Measles is one of the most dangerous and contagious diseases. One in 3 people with measles will be admitted to hospital. Measles could cause significant disruption to education settings from kaiako (teacher) and ākonga (learner) absences due to prolonged illness and isolation/quarantine requirements.
While it is the responsibility of Public Health Services to manage measles outbreaks, they need your support to keep education kaiako and ākonga safe.
PHS teams are always available, including after hours, weekends and public holidays, and can advise and support you through next steps.
It is very important that you follow their advice on when and how to communicate with people about a risk of measles.
This information provides a brief overview of measles and the actions you can take to help stop this serious illness spreading in your education setting.
Measles — who is at risk, symptoms, how it spreads and testing
Measles is one of the most dangerous viral illnesses a person can get. Measles makes people feel very unwell and 1 out of every 3 people with measles will be sick enough to need hospital care.
Who is at risk
Who is at risk
Measles can affect anyone of any age who is not immune to it. Anyone who has not received at least 2 doses of a measles vaccine or has not already had the disease is at risk of catching and spreading measles.
You can still get and spread measles with only one dose of the MMR vaccine, but 99% of people who receive 2 doses will be fully protected against the disease.
Symptoms of measles
Symptoms of measles
The first symptoms of measles are similar to other respiratory illnesses such as a cold, COVID-19 or influenza (flu) which can make it hard to tell in the early stages of this illness that a person has measles.
Symptoms include:
fever (a temperature of at least 38°C)
cough
runny nose
sore red eyes
The next symptom is a red or dark pink rash. The spots are blotchy and join together. It usually starts on the face or behind the ears 3 days after the other symptoms, before moving down the body.
A key feature of measles is that a fever is still present when the rash develops.
How measles spreads
How measles spreads
You can catch measles by breathing in virus particles in the air after a person with measles has coughed, sneezed, talked or even just breathed. This can occur through:
face-to-face contact, such as having a conversation
spending time in a confined indoor space at the same time as the infected person (known as a case)
spending time in a confined indoor space within one hour of the case leaving the space.
Measles is much more contagious than most other viruses, including COVID-19 and flu.
A person with measles is infectious – meaning they can spread measles to other people - from 4 days before until 4 days after their rash first started to show. This means they can spread the virus to others before they are aware they have it themselves.
One person with measles could infect 18 other people if those people are not immune to measles.
Testing for measles
Testing for measles
Testing for measles involves the healthcare provider taking a swab of a person’s nose or throat (the same testing process as for COVID-19 or the flu) and sending the swab to a laboratory for processing.
For more information on symptoms, how measles spreads, diagnosis and treatment see our Health Information and Services website.
Education settings could start seeing measles cases
Education settings could start seeing measles cases
There has been a big increase in measles globally with outbreaks occurring in many countries with strong travel connections to Aotearoa New Zealand, including South-East Asia, Europe and the United States.
This means it is becoming more likely that kaiako, ākonga, other staff or visitors with measles could attend an education setting while they are infectious.
Education settings are at high risk of outbreaks
Education settings are at high risk of outbreaks
Kaiako and ākonga spend a lot of time together in indoor spaces such as classrooms where measles could spread easily.
Anyone who is not immune to measles can become infected if they are exposed to a measles case in an education setting. To prevent measles from spreading, 95% of people in an education setting would need to be immune to measles (this means they need to have had 2 MMR vaccines or have previously had measles). Aotearoa’s current vaccination rates are well below this level. Education settings with lower rates of immunity are likely to see the biggest outbreaks.
Changes to the New Zealand immunisation schedule over time means many adults who got all their childhood vaccinations may have missed one or both MMR vaccines. This means some adults may not be protected from measles.
Our Health Information and Services website has more information about the importance of being immune, how to become immune and how to check your immunity.
Kaiako (teachers) and ākonga (learners) may be absent for long periods of time
Kaiako (teachers) and ākonga (learners) may be absent for long periods of time
Anyone who is diagnosed with measles must isolate (stay at home and not go to their workplace, education setting or be out in the community) until 4 days after their rash develops to prevent spreading measles to other people. However, most people with measles will be absent for much longer than this.
This is because measles makes people feel very unwell and it usually takes at least 1 to 2 weeks until they can return to normal activities.
