Measles outbreak prompts schools to push immunizations

January 26, 2015

Updated Feb. 2: The number of confirmed cases of measles in California is now 92, with 18 of those cases in persons ages 5 through 19, according to the California Department of Public Health.

The largest outbreak of measles in California in years is prompting school officials to redouble their efforts to convince parents to vaccinate their children.

Sheri Coburn, the president-elect of the California School Nurses Organization, said the push for immunization is “one positive thing” to come from the rash of cases – now at 73 statewide – of the highly contagious and sometimes serious illness. The majority of cases are linked to exposure to the measles virus at two Disney theme parks.

“We continue to advocate for people to be vaccinated,” Coburn said, noting that three-quarters of those who contracted measles were “not vaccinated at all,” referring to the Disney outbreak.

The push for immunization is ‘one positive thing’ to come from the measles outbreak, said Sheri Coburn, president-elect of the California School Nurses Organization.

State law requires children to be vaccinated for a variety of illnesses by the time they enter kindergarten. But parents may obtain “personal belief exemptions” from the required vaccinations, making their children more vulnerable to contracting potentially fatal illnesses and transmitting the viruses to others.

The proportion of parents seeking those exemptions varies greatly from district to district, and even from school to school, as noted in an earlier EdSource report.

The number of school-age children with confirmed cases of measles in California reached 13 on Monday. The outbreak has prompted many school districts to take action, including emailing measles alerts to parents, urging them to vaccinate their children if they haven’t already, and referring families to free immunization clinics.

In San Bernardino County, for example, public health and school officials collaborated on a letter that districts can send to parents or post on their websites. The letter recommends that children who have not had a measles vaccination “have that done,” said Dan Evans, spokesperson for the San Bernardino County Superintendent of Schools.

In the Santa Monica-Malibu Unified School District, where a freshman baseball coach contracted measles, school nurses and public health investigators last week quickly scrutinized the immunization records of baseball team members and found that all were up to date. Following advice from the Los Angeles County Public Health Department, the district did not exclude any students from school, regardless of their vaccination status, because exposure appeared to be limited.

However, parents have received letters from school nurses and the district superintendent, and in the case of Santa Monica High, a letter from principal Eva Mayoral urging that “all students be up to date with all immunizations.”

Los Angeles Unified’s District Nursing Communicable Disease Control Team has mobilized, with school nurses teaming up with county public health investigators to track suspected cases of measles; five cases have been investigated, but none of them has proved to be measles.

Nurses in the Laguna Beach Unified School District have sent letters to parents of unvaccinated students urging them to have their children immunized. And Oceanside Unified posted on its website a letter from the San Diego public health department encouraging vaccinations and thanking parents for taking steps to protect their families and the community from measles.

Even in Santa Clara Unified, far from Disneyland, the school district last week posted a message from the county’s public health department on its website that was both a call for calm and a call to action. Two cases of measles have been reported in Santa Clara County, both of them in adults.

“We want to reassure parents that there is no need to be alarmed,” the message on the website stated. “If your children have been vaccinated, they are protected from catching measles. However, a measles outbreak serves as an important reminder that everyone does need to make sure that they are either immune or have been vaccinated against measles.”

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Dr. Gilberto F. Chávez, deputy director of the Center for Infectious Diseases at the California Department of Public Health, has made it clear that if a school has a student with a confirmed case of measles, districts should send unvaccinated students home.

“That is standard practice in this state,” Chávez said in a telephone press briefing. “If there is a child with measles in a school setting, the expectation is that the rest of the children who are not immunized need to be excluded from that school.”

So far, Huntington Beach High, with an enrollment of about 3,000 students, is the only known school where students have been sent home as a result of the disease.

A case of measles at the school came to light when a parent, whose unvaccinated daughter was sent home, appeared on a television news show to explain her child’s medical exemption to the measles vaccine.

Officials at the school initially notified 24 students that they would have to stay home because they were not vaccinated, but four of those students provided evidence of vaccination, said Pamela Kuhn, a certified school nurse and coordinator of health and wellness for the Orange County Department of Education.

News that the unvaccinated students were being kept at home has generated calls and emails overwhelmingly in favor of the decision to exclude unvaccinated children from attending classes, she said. “I’m getting more calls supporting our decision to exclude,” Kahn said.

The students will be out of school for 21 days, which is the length of time it takes before the measles could appear. They are scheduled to return to school on Friday.

Measles has been confirmed in patients from seven months to 70 years old by 11 county or local public health agencies: Alameda, Long Beach City, Los Angeles, Orange, Pasadena City, Riverside, San Bernardino, San Diego, San Mateo, Santa Clara and Ventura, according to the California Department of Public Health. Earlier last week, before the numbers increased, the department said that 25 percent of the cases required hospitalization.

The “great majority” of the cases involve unvaccinated people, Chávez said.

The highly contagious virus was declared eradicated in the U.S. in 2ooo, but an increase in the number of parents choosing not to vaccinate their children has led to outbreaks, Chávez said. Parents who say it is safer not to vaccinate their children are basing their decision on “pure misinformation,” he said.

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