Health Services Agency

Measles is a highly contagious viral disease that causes fever and a rash.

Anyone who is not vaccinated can get measles at any age.

The measles virus lives in an infected person's nose and throat mucus. When that person sneezes or coughs, the measles virus sprays into the air, and people can breathe in the virus. The virus remains active and contagious in the air for up to two hours. The disease is highly contagious — if one person has it, 90 percent of people around them will also get it if they are not immune.

Early symptoms of measles include fever (which can reach 103 to 105 degrees F), cough, runny nose, and red, watery eyes. Three to five days after symptoms start, a rash of red spots appears on the face and then spreads over the entire body.

Symptoms usually appear 10 to 12 days after breathing in the virus; symptoms may start as early as seven days or as late as 21 days after exposure.

A person can spread measles from four days before through four days after the appearance of the rash.

No. Infection makes a person immune for the rest of their life; that means they cannot get it again.

Yes. The measles vaccine is given on or after a child's first birthday. It is combined with the mumps and rubella vaccines into one vaccine called MMR (measles, mumps, and rubella). A second dose of the MMR vaccine is recommended before children enter school at 4 to 6 years of age. Anyone who has received two doses of a measles vaccine is considered immune and is unlikely to get measles.

Measles is easily spread from person to person. When an infected person talks, coughs, or sneezes, the virus is released into the air and enters another person's body through the nose, mouth, or throat. People can also become sick if they come in contact with an infected person's mucus or saliva (spit). The measles virus can live on contaminated surfaces and in the air for up to two hours. If other people breathe the contaminated air or touch the contaminated surface, then touch their eyes, noses, or mouths, they can become infected. Measles may be transmitted from 4 days before through 4 days after rash onset.

“Exposed” means you've been in a situation where you can catch the virus from someone who already has measles. For example, you can be exposed to the measles virus by being in the same room, home, office, or waiting room with someone who has measles or by being there up to 2 hours after the person with measles has left. People are less likely to get sick with measles if vaccinated appropriately. Approximately 90 percent of susceptible people will get measles if they are exposed to someone with the disease.

Generally, a person is considered immune if they:

1. Had measles in the past and have laboratory confirmation to prove it, OR
2. Have laboratory evidence (a blood test that shows whether the body has antibodies to fight off the virus) of immunity OR
3. Have written documentation of adequate vaccination with measles-containing vaccine in the past (often given as MMR [measles, mumps, and rubella] vaccine)
   • One or more doses of a measles-containing vaccine administered on or after the first birthday for preschool-age children and adults not at high risk
   • Two doses of measles-containing vaccine for school-age children and adults at high risk, including college students, health care personnel, and international travelers, OR 4. Were born before 1957
   • Adults born before 1957 are likely to have had measles disease as a child and are generally (but not always) considered not to need vaccination.

• Call your healthcare provider as soon as possible to discuss your exposure so special arrangements can be made for you to be evaluated without putting other patients and medical office staff at risk. A person infected with measles can be infectious before they have any disease symptoms. Your healthcare provider is the best person to determine if you are immune to measles based on your vaccination record and any medical conditions you might have.
• If you or your child are not immunized, you may be advised to stay home (quarantine) and away from work, school, and public places for 21 days to ensure you/your child does not become infected and pass measles to others.
• If you have not been vaccinated, the measles vaccine may help prevent disease if given within 72 hours of first exposure. Immune globulin (a blood product containing antibodies to the measles virus) may prevent or lessen the severity of measles if given within six days of first exposure.
• If you are immunized or have other proof of immunity to measles, you do not need to be quarantined and may continue your normal activities.

If you were able to receive the vaccine within 72 hours after first exposure to someone with measles, you might not need to be quarantined. However, if you receive the vaccine after 72 hours, you must be quarantined for 21 days.

No. Entering the home where a person is quarantined is highly discouraged. However, some individuals, such as children or older people, will be allowed to enter the household in cases requiring caregivers. Public Health officials will need to see documentation of birth before 1957, two valid measles vaccine doses, or a blood test showing measles immunity for persons wanting to enter the quarantined home. No others will be allowed to enter.

If you do not get measles, you cannot spread it to others. However, you may not know you are infectious because you are still in the period when you could become ill. You can spread the disease up to four days before you develop a rash. Therefore, it is best to limit contact with those in your household, and they should review their immune status. Please see above: “How do you know if someone is immune to measles?”

Contact your healthcare provider. The measles vaccine is usually given after 12 months of age, and if your provider administers a dose earlier than 12 months, it will need to be repeated.

Contact your local pharmacy or healthcare provider.

There is a slight chance that you can get measles if you have the vaccine. Fully vaccinated people who get measles seem more likely to have a milder illness.

Check your vaccination records, get another MMR (measles, mumps, and rubella) vaccine, or have your blood tested to determine if you're immune.

Reach out to your local public health department for information @ 209-558-7535.

Contact your healthcare provider and let them know so they can determine if you are immune to measles based on your vaccination record, age, or laboratory evidence. If seen, they can make special arrangements to evaluate you without putting other patients and medical office staff at risk. An MMR vaccine or a medicine called immune globulin may help reduce your risk of developing measles. Monitor yourself for signs and symptoms of measles (fever, dry cough, runny nose, red eyes). If you are not immune and do not get MMR or immune globulin, you should stay away from settings where there are susceptible people (schools, hospitals, childcare) for 21 days after the date of last exposure.

If you have measles, you should stay home for four days after you develop the rash. Staying home is an important way to not spread measles to other people. Ask your healthcare provider when it is safe to be around other people again.

You should also

• Cover your mouth and nose with a tissue when coughing or sneezing, and put your used tissue in the trash can. If you don't have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands.
• Wash your hands often with soap and water.
• Avoid sharing drinks or eating utensils.
• Disinfect frequently touched surfaces, such as toys, doorknobs, tables, and counters. Standard household disinfectants will readily kill the measles virus.

Call your healthcare provider if you are concerned about your symptoms.

Contact your local public health department at 209-558-7535 to advise the date of your last exposure to the measles case.

Follow your school's policy regarding symptomatic student's isolating at home. The student should contact their healthcare provider. Implement your school policy for environmental cleaning.

Reference your daycare mitigation plan for sick child policy, which should include reaching out to the parent for pick-up of the child from daycare immediately. Due to active measles in the community, it is recommended that parents be notified. Infection prevention measures would need to be instituted, including deep cleaning of the facility at the end of the day.

Call your company's benefits manager.

Please check your health plan (Healthnet, The Alliance, Health Plan of San Joaquin) card for a phone number. If you don't have your health plan card, call 1-877-652-0734. This is the number of Community Services Agency (CSA).