FAQs Data Reporting Investigation Immunization Resources VPD
Organism, Causative Agent, or Etiologic Agent
Measles virus is a paramyxovirus from the genus Morbillivirus.
Measles is so contagious that if one person has it, 90% of the people close
to that person who are not immune will also become infected with the measles
virus. The virus lives in the mucus in the nose and throat of the infected
person. When that person sneezes or coughs, droplets spray into the air and can
infect people around him.
A typical case of measles begins with mild to moderate fever, cough, runny
nose, red eyes, and sore throat. Two or three days after symptoms begin, tiny
white spots (Koplik’s spots) may appear inside the mouth. Three to five days
after the start of symptoms, a red or reddish-brown rash appears. The rash
usually begins on a person’s face at the hairline and spreads downward to the
neck, trunk, arms, legs, and feet. When the rash appears, a person’s fever may
spike to more than 104 degrees Fahrenheit.
Immunization is the only way to prevent measles. Measles vaccination is
required for school entry in Texas.
School Exclusion Policy
Children with suspected or confirmed measles should be kept out of school or
childcare until 4 days after the onset of rash. Rules for exclusion of sick
children from school and childcare are outlined in the Texas Administrative
Code, specifically Rule 97.7 for schools and Rule 746.3603 for childcare.
Recent Texas Trends
Prior to vaccine introduction, annual measles incidence peaked at 85,862 in
1958 in Texas. Since the introduction of vaccine, cases have decreased by 99.9
percent in Texas. Nearly all cases and outbreaks of measles in the US and Texas
since 2000 have occurred among persons exposed to imported cases from countries
where measles is still endemic. Because measles is still endemic in many parts
of the world and is highly contagious, measles can easily be re-introduced into
Texas in unvaccinated communities. This was seen in 2013, when a person
traveling to Asia returned with the measles and interacted with a
vaccine-hesitant community. In a matter of weeks, 20 additional people were
infected with measles. Overall in 2013, 27 cases were reported, the highest
annual case count in over 20 years. In 2015, one case of measles was reported in