Communicable Diseases

Some people think of measles as just a little rash and fever that clear up in a few days. But measles can cause serious health complications, especially in children younger than 5 years old.

Measles is highly contagious. If one person has it, up to 9 out of 10 people nearby will become infected if they are not protected.

The best protection against measles is measles, mumps, and rubella (MMR) vaccine. MMR vaccine provides long-lasting protection against all strains of measles.

Measles symptoms appear 7 to 14 days after contact with the virus. Common measles symptoms include:

• High fever (may spike to more than 104° F)
• Cough
• Runny nose (coryza)
• Red, watery eyes (conjunctivitis)
• Rash

Complications

Measles can cause serious health complications, especially in children younger than 5 years of age. Common complications are ear infections and diarrhea. Serious complications include pneumonia and encephalitis.

Anyone who is not protected against measles is at risk.

Measles was declared eliminated from the United States in 2000. However, measles is still common in many parts of the world. Every year, measles is brought into the United States by unvaccinated travelers who get measles while they are in other countries. These travelers are mostly Americans and sometimes international visitors.

Some people are a higher risk of experiencing severe complications from measles.

Measles is very contagious. It spreads through the air when an infected person coughs or sneezes. You can get measles just by being in a room where a person with measles has been. This can happen even up to 2 hours after that person has left.

Protect yourself with the vaccine. The best way to protect against measles is with the measles, mumps, and rubella (MMR) vaccine. MMR is safe and effective. Two doses of MMR vaccine are about 97% effective at preventing measles; one dose is about 93% effective.

Prevent measles and talk to your healthcare provider about the MMR vaccine, especially if planning to travel.

• Measles- Rubeola Education (english)
• Measles- Rubeola Education (spanish)
• Measles Flyer & Education (english)
• Measles Flyer & Education (spanish)
• School Guidance for Measles
• How Measles Spreads
• Measles Symptoms and Complication information
• People at Higher Risk of Measles Complications

The symptoms of an S. aureus infection, including MRSA, depend on the part of the body that is infected. Broken skin, such as scrapes or cuts, is often the site of a MRSA infection. Most S. aureus skin infections, including MRSA, appear as a bump or infected area on the skin that might be:

• Red.

• Swollen.
• Painful.
• Warm to the touch.
• Full of pus or other drainage.
• Accompanied by a fever.

You cannot tell by looking at the skin if it's a MRSA infection. People sometimes confuse some MRSA skin infections with a spider bite. However, unless you actually see the spider, the irritation is likely not a spider bite.

Most students with MRSA infections can attend school unless a healthcare provider tells them not to. They should not attend school if:

• They cannot maintain good personal hygiene.
• They have a wound with drainage (pus) that cannot be covered and contained with a clean, dry bandage.

A healthcare provider must send a clinical specimen to a laboratory to determine if MRSA is the cause of an infection.

Closing to clean or disinfect

Generally, you don't need to close schools to "disinfect" them when MRSA infections occur. Routine cleaning practices are enough in most cases.

• Usually, you don't need to inform the entire school community about a single MRSA infection.
• In most schools, the school healthcare provider should notify the student's teacher or staff of any disease or infection. Consult with your school about its policy.
• The school healthcare provider should decide whether they should notify some or all students, parents and staff. If healthcare providers are not available at the school, consult with the local public health department to guide this decision.

If multiple MRSA infections are identified in the school (i.e., an outbreak), facilities should report the outbreak to the local health department for further investigation and/or guidance.

Guidance for teachers and staff

• If you observe a child with open draining wounds or infections, take them to the school medical personnel. If one is not available, call the child's guardian and tell them to seek medical attention.
• Reinforce the need for hand hygiene by everyone as a part of general good health practice:
  • Before eating.
  • After touching infected wounds or soiled bandages.
  • After using the bathroom.

Guidance for school medical staff

• If a student has a skin infection, refer them to a healthcare provider for diagnosis and treatment.
• Notify parents/guardians when you detect possible skin infections.
• Use Standard Precautions when caring for broken skin (open wounds) or potential infections.
• Use barriers such as gloves, gowns, masks and eye protection if splashing or other contact with infected body fluids is anticipated.

