April 22, 2019
DepEd Memorandum No. 47, s. 2019
MEASLES OUTBREAK RESPONSE AND PREVENTION OF TRANSMISSION IN SCHOOLS
Bureau and Service Directors
Schools Division Superintendents
Public and Private Elementary and Secondary School Heads
All Others Concerned
The declaration of measles outbreak of the Department of Health (DOH) calls for emergency response from all government agencies, including the Department of Education (DepEd) to address the health issue.
Measles is an acute viral respiratory illness. It is a highly contagious disease and can be transferred from one person to person by coughing, sneezing, and direct contact with infectious droplets. The DOH, in partnership with DepEd, shall take appropriate measures to protect school-age children and prevent measles transmission in schools and during large scale school events.
In line with this, a Joint Memorandum Circular (JMC) between DepEd and DOH (copy enclosed) has been crafted to prevent transmission of measles to learners. The policy shall cover schoolchilden from Kindergarten to Grade 6 enrolled in public schools nationwide and those athletes who will participate in the Palarong Pambansa 2019.
Regional directors, schools division superintendents, and other school officials are enjoined to provide full support in the implementation of the JMC. Health personnel are expected to coordinate with DOH regional and provincial health offices for this concern. This activity shall be monitored by the DOH and by the DepEd central office, regional, and schools division offices.
Parental consent must be secured prior to the conduct of the vaccination.
Immediate dissemination of this Memorandum is desired.
LEONOR MAGTOLIS BRIONES
Measles Outbreak Response and Prevention of Transmission in Schools Joint Memorandum Circular (JMC) No. 1, s. 2019
Measles is an acute viral respiratory illness. It is a highly contagious disease and can be transferred from person to person by coughing, sneezing and direct contact with infectious droplets. On February 7, 2019 the Department of Health (DOH) declared measles outbreak in the National Capital Region, Regions III, IVA, VI, and X. As of 17 February, 2019, there were 9,267 reported measles cases with 202 deaths. As part of the outbreak response, the DOH, in partnership with the Department of Education (DepEd), shall take appropriate measures to protect school-age children and prevent measles transmission in schools and during large-scale school events.
1) Prevent transmission of measles and other infectious diseases in schools.
2) Provide guidelines on screening of students participating in school events.
3) Provide guidelines on triaging and referral of measles cases in school events.
III. SCOPE AND LIMITATIONS
This policy shall cover school age children (Kindergarten to Grade 6) enrolled in public schools nationwide and those athletes that will participate in the Palarong Pambansa 2019.
IV. DEFINITION OF TERMS
1) Eligible learners – learners enrolled in kindergarten to grade 6 who, after screening for immunizations status, have no or incomplete measles vaccination.
2) Incomplete measles vaccination -Status of having received only 1 dose of measles contacting vaccine (MCV)
3) Measles Containing Vaccine (MCV) – A vaccine containing live, attenuated measles virus either as monovalent vaccine or combination with one or more of rubella, mumps, and varicella vaccines (e.g. measles only, MMR, MR)
4) Recent exposure to measles – refers to the situation wherein an individual was in close contact with a confirmed or suspected measles case four (4) days before to four (4) days after the appearance of rashes and symptoms in the index case.
5) Triaging – the process of determining the proper intervention for confirmed and suspected measles as well as exposure to such cases, based on the existing protocol and guidelines.
V. SPECIFIC GUIDELINES
1) Prevention of Further Transmission of Measles in Schools
Measles is characterized by fever and malaise (body pain), cough, coryza (runny nose), and conjunctivitis (red eyes) followed by a maculopapular rash. Patients are considered to be contagious from four (4) days before to four (4) days after the rash appears. School teachers need to be alert in identifying possible measles cases to implement critical measures to stop the measles transmission.
a. School officials should advise parents/guardians whose children manifest flu-like symptoms (fever and body malaise, cough, colds, conjunctivitis) to keep them at home and seek immediate medical attention.
b. Learners should not attend schools while sick to avoid further transmission and to allow for further recovery. Patients with measles should remain isolated until four (4) days after the appearance of rashes.
c. School officials shall promptly isolate and refer the student with symptoms to the nearest facility/health center.
d. Standard precautions such as hand hygiene and respiratory hygiene/cough etiquette should be observed at all times.
e. Immediately report the suspected measles case to the health center or rural health unit for proper case investigation.
f. Principal shall declare suspension of classes for four (4) days in a particular classroom with a suspected measles case and with an established clustering of cases in the community.
g. Principal shall declare school-wide suspension for four (4) days when >20% of the classrooms among Kindergarten to Grade 6 have suspected measles cases.
h. Upon resumption of classes, students who remain symptomatic shall be advised not to report to school, and the teacher should be vigilant in monitoring the health condition of their learners. Sick learners must be sent home.
