Opinion ID: 2037673
Heading Depth: 1
Heading Rank: 6

Heading: Measles and Its Consequences.

Text: A graphic and detailed description of measles and its consequences was given by Dr. Morin at the administrative hearing on May 18, 1989. According to Dr. Morin, an internist who specializes in diagnosing, treating, and preventing infectious diseases, measles is synonymous with rubeola, an acute epidemic and highly contagious disease that is contrasted with rubella, a usually mild disease commonly called German measles. Features of rubeola, or measles, include fever, rash, coryza (runny nose), congestion of nasal mucosa, and conjunctivitis (pink eye). Since the measles virus locates in a person's air way, exposure to measles results from an infected person's coughing or sneezing in the air, spreading the virus contained in the mucous that has been sprayed in the air. The sprayed virus is viable for several hours. Measles is especially dangerous, because an infected person may be relatively asymptomatic, but can communicate the disease several days before and after the manifested symptoms of measles. Measles is especially dangerous in a community where there has been a long period without reported cases of measles, such as the time during which the Lincoln area had no reported cases of measles, and is particularly dangerous in those situations in which there are multi-handicapped individuals such as those who attend [Lincoln] East Junior-Senior High School. Results from laboratory tests to verify presence of measles take as long as 2 weeks and may not necessarily be conclusive; hence, laboratory tests provide no prompt information and are impractical as a means to determine whether a student should be excluded from school on account of measles. For a person who is unimmunized against measles, the disease has a practically 100 percent infection rate. Proper vaccination is generally 95 percent effective against measles, while vaccination between the ages of 12 months and 15 months has an 85 percent protection rate. Therefore, persons with the highest risk of catching measles are the unimmunized, while those vaccinated have lower risks of acquiring the disease. Complications from measles include otitis (ear infection), pneumonia, and encephalitis (inflammation of the brain that may result in convulsions, deafness, or mental retardation). Once an individual is infected with measles, there is nothing medically, including treatment with drugs, that prevents further medical problems, which may include death in approximately 1 out of every 3,000 cases of measles. Dr. Morin concluded that in view of the community-wide outbreak of measles and the clinically confirmed case of measles at Lincoln East Junior-Senior High School, without immunization against measles Jessica and Melissa Maack were a clear threat to the physical safety of themselves and others at the junior-senior high school. Also, in Dr. Morin's opinion, as previously related to Ford, director of the Lincoln-Lancaster County Department of Health, the clinically confirmed case of measles at Lincoln East required that all unimmunized children be excluded from Lincoln East for a period of 2 weeks or until they were properly immunized or their immune status was confirmed.