• EPA’s Registered Antimicrobial Products Effective Against MRSA 

• Athletic Facilities: Prevention and Control 

• Schools and Daycares: Prevention and Response 

• Cleaning Procedures 

• Fact Sheet- For Staff

• Fact Sheet- For Parents 

• MRSA- Parent Template Notification 

(notification not required by Health Dept, sole discretion of campus admin/DON/Campus Nurse based on situation. Recommend not to use unless multiple confirmed cases of MRSA have been diagnosed by a physician) 

Mumps is a contagious disease caused by a virus that affects the salivary glands. Mumps is still a common disease in many countries, so it's important to get vaccinated to protect yourself. Most people with mumps recover completely within 2 weeks.

People who are infected with mumps don’t get sick right away. It can take 2 to 4 weeks for them to show signs of infection.

Common signs of mumps are puffy cheeks and a tender, swollen jaw. This is caused by the swollen salivary glands under one or both ears. Early symptoms can begin a few days before the swelling. The most serious complication is brain inflammation of the brain.

Some people who have been vaccinated against mumps can still get the disease. However, they usually have milder symptoms and complications are less frequent.

Anyone who is not protected against mumps is at risk of getting the disease.

Some groups of people have a higher likelihood of spreading disease because they are constantly in close contact with each other. These include school-aged children, students at post-high school educational institutions, and healthcare personnel.

People traveling internationally to areas where mumps is still common, or people near outbreaks, are also more likely to get mumps.

Let your doctor know right away if you think you or someone in your family may have mumps. Limit your contact with others for up to 5 days after swelling begins. Stay home from school, work, and do not attend social events.

Mumps is a contagious disease caused by the mumps virus. It spreads through direct contact with saliva or respiratory droplets from the mouth, nose, or throat.

You can get mumps and spread the virus by:

• Coughing, sneezing, or talking.
• Sharing items that may have saliva on them, such as water bottles or cups.
• Participating in close-contact activities with others, like playing sports, dancing, or kissing.

A person infected with mumps can spread it:

• Beginning a few days before their salivary glands begin to swell.
• Until up to 5 days after swelling begins.

Protect yourself with the vaccine. Getting two doses of the mumps vaccine is the best protection against mumps. It's usually given as a combination vaccine called measles, mumps, and rubella (MMR) vaccine, which protects against all three diseases. Your child’s doctor may also offer the MMRV vaccine, a combination vaccine that protects against measles, mumps, rubella, and varicella (chickenpox).

After the U.S. mumps vaccination program started in 1967, there has been a more than 99% decrease in mumps cases in the United States.

• protect yourself against mumps (english)
• protect yourself against mumps (spanish)
• mumps informational
• mumps questions and answers
• resource information from cdc
• mumps: more than just swollen glands

Pertussis is highly contagious illness caused by the bacteria Bordetella pertussis. Early symptoms are very similar to the common cold. One to two weeks after the first symptoms start, people may develop paroxysms (coughing fits). The cough generally gets worse and becomes more common as the illness continues and can cause people to vomit or make a “whoop” sound when breathing in.

Coughing fits may continue for several weeks or even months. Many infants with pertussis may not have coughing fits; instead, they may gag, gasp, vomit, stop breathing, or turn blue. The best way to prevent pertussis is to get vaccinated. The specifics of the vaccine recommendations can be found here. However, immunized children and adults can still get pertussis, so a history of immunization should not preclude a pertussis diagnosis. Immunized children, adolescents and adults may not present with the classic “whoop” symptom.

Pertussis can cause serious and potentially life-threatening complications in infants and young children who are not fully immunized. Infants under one year old are at greatest risk for serious disease and death because their immune systems are still developing. About a third of babies younger than 12 months old with pertussis need treatment in a hospital. Early recognition of cases, effective treatment and prophylaxis, and appropriate vaccination are vital to limiting the spread of pertussis.