Non-immune contacts need to stay away from education settings to prevent spread
Non-immune contacts need to stay away from education settings to prevent spread
Anyone who is not immune to measles and is identified by Public Health Services (PHS) as a 'close contact' to a measles case will not be able to attend an education setting until they advised by public health that it is okay to return. This will usually be for a minimum of 8 days but this may need to be extended in some circumstances, including if there are ongoing cases in the education setting.
A 'close contact' is a person who has spent time or been in close proximity to a person with measles, or has been in a room within the hour after the person with measles has left.
Our Health Information and Services website has advice on how to check your immunity to measles.
As most people are happy to follow public health advice to reduce the spread of measles, closing an education setting or requiring a move to online learning, is unlikely to be required to control an outbreak.
In exceptional circumstances a Medical Officer of Health (a doctor who specialises in public health) in a local PHS may use powers under the Health Act 1956 to close a school for the purpose of controlling an outbreak.
However, if kaiako are cases or non-immune close contacts there may be insufficient kaiako available, and your education setting may decide to close part or all of your education setting and move to online learning. It is recommended that education settings discuss and reach a decision on this with the support of their Board and/or Ministry of Education representative (for early learning services and state schools).
For more information about your role and responsibilities regarding communicable and notifiable diseases refer to the Ministry of Education website.
What will happen if someone with measles attended your education setting
These are the likely ways you will learn that someone in your education setting is suspected or confirmed as having measles:
Scenario 1: Your local Public Health Service (PHS) contacts you to let you know someone with measles attended your education setting.
Scenario 2: You are informed by a parent/caregiver that their ākonga has measles, or a kaiako advises you that they have measles.
Scenario 3: Someone at your education setting develops symptoms that could mean they may have measles.
It is very important that you do not communicate with people (other than confidentially with relevant kaiako) until the suspected measles case is confirmed to have measles through test results, and you have received guidance from your local PHS on what to say to who and when.
It is essential that correct and consistent information is provided to avoid confusion and unnecessary distress among the wider group of people attending your education setting.
Scenario 1: When your local PHS notifies you
Scenario 1: When your local PHS notifies you
As measles is a notifiable disease, doctors, nurses and laboratories must inform the Medical Officer of Health at their local PHS of any suspected or confirmed cases of measles. This means the most likely way you will find out about a case of measles in your education setting will be through a phone call from your local PHS.
providing ongoing support to your education setting as required.
The PHS will communicate directly with anyone at the education setting who is identified as a measles case or close contact.
What you may be asked to do
You may be asked to provide the following information:
your attendance registers for the days the person with measles attended while they were infectious
contact details for parents/caregivers of ākonga, kaiako and visitors who were on site at the same time as the person with measles
information about the layout of your facility so public health can determine the risk to others.
You may also be asked to do the following to prevent any further spread of measles.
1. Control access your education setting
Ensure the following people do not enter your education setting until they are advised by public health that it is safe for them to return. This includes:
anyone with measles (a case) who is at risk of infecting others
anyone who is not immune to measles and has been in close contact with someone with measles (a close contact), so could be at risk of becoming infected.
2. Contact public health
Contact public health urgently if you are concerned that someone else in your education setting has measles.
Scenario 2: When a kaiako or parent/caregiver notifies you
Scenario 2: When a kaiako or parent/caregiver notifies you
With measles being a notifiable disease, it would be unusual for a person to be informed they have measles before the local PHS is informed as a positive measles laboratory test result is required to confirm a person's measles diagnosis.
However, a health professional might consider measles a possible cause of a person’s symptoms and advise them to isolate (which means they should not leave their home) until their test results are available. If this happens, the kaiako or ākonga will not be able to attend their education setting and they might advise you they have measles, even if this has not yet been confirmed.
Currently in Aotearoa New Zealand, most people who are tested for measles do not end up getting a positive test result and their symptoms are caused by another illness.
What you should do
If you are informed by a kaiako or parent/caregiver that someone who attends or visits your education setting has measles it is important to check with your local PHS before taking any action.
Take the following steps.
Advise the kaiako or parent/caregiver of the ākonga that you will be contacting the local PHS for advice because measles is a notifiable disease, and that the PHS may contact them.
Advise the suspected measles case to stay at home and away from the education setting until they are told by public health it is safe to return.
