Measles in schools and childcare facilities

How to be prepared

• Know the signs and symptoms of measles.
• Ensure students are vaccinated with the MMR vaccine or have a legal exemption on file.
• Save immunization and exemption records for all students. Make sure these records are current and easy to find.
• Encourage staff to confirm they have received the MMR vaccine or have immunity to measles.
  • What counts as evidence of immunity?
• Inform unvaccinated staff and families of unvaccinated children that they may need to stay home for up to 21 days each time they are exposed to measles.

Steps to take if someone with measles has been at your child care or school

• Report suspected measles cases to Public Health at 206-296-4774.
• Review attendance records for all children and staff that attended child care or school during the time the person with measles was at child care or school. Be prepared to provide Public Health with contact and vaccine information:
  • Student/staff first and last name
  • Address
  • Date of birth
  • Phone number
  • MMR vaccination date/s
• Review visitor log for all volunteers or organizations that provide student support that were onsite during the time the person with measles was at child care or school.
• Distribute the Public Health provided measles exposure notification letter to families of children, staff, and volunteers.
• Enforce Public Health exclusion recommendations for exposed students and staff who do not have evidence of measles immunity.

People at highest risk from exposure to measles

• Those who are unvaccinated
• Anyone who is pregnant
• Infants under six months of age
• Those with weakened immune systems

There is no specific treatment for measles. Vaccination is the best protection to prevent catching the disease.

Who should be vaccinated for measles

• Children should be vaccinated with two doses of the Measles Mumps Rubella (MMR) vaccine. The first dose should be given at 12-15 months of age, and the second dose at 4-6 years of age.
• Infants traveling outside the United States can be vaccinated as early as 6 months of age, but they must still receive the full two dose series beginning at 12 months of age.
• Adults should have at least one dose of measles vaccine. You should get two doses if you are an international traveler, healthcare worker, or a student in college, trade school, and other schools after high school.

Children and staff exposed to measles and not immune can be excluded from child care and school

According to the Washington Administrative Code WAC 246-105-080, students and staff at any childcare facility or school in King County who have been exposed to measles and are not immune must stay home:

• They must stay home starting seven days after first exposure through 21 days after the last exposure.
• It's important that they stay home from all public activities, not just school and childcare.
• Staying home greatly reduces the risk that the disease will spread to others who are unprotected, such as infants and pregnant women.

How Public Health determines who will be excluded from a childcare facility or school

When a case of measles is confirmed in a childcare facility or school, Public Health investigates and confirms when the infected person attended the childcare facility or school.

If the infected person attended childcare or school while contagious, the childcare facility or school gives Public Health a list of everyone who may have been exposed to the infected person.

Anyone who cannot provide acceptable evidence of vaccination for measles or already having measles will be excluded from the childcare facility or school. Evidence of immunity could include documentation from a doctor of dates the vaccines were given or documentation of blood tests that show that a person has already had the vaccine or measles disease.

Number of cases of measles that have to occur in a childcare or school before children and staff who are not immune will be excluded

Because measles is one of the most contagious diseases, anyone not immune to measles must be excluded when one case is identified.

Child care facilities and schools determine if they should close during a measles outbreak

Generally, it is not necessary to close childcare facilities or schools during a measles outbreak. However, it may be necessary to close a childcare facility or school if there are not enough providers/teachers or enough students to safely and effectively operate. This decision should be made by the facility or school.