In the wake of an outbreak of 43 cases of measles at Torrance’s South High School in which 34 of those stricken had been immunized against the disease, county Department of Health Services officials are recommending that students who were immunized before the age of 15 months be revaccinated.
Health officials say this outbreak mimics those elsewhere in the state and country, which show that many children getting measles “were immunized between the ages of 12 and 15 months,” said Dr. Steve Waterman, chief of communicable disease control for the county Department of Health Services. “Kids have an inadequate immune response to the vaccine at that age.”
County health officials are also recommending vaccinations for children whose parents have no record of the child’s measles immunization.
The recommendations apply to 15 schools in the South Bay, 12 of them in the Torrance Unified School District, Bishop Montgomery High School--a private school in Torrance--and two schools in the Palos Verdes Unified School District, where health officials this month completed an audit of measles immunization records. School officials have mailed letters to the parents of students who are not in compliance with state measles immunization requirements.
Health officials said Wednesday that they will do an audit Monday of the records at the private Advanced Education elementary school in Lomita because of a report of a rash among students there.
Attention to the immunization problem in the South Bay began last November, with an outbreak at South High School in the Torrance Unified School District. An audit there showed 66 students not in compliance with state law on measles immunization--they could not prove they had been immunized after their first birthday or had had measles--and eight more who claimed an exemption from the law.
As a result, county health officials began their wider audit expecting to find similar gaps in the immunizations records at other schools. Officials expressed concern for siblings who may have been exposed to the virus and may have been vaccinated at too young an age. Two South High teachers also developed symptoms of the disease, officials said.
Must Show Proof
Since January, 1968, state law has required that children enrolling in schools show proof of immunization against measles or that they have had measles. The only exemptions are for medical reasons or personal beliefs.
Brad Prescott, administrative assistant for the county’s immunization program, said about 3% of South High students have been able, for a variety of reasons, to enroll in school despite having no proof of measles immunization.
“Occasionally they do slip through the cracks,” Prescott said.
Bishop Montgomery High had the greatest number of students--369--who did not meet state immunization requirements.
Bishop Montgomery was included in the audit after its basketball team in December played South High School, Prescott said. Also, a number of Bishop Montgomery students live near South High, he said.
The number of students lacking proof of immunization may be high at Bishop Montgomery because the records for students in the senior class listed only year of immunization and did not include the month and date as required by state law, said Glen Fujimoto, health program coordinator who did the audit.
Statement From Doctor
Parents who claim that their child already had the disease must present a verifying physician’s statement or have the child immunized again before the child can return to any of the 15 schools, Prescott said. Proof of vaccination is also mandatory for students who received the vaccination before their first birthday, or if the month and date of the vaccine are missing from the records.
Students not in compliance with state requirements--because of exemptions--have been ordered to stay out of school until two weeks pass without any new measles cases being reported. The last case was reported Dec. 18.
Torrance schools are still on Christmas vacation, and if no new measles cases are reported during the break, exempted students will be able to return to school as scheduled on Jan. 4, health officials said.
“What’s gradually being recognized more fully by public health officials is that we’re going to have a lot more difficulty than we expected trying to contain and eliminate measles in this country because the vaccine doesn’t give 100% protection,” said Waterman of the county health department.
Health officials said that is the case even when the vaccine is administered to children who are at least 15 months old.
Measles cases are up statewide, said health officials. As of October, there were 839 cases in California, compared to 443 in the first 10 months of 1986 and 243 in the first 10 months of 1985.
Although figures are rising in California, they are decreasing nationwide, with 3,572 measles cases reported in 1987, compared to 5,961 in 1986, according to the Centers for Disease Control in Atlanta.
One reason for the higher incidence of measles in California may be the large number of undocumented workers whose children may not be immunized, Prescott said. “A lot of people who are here illegally are afraid even to go the public health centers” for fear of being discovered, he said.
Prescott said it is difficult to estimate whether the school vacation period will help contain the outbreak or cause it to spread further.
“With all the shopping, get-togethers and school holiday occasions like (sports) games, there’s a lot of opportunity for exposure this time of the year,” he said.
There are no medical risks associated with the measles vaccine, which contains a live virus, Prescott said. However, he said medical exemption may be granted if a child has a contraindication to the vaccine or has an altered immune system like that associated with leukemia, or is on prolonged X-ray or corticosteroid treatment.
Measles symptoms include a rash, high fever, red or watery eyes, a cough and a runny nose. Those who develop these symptoms should remain home and report the illness to the Department of Health Services at (213) 974-7937.
RESULTS OF L.A. COUNTY AUDIT
The County Department of Health Services this month audited the measles immunization records at 15 South Bay schools. All are in the Torrance Unified School District except Rolling Hills High and Ridgecrest Elementary schools in the Palos Verdes Unified School District, and Bishop Montgomery High School, a private school in Torrance.
No Proof of Granted School Enrollment Immunization Exemption* Bishop Montgomery High 1,620 369 1 North High 1,950 8 3 Rolling Hills High 1,547 23 11 Sheryl High 245 10 2 South High 1,566 74 8 Torrance High 1,875 54 7 West High 1,781 77 5 Calle Mayor Middle 826 14 0 Casimir Middle 552 15 0 Hull Middle 671 9 0 Lynn Middle 760 57 2 Madrona Middle 544 36 3 Magruder Middle 556 12 4 Ridgecrest Elementary 915 12 6 Riviera Elementary 445 7 2
* Exempt students include those who are also listed as lacking proof of immunization.