Measles information from the DuPage County Health Department

May 23, 2019

Dear DuPage County School and Child Care Center Parents, Administrators, and Health Professionals:

There has been a recent increase in measles cases in the U.S. across several states (including Illinois), largely due to cases among persons from the U.S. and abroad who were either unvaccinated or with unknown vaccination status. Due to the presence of measles in our region, we would like to make you aware of important and timely prevention measures to help keep our schools and child care centers safe, open, and operational.

In order to protect the health of the community, especially our most vulnerable populations, please partner with us in these important efforts to prevent disease transmission:

1. Schools and child care center staff should review your list of students/attendees susceptible to measles (those children under or un-vaccinated for MMR). Notify those families specifically of the presence of measles in our region and encourage heightened awareness of disease, consultation with their physician about this issue, and vaccination with MMR.

2. All parents and school/child care center staff should review and maintain their own and their family’s records on immunity to measles. Disease transmission and disruption of school and work activities can be prevented with some informed planning and action. Questions to consider: Are you and your family up-to-date with immunizations? Do you have your records reflecting documented evidence of your and your family members’ immunity to measles? Please note: per Illinois Administrative Code Section 690.520, any individual without evidence of measles immunity identified as a susceptible contact to a person with measles (e.g., on a flight, in a waiting room or classroom, in team or intramural sports, in shared space within 2 hours of the presence of a person infected with measles, etc.) “shall be excluded from school, workplace, child care facility, or other facilities until 21 days after the onset of the last reported measles case.”

Susceptible contacts will be excluded until and unless acceptable proof of measles immunity is presented, which includes the following criteria:
• You have written documentation of adequate vaccination:
    o at least one dose of a measles, mumps, and rubella virus-containing vaccine administered on or after the   
       first birthday for preschool-age children and adults not at high risk for exposure and transmission
   o 2 doses of measles and mumps virus-containing vaccine for school-age children and adults at high risk for
      exposure and transmission, including college students, healthcare personnel, international travelers, and
      groups at increased risk during outbreaks
• You have laboratory confirmation of past infection or had blood tests that show you are immune to measles,     
   mumps, and rubella.
• You were born before 1957.*

* Birth before 1957 provides only presumptive evidence for measles, mumps, and rubella. Before vaccines were available, nearly everyone was infected with measles, mumps, and rubella viruses during childhood. The majority of people born before 1957 are likely to have been infected naturally and therefore are presumed to be protected against measles, mumps, and rubella. Healthcare personnel born before 1957 without laboratory evidence of immunity or disease should consider getting 2 doses of MMR vaccine.

Tips for locating old immunization records are available at: www.immunize.org/catg.d/p3065.pdf

3. Vaccine Recommendations: Measles can spread quickly in communities where people are not vaccinated. Measles can be prevented with MMR vaccine, a combination vaccine that provides protection against measles, mumps, and rubella. The MMR vaccine is strongly endorsed by medical and public health experts as safe and effective.

Currently, there are no changes to the national guidelines regarding MMR vaccine schedules:

Children: 2 doses of MMR vaccine, at 12-15 months of age and 4-6 years of age.
Adults (non-high risk): Adults born during or after 1957 should have at least one dose of the MMR vaccine, or presumptive evidence of immunity. At this time, booster doses are not recommended for the general adult population, and there is no recommendation to give second doses for adults born before 1989.

There are additional recommendations for certain high-risk populations:
• Students at post-high school educational institutions: Should have 2 doses of MMR, spaced out by at least
   28 days, or evidence of immunity.
• For individuals who are traveling internationally:
   o Infants 6 through 11 months of age should be given one dose of MMR vaccine. These children will still need
      their regularly scheduled MMR doses.
   o Individuals 12 months of age or older should have 2 doses of MMR, separated by at least 28 days

4. Maintain heightened awareness of student and/or staff reporting signs and symptoms compatible with measles illness. Symptoms of measles typically include high fever, cough, runny nose, and red eyes, followed by a rash that breaks out 3-5 days after symptoms begin. Measles can cause severe health complications, including pneumonia, encephalitis, and death. Measles is a highly contagious respiratory disease and is transmitted by contact with an infected person through coughing or sneezing. Measles virus can remain in the air and on surfaces for up to 2 hours. Infected people are contagious from 4 days before their rash starts through 4 days after the rash develops.

5. Patients suspected of having measles should contact their physician for further evaluation and laboratory testing. Patients/parents should notify their physician or emergency department before seeking care by calling ahead, so that staff are able to take appropriate precautions to prevent others from being infected.

For questions or to report a suspect or known case of measles, please contact the DuPage County Health Department at (630) 221-7553. More information on measles and measles vaccination is available at: www.cdc.gov/measles/index.html. Thank you for your time and cooperation.

Sincerely,
Rashmi Chugh, M.D., M.P.H.                             Karen Ayala, M.P.H.
Medical Officer                                                   Executive Director

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