Current through March 20, 2024
Authority: IC
16-19-3-4;
IC
16-41-2-1
Affected: IC 16-41-2; IC 16-41-9
Sec. 118.
The specific control measures for measles (rubeola)
(infectious agent: measles virus) are as follows:
(1) An investigation by a department field
representative, in cooperation with the local health officer, shall be
performed immediately, include case management, and consist of the following:
(A) Ascertainment of immunization
history.
(B) Case
ascertainment.
(C) Identification
and listing of contacts. Contacts are defined as any individual who was in the
same room while the case was present or for two (2) hours afterwards at any
time during the infectious period. The infectious period is defined as four (4)
days before rash onset until four (4) days after the appearance of the rash.
All children and adults (including staff members) attending the same school,
daycare, or preschool as the case are defined as contacts.
(D) For outbreak control in public or private
schools, daycare facilities, preschools, or postsecondary facilities, on the
same day that a report of a suspected case of measles is received, school
personnel shall do the following:
(i) Conduct
an inquiry into absenteeism to determine the existence of any other cases of
the illness.
(ii) Immediately
report the suspect case or cases to the local health department or the
department.
(iii) Send a notice
home with each student, attendee, or employee born in or after 1957 who has not
presented proof of immunity explaining that the student, attendee, or employee
shall be excluded from the date of the letter, until acceptable proof of
immunity is received by the school, daycare facility, preschool, or
postsecondary facility, or in the case of medical or religious exemptions,
until twenty-one (21) days after the onset of the last reported measles case.
Persons receiving second doses of measles-containing vaccine, as well as
previously unvaccinated persons receiving their first dose as part of the
outbreak control program, may be immediately readmitted to school provided all
persons without documentation of immunity have been excluded and that
vaccination occurred within seventy-two (72) hours of exposure. Acceptable
proof of immunity shall consist of a:
(AA)
written record from the student's or employee's physician, parent, or guardian
that indicates the dates of vaccination (on or after the first birthday) and
the type of vaccine administered;
(BB) laboratory report showing confirmation
of previous measles infection; or
(CC) laboratory report showing a protective
measles antibody titer.
(iv) Make available to officials of the local
health department or the department, or both, involved in investigating and
controlling the outbreak, immunization records of all students and employees
born in or after 1957 in the school or attendees, students, and employees born
in or after 1957 in the daycare or preschool.
(E) For outbreak control in health care
facilities, all health care workers and employees, regardless of age, without
evidence of immunity who have been exposed to measles should be excluded from
the facility from the fifth day to the twenty-first day after exposure, even if
postexposure vaccination or immune globulin (IG) was administered.
(2) In addition to standard
precautions, airborne precautions shall be followed for hospitalized patients
through the fourth day of the rash to reduce the exposure of other persons at
high risk. Other infected persons shall be excluded from:
(A) school and daycare facilities or
preschools;
(B) public gatherings;
and
(C) contact with susceptible
persons outside the household; for at least four (4) days after appearance of
the rash.
(3)
Concurrent disinfection is not required.
(4) Quarantine may be required. Children in
institutions, wards, or dormitories for children may be quarantined. If measles
occurs in an institution where infants reside, these infants shall be
segregated from infected persons and susceptible contacts. Susceptible
individuals exposed to measles should avoid contact with other susceptible
persons outside the household.
(5)
Protection/immunization of contacts shall be as follows:
(A) Live measles vaccine given to
inadequately vaccinated persons within seventy-two (72) hours of exposure may
provide protection against disease.
(B) IG may be given within six (6) days to
the susceptible household or other contacts, especially those for whom:
(i) risk of complications is very high, such
as contacts less than twelve (12) months of age; or
(ii) the measles vaccine is
contraindicated.
(C)
Live measles vaccine should be given five (5) months later to IG recipients for
whom vaccine is not contraindicated.
(6) The Centers for Disease Control and
Prevention and the Council of State and Territorial Epidemiologists set the
standard clinical and laboratory case definition.
