2,100 Students at High School Asked to Get Measles Shots : Health: The action is prompted by 10 confirmed cases and 15 suspected cases of the disease at Huntington Beach High in the last three weeks.

More than 2,100 students at this city’s largest high school have been asked to report to the campus career center for measles shots Friday as school and county health officials hurry to stem a serious outbreak of the disease.

With 10 confirmed measles cases and another 15 suspected cases in the last three weeks, “I’ve not seen anything like this--so many cases of measles,” said Huntington Beach High School’s school nurse Carol Kanode. “And I’ve been a school nurse 15 years.”

Kanode noted that two of the students were hospitalized because of the illness but have recovered without permanent effects.

The mass vaccinations, offered free by the Orange County Health Care Agency, will be the third at Orange County schools since February, local officials said Wednesday, and are yet another sign that the national measles epidemic--first noted here in late 1988--continues out of control.

Last week, county health officials reported that two people--a 2-year-old girl and a 32-year-old man--had died this year of complications from rubeola, or red measles.

Though measles cases this year are running well below last year’s levels, Orange County is currently one of the most active areas in California for the disease, a key state immunization health officer said Wednesday.

From Jan. 1 to March 16 the county ranked second only to Los Angeles County--with 133 new measles cases, said John Dunajski, assistant chief of the state Department of Health Services immunization unit. Outside Southern California, most California counties have reported only one or two cases in this period, Dunajski said.

Adding to the concerns, county health official Dr. Gerald Wagner warned that measles cases traditionally seem to rise in the spring and that an “upswing” here may have begun.

The measles outbreak at Huntington Beach High began about three weeks ago when a couple of teen-age boys on the school swim team came down with a rash and fever that turned out to be measles, Principal Gary Ernst said.

“Then we had to find out who was in contact with whom and did they have measles too. And then notify the parents. And then little by little, more and more kids came forward.” Where did they get it? “You never know,” Ernst said.

He and Kanode noted that virtually all their students who contracted measles had been vaccinated against the disease--but the vaccine apparently failed.

Once school officials realized the number of students infected, Ernst said, they began excluding children lacking vaccinations from school. There were about 20 in all, some of whom had never been vaccinated for religious reasons. They will not be allowed back until they have been vaccinated or “until it’s safe to go back,” probably after spring vacation, Ernst said. Officials also quickly notified parents of children with serious illnesses, for instance students undergoing chemotherapy.

In addition, last Friday, “We notified every family in our school--2,147 families--that if the parents wish to have their kids immunized, they must sign a release form,” Ernst said. Students who have never had a second measles vaccination will receive that vaccination this Friday.

On that day, those students will be taken out of class early in the morning and sent to the career center, Kanode said. There, six county nurses and three nurses from the school district will spend the day inoculating student after student--and some school staffers if they too wish the shot.

Ironically, because the Huntington Beach school district is pressed for funds, officials are considering cutting at least three of its seven school nurse positions this spring. Kanode expressed concern about this move--especially during a measles epidemic. “What happens when the nursing positions aren’t here (is) you don’t get early identification of a problem,” she said. “In this high school, we immunize all the kids that come to the school. . . . We’re in the line of primary prevention because we’re here.”

Added Principal Ernst, “I’ve tried to figure what would happen if we hadn’t had a school nurse” to help deal with the measles outbreak.

“We probably would not have become aware of the situation. . . . It would have gotten worse,” he said. Ernst noted that Kanode played a key role in alerting others to the outbreak, including going through student files “and immediately identifying those most susceptible to measles, ones who hadn’t had immunizations, students on other medications.”

Ernst noted that the school board will be receiving comments over the next several weeks on a proposed $2.6 million in budget cuts and is faced with the difficult problem of cutting programs with “no fat” left in them.

Mass inoculations at schools with measles cases are part of new U.S. Public Health Service protocols begun this January to stem the nationwide epidemic, said Dr. Gerald Wagner, the county’s medical director for adult and child health services. With the new guidelines and more money from Congress to purchase vaccine, “if there are cases of measles in a school, we offer measles vaccine to anyone who doesn’t have documentation of two doses” of the measles-mumps-rubella inoculation.

Until last year, most people were vaccinated only once, but it has long been known that the standard vaccine had a 5% failure rate. So the new second vaccination effort is designed to catch those for whom the first vaccine may have failed, Wagner and other experts said.

In Orange County, health officials in February offered free mass vaccines to students at Santa Margarita High School in Rancho Santa Margarita and at Marina High School in Huntington Beach after measles outbreaks there. Reportedly, 800 students at Marina were vaccinated. Also, Wagner said, Orange County students at two to three large schools were offered free vaccinations last year after measles was discovered there.

Elsewhere in the state, three or four schools this year have had mass vaccinations, including one last month in Sacramento, state immunization official Dunajski said.

The county’s Wagner noted that the recommendation for a second dose of measles vaccine is a recent one. The American Academy of Pediatrics made the recommendation last year, suggesting that a second dose be given routinely to children entering sixth or seventh grade. Also last year, the Public Health Service recommended a second dose between 4 and 6 years of age, about the usual time for preschool shots.

Previously the vaccine had been given once--to 15-month-old infants--but last summer after two Orange County babies died of measles, local public health officials began recommending that a first vaccine be given much earlier--at 6 months.