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.