In 2019, four outbreaks linked to patients with international travel have been reported in California, and over 700 cases have been reported nationally. On April 30, 2019, Marin County schools and parents were notified that unvaccinated children and non-immune staff/volunteers will be excluded from school (up to 21 days) if there is a measles case at school. As of May 2, 2019, there have been no confirmed cases of measles in Marin County.
Information for Health Care Providers
Health care providers should consider measles in patients with fever and a descending rash in a person with a history of travel or contact with someone who has traveled outside North America whether or not the patient has had 2 doses of MMR or prior measles disease. However, persons without a history of travel or exposure to a traveler, are unlikely to have measles in the absence of confirmed measles cases in our community.
If you suspect measles, immediately isolate the patient and contact Marin County's Communicable Disease Prevention and Control (CDPC) unit at 415 473 4163 for additional instructions.
- Full clinical guidance from the California Department of Public Health (CDPH)
- Measles Outbreak Toolkit for Health Care Providers from Centers for Disease Control and Prevention (CDC)
- Additional CDC Guidance
- Clinic front desk alert poster
Frequently Asked Questions about Measles in Marin
Updated May 2, 2019
Has anyone in Marin County have been diagnosed with measles?
How infectious is measles?
Measles is a highly contagious virus that lives in the nose and throat mucus of an infected person. It can spread to others through coughing and sneezing. Also, measles virus can live for up to two hours on a surface or in an airspace where the infected person coughed or sneezed. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected. Measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected.
Is Measles life-threatening? What are common complications from Measles?
Measles can be a serious disease in all age groups. However, children younger than 5 years of age and adults older than 20 years of age are more likely to suffer from measles complications.
Can the Health Department exclude unvaccinated children from school?
Yes. Under Health and Safety Code SS 120365; Title 17, Code of Regulations, SS 6060 if the Health Officer determines that unvaccinated individuals are at risk of developing or transmitting the disease they can exclude from school (including child care facilities) until completion of the period in which the disease is communicable.
Can you exclude a child with a permanent medical exemption (PME)?
In what case would you exclude unvaccinated children from school?
On April 30, 2019, Marin County Public Health notified Marin schools and child care facilities that, if there is a measles case at their school, children/students who are unvaccinated or cannot provide laboratory confirmation of immunity will be excluded from school for up to 21 days to protect themselves and to limit further spread of disease.
Have you excluded children from school in the past? Under what circumstances?
In 2007 children were excluded during a large chicken pox (varicella) outbreak in West Marin schools. Once children were excluded, Public Health was able to stem the outbreak.
Doesn't the fact that there are so many cases in California right now constitute an outbreak and reason enough to exclude unvaccinated children from school?
There is no precedent to do so. We follow the guidance of the California Department of Public Health (CDPH) and follow the best practices along with other counties in excluding children should a child with measles attend school during the infectious period. Students will be excluded only when there has been the potential of an exposure.
Is it too late to vaccinate my child?
It's never too late to vaccinate! Contact your health provider to arrange vaccination. It takes approximately 2 weeks to develop immunity after vaccination. Unvaccinated or under vaccinated children should be vaccinated as soon as possible so they will have protection and to prevent future absences from school.
Are adults at risk?
Absolutely. Anyone who is not immune to measles is at risk for contracting the disease. It can be a serious illness in adults, infants and children, and potentially causes severe complications which may lead to death.
Does every adult need a vaccine to become immune to measles?
Adults born before 1957 are generally considered to be immune to measles because they lived through several years of epidemic measles before the first vaccine was licensed. As a result, these people are very likely to have gained immunity through infected with measles. However if a person born before 1957 is a healthcare worker and does not have documented evidence of prior disease, then he or she should have a titer done or receive a booster of MMR vaccine.
How do you know if you are immune to measles?
You are considered immune if you have received two doses of measles vaccine (the first dose should have been received after 1 years old). If you served in the armed forces or were born in the U.S. after 1970 [or entered the U.S. after 1996] and attended a U.S. elementary school, you are likely to be immune to measles (unless you received a medical or personal belief exemption).
Who should not receive the measles vaccine?
- Pregnant females: Pregnancy should be avoided for 4 weeks after immunization. Children and household contacts of pregnant women may be vaccinated. Women who are breast-feeding can be vaccinated.
- Severely immunocompromised patients: Examples include congenital immunodeficiency, AIDS, leukemia, lymphoma, generalized malignancy, and those receiving treatment for cancer with drugs, radiation, or large doses of corticosteroids. Household contacts of immunocompromised people should be vaccinated according to the recommended schedule.
- Infants who are <12 months of age. If there has been recent travel to an outbreak area, parents/guardians of infants 6 - 11 months old should consult with their health care provider to discuss the risks and benefits of early vaccination.
Are adults who work with kids required to be vaccinated?
Under California law (SB 792), employees and volunteers at daycare centers and preschools licensed by California Department of Social Services (CDSS) must be vaccinated for measles, pertussis and flu, effective September 1, 2016. On April 30, 2019, Marin County schools were notified that adults without immunity to measles will be excluded from school (up to 21 days) if there is a measles case at their school.
What else can I do?
Make sure that you and your family have received their vaccinations. If you are not vaccinated, consider obtaining the MMR (Measles, Mumps, Rubella) vaccine. If you suspect that you or someone in your family has measles, do not go to your health care provider's office without calling first for instructions. Your health care provider may provide instructions to minimize exposure to others.
How effective is the vaccine?
94-98% of people develop immunity to measles after receiving their first shot. Following a second MMR vaccine, immunity levels rise to more than 99%.
Where can I go for more information?
- Visit CDC's website
- Visit the California Department of Public Health (CDPH)
- Or, talk to your health care provider.