaccines listed below. It is important to note that healthcare providers will likely add additional vaccinations to those listed above, such as yellow fever and Japanese encephalitis, if these vaccines are required by the traveler's host country and/or if the disease is endemic in the destination country.
Employers should encourage all international travelers to contact a physician who has expertise in travel medicine four to six weeks prior to travel. This will allow enough time for the traveler to complete any vaccine series as well as give their body time to build up immunity.
Chickenpox (Varicella): Recommended for travelers without a history of chickenpox or evidence of immunity to chickenpox by blood test. This vaccine is administered as a two-dose series.
Hepatitis A: This vaccine is included in routine children's immunizations. The Hepatitis A vaccination is most important for travelers who are traveling to countries with an intermediate to high prevalence of Hepatitis A. This vaccine is administered as a two-dose series. A Hepatitis A/Hepatitis B combined vaccine is also available.
Hepatitis B: Recommended for all unvaccinated persons who might be exposed to blood or body fluids, have sexual contact with the local population, or be exposed through medical treatment, such as for an accident, even in developed countries, and for all adults requesting protection from HBV infection. The Hepatitis B vaccination is most important for travelers who are traveling to countries with an intermediate-to-high prevalence of Hepatitis B. This vaccine is administered as a three-dose series. A Hepatitis A/Hepatitis B combined vaccine is also available.
Influenza: Recommended for all travelers over the age 50, very young children, and/or travelers of all ages who have a chronic disease such as diabetes or emphysema. This vaccination is administered annually.
Measles, mumps, rubella (MMR): Recommended for travelers born after 1957, and those who did not have these diseases as children. People born before 1957 generally acquired immunity to these diseases in childhood. This vaccine is administered as a two-dose series.
Pertussis (Whooping Cough): This vaccine is included in routine children's immunizations with tetanus and diphtheria (see below). It is also now available for adults in combination with the tetanus/ diphtheria booster.
Pneumococcal pneumonia: Recommended for all adults over age 65, and anyone with chronic disease. Physicians in the US also recommend this vaccination for smokers and anyone with asthma.
Tetanus and diphtheria: A booster is recommended every 10 years after initial immunization series.Infectious diseases have the potential to greatly impact business productivity by eroding and diminishing human capital on an individual and corporate level. Since infectious diseases are a constant threat to the bottom line of every business, it is imperative that businesses monitor local and international disease threats, and adopt proactive healthcare measures. For that reason, thoughtful proactive disease prevention protocols are key to eliminating threats posed by local and international infectious diseases.
About the Author
Melissa Dudley is a Health Intelligence Analyst at iJET International. She holds a B.S. in Biology and minor in Chemistry from Frostburg State University and is currently completing her MPH. Melissa also attended the West Virginia School of Osteopathic Medicine and served as an officer in the US Army.
References
1. "Pertussis Outbreak Trends"; US CDC; Sept. 8, 2015; http://www.cdc.gov/pertussis/outbreaks/trends.html; Accessed, Sept. 28, 2015.
2. "Measles Cases"; US CDC; Sept. 23, 2015; http://www.cdc.gov/measles/cases-outbreaks.html; Accessed Sept. 28, 2015
