Measles and School Exclusion
Measles is a highly contagious viral respiratory disease that begins with a high fever, as much as 104 degrees F. Other symptoms include cough, runny nose, red eyes, and a rash. The rash consists of tiny, red spots that start at the head and spread to the rest of the body. Measles can be a dangerous disease for anyone, but especially for babies, young children, and those whose immune system is compromised. Complications from measles include ear infections, pneumonia, and encephalitis. Children younger than 5 years and adults over 20 years are more likely to suffer complications.
Measles is spread through the air when an infected person coughs or sneezes. The virus can linger in the air or on a surface for up to 2 hours, so a person can become infected without direct contact with someone who has the measles. A person infected with measles is contagious four days before the rash occurs until four days after the onset of the rash.
Measles can be prevented with the MMR vaccine. This vaccine protects against not only measles, but also, mumps and rubella. The vaccine is very effective in preventing the spread of measles and very few cases have been reported in the U.S. In countries where people are not vaccinated, measles is still common and the disease spreads rapidly. Because is extremely contagious, 90% of unvaccinated people in contact with an infected person will become ill with this virus.
The CDC recommends that all children get two doses of MMR vaccine. The first dose is administered between 12 months and 15 months of age. The second dose is given between the 4th and 6th birthday. The second dose can be given earlier, as long as it is at least 28 days after the first dose.
Traveling internationally, including some countries in Europe, Asia, the Pacific, and Africa, poses a risk for people who are unvaccinated. In fact, most cases of measles in the U.S. result from travelers who are not vaccinated. The CDC has developed guidelines for people who travel out of the country and these recommendations can be found on their website. All people 6 months of age and older should be protected against measles.
Exclusion from school during disease outbreaks:
Massachusetts Department of Public Health has developed guidelines for exclusion from school in the event a serious communicable disease occurs in the school setting. These guidelines include measles. The law reads:
In situations when one or more cases of a vaccine-preventable or any other communicable disease are present in a school, all susceptibles, including those with medical or religious exemptions, are subject to exclusion as described in the Reportable Diseases and Isolation and Quarantine Requirements (105 CMR 300.000)
Mandated requirements in the case of measles:
For Case and Symptomatic Contacts - Exclude student/staff through 4 days after onset of rash. (Count the day of rash onset as day zero.)
For asymptomatic contacts – If one case of measles: exclude susceptibles from work or classes from the 5th through the 21st day after their exposure. If multiple cases or continuous (two or more days) exposure: exclude susceptibles through the 21st day after rash onset in the last case.
These restrictions remain even if the contact received immune globulin (IG).
These mandates are in place to protect the health and well-being of all school and community members. As a public school we are required to follow these regulations and all children without two MMR vaccinations will be excluded from school if a case of measles is reported.