Infectious Disease

In Florida measles outbreak, state lets parents send unvaccinated children to school

Evan Vega February 23, 2024

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February 23, 2024

3 min read

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Key takeaways:

Six students at a Florida elementary school have contracted measles.
The state surgeon general said parents can send unvaccinated children to the school.

Bucking CDC guidance, Florida’s top health official said parents and guardians can decide for themselves whether to send unvaccinated students to an elementary school with an ongoing measles outbreak.

The outbreak at Manatee Bay Elementary School in Weston, Florida, remained at six confirmed cases as of Friday morning, a spokesperson for Broward County Public Schools told Healio. The first case was reported Feb. 16 in a third grader with no history of travel, according to a state health department alert sent to providers.

The CDC recommends that unvaccinated children who have been exposed to measles stay home from school for 21 days. Students who are not vaccinated can remain in school if they receive a dose of vaccine within 72 hours after they are exposed to measles, according to the agency’s guidance.

In a letter this week to parents and guardians of students at Manatee Bay Elementary, Florida Surgeon General Joseph A. Ladapo, MD, PhD, referenced the CDC’s guidance but did not recommend that parents keep unvaccinated children at home.

“When measles is detected in a school, it is normally recommended that individuals without history of prior infection or vaccination stay home for up to 21 days. This is the period of time that the virus can be transmitted,” Ladapo wrote. “However, due to the high immunity rate in the community, as well as the burden on families and educational cost of healthy children missing school, [the department of health] is deferring to parents or guardians to make decisions about school attendance. This recommendation may change as epidemiological investigations continue.”

Phone and email messages from Healio seeking comment and a copy of the letter were not returned by the Florida Department of Health. Ladapo’s letter was posted online by multiple media outlets.

Pediatricians and health officials have expressed concern about the potential for vaccine-preventable diseases to surge in the United States amid dwindling vaccination rates.

CDC data published in November showed that vaccine exemptions in U.S. schools reached an all-time high during the 2022-2023 school year, driven by nonmedical exemptions, and that routine vaccine coverage among U.S. kindergarteners dipped below 95%.

In Broward County, the rate of routine vaccination among children enrolled in public and private kindergarten was below 92% during the 2021-2022 school year, according to data published online by the state health department. Vaccine coverage of 95% or above is widely considered necessary to prevent measles outbreaks.

Dozens of measles cases have been reported in the U.S. since Dec. 1, 2023, according to a CDC alert sent to health care providers last month. A recent outbreak involving nine cases in Philadelphia was linked to a day care center. A 2022 outbreak in Ohio involved dozens of unvaccinated children.

Initial symptoms of measles appear 7 to 14 days after a person is exposed and include a high fever, cough, runny nose and watery eyes, followed 3 to 5 days later by a rash that usually starts as flat, red spots on the face and hairline and spread down the body, according to the CDC. A patient’s fever could spike to 104°F or higher once the rash appears.

Measles virus is among the most infectious pathogens, remaining contagious in the air for up to 2 hours after an infected person leaves.

Globally, deaths due to measles rose more than 40% in 2022, according to data published last year by the CDC and WHO.

References:

CDC. Measles outbreak toolkit for local/state health departments. https://www.cdc.gov/measles/toolkit/state-health-departments.html. Last reviewed Nov. 5, 2020. Accessed Feb. 23, 2024.

CDC. Measles signs and symptoms. https://www.cdc.gov/measles/symptoms/signs-symptoms.html. Last reviewed Nov. 5, 2020. Accessed Feb. 23, 2024.

City of Philadelphia. Health department update on measles outbreak – January 29. https://www.phila.gov/2024-01-30-health-department-update-on-measles-outbreak-january-29/. Accessed Feb. 23, 2024.

Florida Department of Health memorandum. https://www.floridahealth.gov/programs-and-services/immunization/resources/surveys/_documents/k-7-status2021-22.pdf. Published Sept. 2 2022. Accessed Feb. 23 2024.

Florida Health Broward County. Notice to Broward County Health Care Providers. https://content.govdelivery.com/accounts/FLDOH/bulletins/38aed3e. Published Feb. 16, 2024. Accessed Feb. 23, 2024.

Seither R, et al. MMWR Morb Mortal Wkly Rep. 2023;doi:10.15585/mmwr.mm7245a2.

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