2) Prevention of Transmission of Diseases in Individual or Groups in School-Related Events/Activities
Crowding can facilitate transmission of diseases. To prevent further transmission of diseases in school-related events, the delegates / attendees are encouraged to follow these protocols:
i. In areas with ongoing measles transmission, the delegates I attendees are enjoined to limit mobility of playing venues and billeting quarters as much as possible;
ii. Discourage those who are sick and those with recent exposure to measles from attending school-related events/activities;
iii. Enforce proper personal hygiene in all areas of the school events:
a. Proper hand washing or use of hand disinfectant is a must
b. Covering of nose when coughing or sneezing using the sleeves of your shirt
c. Proper disposal of used tissues with respiratory secretions
d. No spitting
e. No borrowing of personal effects
iv. Intensify campaign for proper health, nutrition and healthy lifestyle
b. Screening and Immunization:
i. All Kinder to Grade 6 (K to 6) learners and athletes participating in 2019 Palarong Pambansa shall be screened for previous measles history and measles vaccination history (i.e. vaccination card, school health records, and parents’ recall) in their respective schools.
ii. All Kinder to Grade 6 (K to 6) learners and athletes participating in 2019 Palarong Pambansa shall undergo screening or assessment on their medical history to determine whether the student is fit to undergo the vaccination process.
iii. All K to 6 learners and athletes participating in 2019 Palarong Pambansa with zero, or only one dose of MCV, or unknown history of measles vaccination shall be entered in the master list for vaccination. The procedures in this and the two immediately preceding paragraphs are to be implemented by the DOH, with the assistance of DepEd Public Health Workers who shall be under the authority and responsibility of DOH.
iv. Vaccination Informed Consent Forms shall be distributed among parents/guardians of K to 6 learners and athletes participating in 2019 Palarong Pambansa included in the master list (see Annex 1: Measles Immunization History and Parent’s Consent Form). Information regarding the vaccination history of the student or pupil shall be provided by the parents, guardians or other authorized persons in a document to be signed by them for confirmation.
v. Only those with signed Vaccination Informed Consent Forms shall be vaccinated
vi. K to 6 learners and athletes participating in the 2019 Palarong Pambansa whose parents refused to give consent for vaccination will be referred to their respective Local Government Units for appropriate action to convince the parents to allow their children to be vaccinated.
vii. School officials shall coordinate with the LGUs hosting special events (e.g. Athletic meets, Festivals, Concerts) to ensure high vaccination coverage among vulnerable age group in their respective areas.
c. Interventions and triaging of suspect measles cases during the 2019 Palarong Pambansa:
i. The medical team shall monitor the health condition of the delegation.
ii. Dedicate an isolation room for suspect measles cases. Those who are exposed will be under close watch preferably in separate room isolated from others.
iii. Coordinate with the local health units of the host LGU for the proper referral and management of cases.
VI. ROLES AND RESPONSIBILITIES
1) Department of Health: The National DOH, Centers for Health Development (CHD), Provincial DOH Offices, and the collaborating Bureaus and Units shall be responsible for the following:
The DOH shall provide the necessary vaccines and other immunization logistics following the routine system of distribution of the immunization logistics.
a. Disease Prevention and Control Bureau (DPCB), in collaboration with DepEd, shall develop guidelines on measles vaccination in school during measles outbreak.
b. Epidemiology Bureau including Regional Epidemiology Surveillance Units, shall collect all reports on adverse event following immunization (AEFIs), conduct case investigation and submit reports to CHD Directors and DPCB and to the Secretary of Health, as needed.
DOH shall ensure that all its units are ready to provide support needed for implementation of the JMC.
2) Department of Education: The DepEd shall be responsible for the following:
The DepEd, in collaboration with DOH, shall develop guidelines on measles vaccination in school during measles outbreak and ensure that all its units follow the guidelines for prevention of transmission of measles in schools, and in individual/school-related events/activities.
The DepEd shall assist and facilitate the implementation of immunization in school, issue memoranda about the said activity, inform learners, parents, teachers, and school clinic staff on measles outbreak vaccination in school, distribute and retrieve informed consent forms for measles vaccination, screen learners on the status of measles vaccination, accomplish the master list of eligible learners for vaccination, and assist vaccinators during immunization schedules. The assistance and facilitation required from DepEd to implement the implementation of immunization in schools will be up to the extent of providing public health workers who will help in conducting the actual process of vaccination in schools but these DepEd public health workers shall be under the authority and supervision of DOH.
VII. DATA PRIVACY
Any necessary personal and sensitive information shall be gathered with the consent of the data subject, declared, specified and used for legitimate purposes in relation to the Project and appropriately protected in consonance with Republic Act 10173 or the Data Privacy Act. Only authorized personnel of the Parties shall have access to any personal and sensitive data/information gathered. All personal and sensitive data/information shall be stored, processed and disposed of in accordance with applicable laws.
This Joint Memorandum Circular shall take effect immediately.