Your local PHS will investigate to confirm if the kaiako or ākonga has measles or not. They will advise and support your education setting as required.
If measles infection is confirmed through a positive test result, the PHS will respond as outlined in scenario one above. If the person does not have measles, the PHS will inform the leader of your education setting.
Scenario 3: When someone at your education setting develops similar symptoms to measles
Scenario 3: When someone at your education setting develops similar symptoms to measles
Many viruses can cause similar symptoms to measles, especially in children, so formal assessment, testing and diagnosis by a healthcare provider is needed to determine if a person has measles.
Measles is very unlikely to be the cause of the person’s symptoms if they have received 2 MMR vaccines.
What you will need to do
If a person develops symptoms of measles when they are at your education setting, they should be isolated in a room away from other people until you can arrange for them to go home. Kaiako caring for the sick person should wear a mask.
Advise kaiako or the parent/caregiver of the person to do the following.
Contact their healthcare or Hauora provider as soon as possible for advice and let the provider know they could have measles. Healthline can also be called for free health advice anytime on 0800 611 116
Phone ahead before visiting a healthcare facility so the facility can prepare for the unwell person's arrival to help prevent measles spreading to others.
Wear a face mask for any in person appointments to reduce the risk of passing measles on.
Stay home until a healthcare professional has confirmed they do not have measles and they are feeling well enough to go back to their education setting. Guidance for parents and caregivers on when it is ok to return is on our Health Information and Services website.
You do not need to contact your PHS in this scenario. If the health professional assessing the kaiako o ākonga suspects they have measles they will inform the local PHS.
Communicating about measles with kaiako, parents/caregivers and relevant others in your community
When a person who attends or visits your education setting is confirmed to have measles, this puts others who are connected to the same education setting at risk and communication with them will need to occur.
However, it is very important that you do not advise people there has been a case of measles in your education setting until your local Public Health Service (PHS) confirms it is appropriate to do so.
Your PHS will guide you on what to say to who and when. This is because it is essential that correct and consistent information is provided to avoid confusion and unnecessary distress among the wider group of people who attend your education setting.
Your local PHS can support with the following.
Providing you with information about measles and the risk to others in the education setting.
Reviewing planned communications to ensure the information you are intending to provide is correct.
Support you to send out relevant information to kaiako and parents/caregivers of ākonga at the right times.
Provide you with letter templates, factsheets and other resources to support you with any communication that is agreed to be led by your education setting.
What you can do to prevent measles
Preventing measles is much easier than controlling a measles outbreak.
Immunisation is the best way to prevent measles. To be fully protected from measles, a person must have received 2 measles, mumps and rubella (MMR) vaccines.
The MMR vaccine is very effective. It:
stops you getting infected — 99% of people who receive 2 doses of the MMR vaccine will be fully protected against measles
reduces the risk of you spreading measles if you get infected
prevents you from becoming severely unwell if you get measles.
Getting immunised also protects people who cannot receive the MMR vaccine. This includes pregnant people, young infants and immune-compromised people.
The MMR vaccine is free for all:
tamariki (children) aged 18 and under in Aotearoa New Zealand
adults over the age of 18 who are eligible for free local healthcare.
How education settings can support immunisation
How education settings can support immunisation
Encouraging kaiako to check if they are immune to measles and to get immunised if they are not immune. As the immunisation schedule has changed over time, some adults may not have received 2 measles vaccines even if they received all recommended vaccines. It is safe to receive additional MMR vaccines
Encouraging parents/caregivers to check if ākonga are up to date with their vaccines and to get immunised if they are not immune to measles
Displaying posters and leaflets, and supporting parents/caregivers to book a vaccine online or over the phone through the vaccine health line 0800 282 926
Education settings can also support kaiako and ākonga who have recently arrived in Aotearoa New Zealand to:
register with a local healthcare provider if they do not have one yet
ask their healthcare provider to check their overseas immunisation records and add these to the Aotearoa Immunisation Register (AIR) — this will ensure they receive reminders when vaccines are due and can confirm their immunity if asked by public health.
Immunisation registers
Immunisation registers
Primary schools and early learning services are required to keep an immunisation register as per the Health (Immunisation) Regulations 1995. Ensure that your immunisation register includes the dates that the MMR vaccine was given to ākonga, as this information is required by public health to assess whether a person is immune to measles.