• Collect the test specimen prior to the patient starting any treatment. Test patients via culture and/or PCR assay, which are the preferred methods of pertussis testing. PCR assays are quick and widely available at hospital and commercial laboratories.
• Consider beginning treatment prior to receiving test results, especially if clinical history is strongly suggestive of pertussis (such as a long cough illness), the patient is at risk for severe or complicated disease (e.g., infants), or the patient has a known pertussis exposure and has not received prophylaxis.

• Early treatment is critical to reduce illness severity and decrease risk of spread to others. Treat patients within three weeks after cough onset, except for infants aged <1 year and pregnant women (especially near term) who should be treated within six weeks after cough onset.
• Consider prescribing antibiotics effective for pertussis treatment and prevention, which include azithromycin, erythromycin, clarithromycin, or trimethoprim sulfamethoxazole (TMP-SMX).
• Treat patients regardless of vaccination history. According to provisional Texas Department of State Health Services data, more than half of 2024 cases (53%) have occurred in persons with one or more doses of pertussis vaccine and 33% have had five or more doses.
  • Note: The Texas Medical Board changed its rules (Texas Administrative Code, Title 22, Part 9, Chapter 190, Subchapter B, §190.8) regarding the prescribing of prophylaxis for close contacts to infectious disease. Physicians may now prescribe pertussis antibiotics to contacts of pertussis cases without first medically evaluating the contact.

• Droplet precautions should be used for any suspected or confirmed pertussis cases until the patient has received at least five full days of an appropriate antibiotic.
• Healthcare workers should wear a mask and face protection, including, but not limited to, performing a physical examination on, feeding, or bathing a patient; bronchoscopy; intubation; or administration of bronchodilators.

• People suspected of having pertussis should be told to stay home from work, school, daycare, and any public outings (e.g., church, grocery store) until they have completed five days of appropriate antibiotic therapy. School and childcare exclusion are mandated by the Texas Administrative Code, Title 25, Chapter 97, Subchapter A, Rule §97.7.
• Additionally, please follow the Postexposure Antimicrobial Prophylaxis Guidelines as recommended by the CDC.

• Several Texas laws (Health & Safety Code Chapters 81 and 84) require specific information regarding notifiable conditions be provided to DSHS. Health care providers, hospitals, laboratories, schools, childcare facilities and others are required to report patients who are suspected of having pertussis within one work day (Texas Administrative Code, Title 25, Chapter 97, Subchapter A).
• Pertussis reports should be made to your local health department (contacts by county at www.dshs.texas.gov/idcu/investigation/conditions/contacts).

• Culture and PCR assay are the preferred methods of pertussis testing. PCR assays are quick and widely available at hospital and commercial laboratories.
• For PCR assays, a nasopharyngeal swab should be done using a synthetic swab. Check with the testing laboratory to determine what transport media, if any, is needed.
• Direct Fluorescent Antibody (DFA) and serological assays are not considered confirmatory tests for pertussis.
• More information on PCR testing is available at Best Practices for Use of Polymerase Chain Reaction for Diagnosing Pertussis.

• Even in an outbreak, antibiotic prophylaxis is only recommended for household and high-risk contacts.
• Active screening for symptomatic patients with suspected pertussis can be considered during outbreaks in settings such as schools, daycare centers, and hospitals.
  • The asymptomatic contacts may remain in group settings if they comply with prophylaxis and lack respiratory symptoms.
  • They should be monitored for 21 days past their last known exposure.
• A broader use of PEP may be appropriate in limited closed settings when the number of identified cases is small and when a community-wide outbreak is not ongoing. However, when continued transmission of pertussis is evident, multiple rounds of antibiotics would not be recommended. Rather than repeating a course of antibiotics, public health should monitor people exposed to pertussis for onset of pertussis signs and symptoms for 21 days.
• During an outbreak, people without documented immunity from vaccination or previous pertussis infection should be isolated from anyone with pertussis to protect those without immunity and control the outbreak. Additional information on school exclusion and readmission can be found at dshs.texas.gov/idps-home/school-communicable-disease-chart.

If you think you have pertussis, isolate yourself from others and call your healthcare provider before arriving so they can prepare for your arrival without exposing other people. 

