Section 690.520  Measles (Reportable by telephone as soon as possible, within 24 hours)


a)         Control of Case


1)         Standard precautions and airborne infection isolation precautions shall be followed for patients in health care facilities from diagnosis until four days after appearance of the rash.


2)         Children with measles shall be kept out of school or child care facilities for at least four  days after appearance of the rash.


b)         Control of Contacts


1)         All susceptible contacts (persons six months of age or older who have not yet received a total of two doses of measles-containing vaccine) should begin vaccination with live virus measles vaccine.  Vaccine should be administered within 72 hours after exposure for maximal protection.  When vaccine is given prior to the first birthday, a second dose shall be given on or after the first birthday, and a third dose at least 28 days later but prior to school entry (four to six years of age).


2)         Susceptible household contacts with high risk of complications or with measles vaccine contraindications should be given immune globulin (IG) within six days after exposure.  IG is not indicated for contacts who have received one dose of vaccine at 12 months of age or older unless they are immune-compromised. Live measles vaccine shall be given five to six months later to those IG recipients, provided that the vaccine is not contraindicated.


3)         Susceptible contacts who have not received vaccination or immune globulin, where medically indicated, shall be excluded from school, workplace, child care facility, or other facilities until 21 days after the onset of the last reported measles case.


4)         Susceptible health care personnel with direct patient contact shall be required to provide proof of immunity to measles as described by the Advisory Committee on Immunization Practices (see Section 690.20(a)(7)).


5)         Susceptible health care workers exposed to measles shall receive a dose of measles-mumps-rubella (MMR) vaccine and should be removed from all patient contact and excluded from the facility from the fifth to the 21st day after the exposure. Susceptible health care workers may return to work on the 22nd day after exposure.  However, susceptible health care workers who are not vaccinated after exposure shall be removed from all patient contact and excluded from the facility from the fifth day after their first exposure to the 21st day after the last exposure, even if they receive post-exposure immunoglobulin. Personnel who become ill with prodromal symptoms or rash shall be removed from all patient contact and excluded immediately from the facility until four days after the onset of the rash.


c)         Measles Outbreak Control


1)         Personnel in each attendance center responsible for investigating absenteeism shall immediately report suspect cases of measles to the school principal or the school nurse.


2)         On the same day that a report of a suspect case of measles is received, school personnel shall conduct an inquiry into absenteeism to determine the existence of any other cases of the illness in the suspect case's class and school.


3)         The school officials shall make a telephone report within 24 hours to the local health authority, either a full-time official health department as recognized by the Department, or a regional office of the Department, specifying the name, age, and sex of any case.  The name of the case's private physician, if any, shall also be reported.  The Department or local health department shall be contacted by school personnel and involved in the investigation of the outbreak so that all necessary vaccination services are assured.


4)         A notice shall be sent home with each student who has not presented proof of immunity, explaining that the student is to be excluded, effective the following morning, until the school receives acceptable proof of immunity or until 21 days after the onset of the last reported measles case.  Acceptable proof shall consist of:


A)        a written record from the student's physician or a health professional that indicates dates of vaccination and type of vaccine administered; or


B)        a statement from a physician indicating the date when the student had measles; or


C)        a laboratory report indicating that the student has a protective measles antibody titer as measured by a test with demonstrable reliability.


d)         Laboratory Reporting

Laboratories shall report to the local health authority patients who have a positive result on any laboratory test indicative of and specific for detecting measles virus infection, including positive results from IgM (measles specific) serologies, measles virus isolates, or a significant rise in antibody results from IgG (measles specific) between paired sera.


(Source:  Amended at 38 Ill. Reg. 5533, effective February 11, 2014)