In anticipation that a measles case could jump state lines from California to Oregon, health officials and school nurses in Deschutes County are going through non-medical exemptions to determine which students remain unvaccinated.

When a measles case occurs in Oregon, exposed unvaccinated students are sent home for 21 days. As of last week, nationwide, there were 146 measles cases in 21 communities, according to the Centers for Disease Control and Prevention. In California, there were less than nine measles cases reported so far this year, but up to 100 in Illinois, according to the CDC.

Currently, there are no reports of measles in Central Oregon, said Dr. Rita Basho, Deschutes County Health Services public health program manager. But health officials want to be ready.

“We do this when we hear of measles scares elsewhere and we start planning,” Basho said. “We’re trying to prepare.”

Vaccination rates

Oregon allows students to be in school who are not vaccinated against an array of diseases that include measles. Each year, families must submit updated vaccination reports, file for a non-medical exemption or a medical exemption.

At Bend-La Pine Schools, non-medical exclusions were filed for 1,313 students for the eight diseases students were asked to be vaccinated against in the 2022-2023 school year. Non-medical exemptions rose to 1,413 in Bend-La Pine Schools in the 2023-2024 school year, according to the district.

The last big outbreak of measles nationwide was in 2019. A Clark County visitor was infected with measles at a point in the contagious period. Measles symptoms usually arise 10 to 14 days after exposure, health officials say.

“Our health services leaders met with the Deschutes County Health Services a few weeks ago to discuss a measles response plan, continuing a conversation that began prior to the pandemic,” said Scott Maben, Bend-La Pine Schools spokesman. “The purpose is not to follow up with the family now, but to ensure we have current records in the event of a measles case in a school.”

School officials are checking state vaccination records and comparing them to their student vaccination records. So far, staff found only a small number of students who had a non-medical exclusion on file who actually received a vaccine, Maben said.

Measles is airborne

Measles is an airborne, highly infectious disease that is vaccine preventable and in 2000 was considered eliminated. It typically starts with a fever and fatigue progressing to a cough, congestion, red eyes and runny nose. The telltale rash usually starts two to four days after the fever.

In 2023, about 92% of the kindergarteners in Oregon were vaccinated for measles. In Deschutes County, the rate of measles vaccination dropped a tad to 90.2% and was about the same in Crook County. Of the three counties, Jefferson County had the highest vaccination rate for measles — 92.9%.

Each year on the third Wednesday in February in Oregon, all students in public and private schools, preschools and day care centers must have proof of vaccinations or provide a completed medical or non-medical exclusion form. Students cannot come to school until they show they are up to date or have a completed exclusion form submitted.

The law is designed to stop the spread of highly contagious diseases, like measles, that can be controlled by vaccinations. Decisions on when or if a student should be excluded because of a potential for disease is done on a case by case basis, Basho said.

“It all depends on the risk at the time,” Basho said. “We will determine if we need to do it or at the time. There are a lot of factors that go into the decision: exposure, how many students are immunized in a school and if the risk or high.”