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Indiana State Department of Health

ISDH Home > About the Agency > Schools Communicable Disease Guide > Measles (Rubeola) Measles (Rubeola)


Clinical Description
Measles is an extremely contagious viral respiratory illness.  Measles is characterized by a rash beginning at the hairline that spreads downward over the entire body by the 3rd-7th day of the infection. Symptoms can include cough, runny nose, conjunctivitis, fatigue, and fever prior to the development of Koplik’s spots.  Measles may cause serious complications, including ear infection, pneumonia, and encephalitis (brain swelling).  In some cases, measles may be fatal. 

Incubation Period
The incubation period is usually about 10 days, varying from 7-18 days.

Mode of Transmission
Measles can spread through contact with droplets in the air from an infected person.  These droplets can remain infective up to two hours in the air.

Period of Communicability
A person can spread measles 4 days prior to the appearance of the rash up to 4 days following the appearance of the rash.

Exclusion/Attendance
Infected persons are excluded from school and contact with other people outside the household for four days after appearance of the rash.  Students who have not presented proof of immunity against measles are excluded from a given date until acceptable proof of immunity, or in the case of medical or religious exemptions, until 14 days after the onset of the last reported measles case.  Previously unvaccinated children who are not vaccinated within 72 hours of exposure are excluded for 14 days after completing vaccination.  For more information on requirements for school exclusions, please see the Communicable Disease Reporting Rule 410 IAC 1-2.3 Sec. 83 at: http://www.in.gov/isdh/files/comm_dis_rule.pdf.

Prevention/Care

•Vaccinate with a single dose of live, attenuated measles vaccine at 12-15 months of age and revaccinate with a second dose at 4-6 years of age. School immunization requirements for measles can be found at: http://www.in.gov/isdh/17094.htm
•Check immunization records for all students to assure they have received 2 doses of a measles containing vaccine.  To prevent transmission identify non immune students (medical or religious exemptions) for possible exclusion.
•Inform high risk people within the school when a case of measles has been identified.  Exposed pregnant women should be tested for rubeola immunity, if unknown, and should be counseled by their healthcare provider. 
•School personnel planning a pregnancy should be vaccinated 28 days prior to pregnancy.

Other Resources
Indiana State Department of Health Quick Fact Link:
http://www.in.gov/isdh/22120.htm

Centers for Disease Control and Prevention (CDC) Links:
http://www.cdc.gov/ncidod/diseases/submenus/sub_measles.htm
http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/meas.pdf
http://www.cdc.gov/measles/index.html