Routine prevention steps including hand washing and covering your mouth and nose while sneezing or coughing are essential to prevent the spread of bacteria. Avoid close contact with people who are sick, and don’t share food, utensils, toothbrushes, cigarettes, or similar personal items.

Review your and your child’s immunization history to see if you are up to date on your pertussis containing vaccines. Additionally, discuss with your provider your immunization history and any questions about these vaccines. 

If you think you’ve been exposed to someone with pertussis, contact your healthcare provider about medication that can keep you from getting sick.

• The best way to protect against pertussis is vaccination. Centers for Disease Control and Prevention recommends pertussis vaccines for people of all ages.
• Pertussis infection may occur in vaccinated people since protection from vaccination fades over time. Thus, all individuals should be kept current with pertussis vaccination. Check the vaccination history of all individuals and offer vaccine to anyone that is not up to date.
• Ensure infants get the DTaP series on time and that pregnant women are vaccinated every pregnancy with Tdap to help prevent infant hospitalization and death.

• DSHS - Pertussis (Whooping Cough)
• CDC - Whooping Cough (Pertussis)
• CDC - Symptoms of Whooping Cough
• CDC - Laboratory Testing for Pertussis
• CDC - About Whooping Cough Outbreaks
• DSHS - School and Childcare Vaccine Requirements
• CDC - Pertussis Vaccination Recommendations
• CDC - Pertussis Infection Control in Healthcare Personnel

Bacterial meningitis is a serious and potentially life-threatening infection of the protective membranes covering the brain and spinal cord. It requires immediate medical attention and can lead to severe complications if not treated quickly.

Symptoms can appear suddenly and may include:

• High fever

• Severe headache

• Stiff neck

• Nausea or vomiting

• Sensitivity to light

• Confusion or difficulty concentrating

• Sleepiness or difficulty waking

In infants and young children, symptoms may also include:

• Bulging soft spot on the head

• Poor feeding

• High-pitched crying

• Unusual irritability or limpness

Individuals at higher risk for bacterial meningitis include:

• Infants and young children

• Adolescents and young adults

• People with weakened immune systems

• Individuals living in close-contact settings, such as dormitories

• Those who are not up to date on recommended vaccinations

Bacterial meningitis spreads through close or prolonged contact with respiratory or throat secretions. This can include:

• Coughing or sneezing

• Kissing

• Sharing drinks, utensils, or personal items

• Living in close quarters

It is not spread through casual contact.

Vaccination is the most effective way to prevent certain types of bacterial meningitis.

• Several vaccines protect against common bacteria that cause meningitis

• Staying up to date on recommended immunizations is key

• Practicing good hygiene, such as handwashing and covering coughs, helps reduce the spread of germs

Anyone showing symptoms of meningitis should seek medical care immediately.

The flu, or influenza, is a contagious respiratory illness caused by influenza viruses. It can range from mild to severe and may lead to serious complications, especially for young children, older adults, and individuals with certain health conditions.

Flu symptoms usually come on suddenly and may include:

• Fever or chills

• Cough

• Sore throat

• Runny or stuffy nose

• Muscle or body aches

• Headache

• Fatigue or extreme tiredness
  Some children may also experience vomiting or diarrhea.

People at higher risk for flu-related complications include:

• Young children, especially those under age 5

• Older adults

• Pregnant individuals

• People with asthma, diabetes, or other chronic health conditions

• Individuals with weakened immune systems

The flu spreads mainly through respiratory droplets when an infected person coughs, sneezes, or talks. It can also spread by touching surfaces contaminated with the flu virus and then touching the mouth, nose, or eyes.

The best way to prevent the flu is through annual vaccination.

• The flu vaccine helps reduce the risk of illness and serious complications

• Frequent handwashing and good respiratory hygiene help limit spread

• Staying home when sick helps protect others

• Covering coughs and sneezes and avoiding close contact with sick individuals also reduce transmission

signs and symptoms of the flu

is it a cold or the flu?

influenza information for schools and childcare facilities

flu prevention tips

flu: you know what to do

the flu: a guide for parents