Text_Files/Measles.txt

MEASLES (cont.) 
Division of Public Health Services  Disease Handbook for Childcare Providers 
Bureau of Infectious Disease Control   REVISED –January 2018 
MEASLES 
 
 
Measles (aka, rubeola, red measles or hard 
measles) is a very communicable viral illness that 
can be prevented by immunization.  Usually it 
causes a rash, high fever, cough, runny nose and 
watery eyes.  The disease lasts one to two weeks.  
Measles may be complicated by an ear infection 
or pneumonia.  One out of every 1,000 children 
who gets measles develops an inflammation of the 
brain (i.e., encephalitis).  Encephalitis can lead to 
convulsions, deafness or mental retardation.  
Approximately one  child in every 10,000 who 
gets measles dies from it. 
 
Who gets this disease? 
Measles cases are generally limited to three 
groups: 1) children less than 15 months of age 
(who are too young to have been immunized), 2) 
those over 15 months of age but remain 
unvaccinated and 3) adolescents and young adults 
who may have received an earlier ineffective 
measles vaccine prior to 1968 OR graduated from 
school prior to the mandatory measles vaccination 
law OR who have received only one dose of live 
virus measles vaccine.  Adults born prior to 1957 
are generally considered to be immune against 
measles. 
 
How is it spread? 
Susceptible individuals spread measles by large 
infectious droplets or direct contact with the nasal 
or throat secretions of infected persons.  Inhal ing 
air that has tiny infectious droplets from sneezes 
and coughs also can spread it.  
Measles is one of 
the most readily transmissible communicable 
diseases.  The communicable period is greatest 
prior to or just after rash onset. 
What are the symptoms? 
The first signs and symptoms of measles – which 
appear approximately 10 -days after exposure –  
are similar to the common cold: cough, runny 
nose, fever greater that can reach as high as  103-
105 degrees Fahrenheit, and red and watery eyes.  
After these cold -like symptoms a rash develops, 
typically beginning on the face and then spreading 
downward over the entire body.  This rash lasts 4 -
10 days. Infected persons may also experience 
loss of appetite or diarrhea.  
 
Infected persons are contagious from the 
appearance of the first cold symptom to four days 
after the appearance of the rash.  A small 
percentage of immunized children may become 
infected if their bodies fail to respond adequately 
to the vaccine. 
 
How can the spread of this disease be 
prevented? 
The Advisory Committee on Immunization 
Practices (ACIP) recommends that children be 
immunized against measles between 12 to 15 
months of age.  Children who are immunized 
before 12 months of age need to be re-immunized. 
 
Children 15 months and older are required  to 
have one dose of measles vaccine for daycare and 
school admittance.  A second dose of measles 
vaccine is required between 4-6 years of age. 
 
Who should be excluded? 
Children and staff with measles shall be excluded 
from the school or work for at least four days after 
the appearance of the rash.  If children are 
unimmunized for medical, religious or other 
reasons they should be excluded for at least 2 
weeks after the onset of the rash in the last case of 
measles reported in the child care setting. 


MEASLES (cont.) 
Division of Public Health Services  Disease Handbook for Childcare Providers 
Bureau of Infectious Disease Control   REVISED –January 2018 
Reportable? 
Yes.  Measles is reportable immediately  by New 
Hampshire law to the Division of Public Health 
Services, Bureau of Infectious Disease and 
Control at (603) 271-4496.