Be aware of the rising cases of measles in schools

14 December 2023 by Pharos Response Leave a Comment

Be aware of the rising cases of measles in schools

Some key points for how schools should respond

Pharos has been involved in supporting a number of schools who subscribe to Pharos’ H&S service following a rise in the number of cases of measles that has involved the local Health Protection Team.

All cases need to be treated seriously and there are set protocols for how to respond, although they are not always obvious for busy schools to find within the guidance available. Pharos’ H&S Manager drafted the following summary of the guidance available for client schools (correct at time of publishing – 13th Dec 2023), also based on conversations with local Health Protection Teams following recent confirmed cases.

As we suspect this might become a wider-spread issue for schools over the winter, we thought it would be useful to share this information more widely. We are hopeful that the Christmas school holiday will act as a natural ‘fire break’ for the spread. (It seems a while since we were writing about fire breaks outside the context of actual fire risks!)

Please do keep an eye on the UK Health Security Agency’s page on National Measles Guidelines for updates (at time of writing this article, this was last updated on 27 October 2023 but we are expecting further updates shortly). You might also be issued specific regional guidance via your local Health Protection Teams as the rising measles cases seem to be more of a regional issue. Clearly either source of advice should trump anything outlined below.

Measles – how schools should respond

Confirmed/suspected cases of measles

If there is a confirmed case of measles the individual will need to isolate for 4 full days after the start of the rash and until they feel well enough to return to school / work.
We have been advised that if there is no rash, it is not measles. Suspected cases should be treated as above until a rash develops or they feel better.
Your local Health Protection Team must be notified if there is a confirmed case of measles. They will support you in the next steps with identifying contacts (see below) and how best to manage the situation.
Medically vulnerable staff and pupils will also need to be identified as they may not be vaccinated, in addition to babies under one year.
Pregnant staff/contacts should promptly contact their GP or midwife for advice.

Contacts of confirmed cases

Similar to Covid times, contacts should be identified from confirmed cases (adults and children) and if contacts are not vaccinated, they should isolate for up to 21 days.
It is highly likely that unvaccinated contacts will contract measles and they will then need to isolate for 4 full days after the start of rash (as above), which will end the 21-day isolation period.
Contacts are to be identified counting back 4 days from the start of the rash (see table below).

Day	Action
Pre-rash day 1	Identify contacts & inform
Pre-rash day 2	Identify contacts & inform
Pre-rash day 3	Identify contacts & inform
Pre-rash day 4	Identify contacts & inform
Rash started	Confirm measles case
Post-rash day 1	Isolate
Post-rash day 2	Isolate
Post-rash day 3	Isolate
Post-rash day 4	Isolate
Post-rash day 5	OK to return to school/work if well enough

UK Health Security Agency describes measles as follows

Measles is highly infectious, the most infectious of all diseases transmitted through the respiratory route. Measles can be severe, particularly in immunosuppressed individuals and young infants. It is also more severe in pregnancy, and increases the risk of miscarriage, stillbirth, or preterm delivery.

This is why it is important that schools respond accordingly and in line with the guidance provided.

Please see here for the full guidance from UKHSA from which the above paragraph was taken.

How to avoid spreading or catching measles (similar controls to Covid)