Are You Seeing Spots? Responding to Measles in the Workplace

Measles outbreaks have been highly publicized. According to the Centers for Disease Control and Prevention (CDC), from January 1 to May 24, 2019, 940 individual cases of measles were confirmed in 23 states, including Colorado, Arizona, and New Mexico. Measles outbreaks (defined as three or more cases) have been reported in nine locations throughout the United States, including California. As of May, measles had not been designated an epidemic or a pandemic by the CDC or the World Health Organization (WHO).

Although the total number of cases is small, some organizations and locations will face significant business impacts, such as the quarantine orders at some California universities or New York City’s mandatory vaccination. Is your organization prepared?

Let’s begin by defining the illness: Measles is an acute viral illness. Symptoms start with fever, runny nose, cough, red eyes, and sore throat. These are followed by a rash that spreads over the body. Symptoms of measles generally appear about seven to 14 days after a person is infected. Measles can cause serious complications, particularly in young children and people with reduced immunity.

One reason this topic is newsworthy is that measles is so highly contagious: if one person has it, up to 90 percent of the people close to that person who are not immune will also become infected. Immunity is gained through vaccination or past infection. The virus spreads easily through coughing and sneezing, and can live for up to two hours in an airspace where the infected person coughed or sneezed. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected. Infected people can spread measles to others from four days before through four days after the rash appears.

So what can you do? For most employers in low-risk occupations, protecting your employees will depend on directing employees to take everyday preventive actions such as:

  • Staying home when  sick;
  • Covering coughs and sneezes with a tissue;
  • Washing hands often with soap and water for at least 20 seconds; and
  • Cleaning frequently touched surfaces and objects.

Check with local public health officials regularly to see if additional actions are recommended. Posters, infographics, and other communications on communicable diseases are also available from organizations such as the CDC and OSHA.

Here is additional guidance for Human Resources departments:

Employee Handbook Review and follow your existing sick leave and time off policies. In most cases, there’s no need to stray from your regular practices.

Fair Labor Standards Act (FLSA) As with any illness, use of sick leave or PTO in partial- or full-day absences is permissible. If sick leave or PTO is exhausted, nonexempt employees may be unpaid. For exempt employees, consult with Employment Law Services at Employers Council to avoid potential violations of the salary basis.

Family and Medical Leave Act (FMLA) Depending on the severity of the infection, measles could constitute a “serious health condition” for the employee or a family member. Look to other leave policies if FMLA does not apply or is exhausted. Recognize that medical certifications may be delayed if doctors’ offices become overloaded, and consider granting additional time for certifications.

Workers Compensation Employees may view the workplace as the point of infection. This will be difficult to determine in most cases. If an employee alleges measles is work-related, report it to your insurer, who will determine compensability under appropriate state law.

Occupational Safety and Health Act (OSHA) There are no standards specific to measles or infectious diseases, although the OSHA website does provide guidance, particularly for employers in health-care settings. However, the General Duty Clause requires employers to provide “a place of employment which is free from recognized hazards that are causing or are likely to cause death or serious physical harm to … employees.” While the extent of this obligation depends on a hazard assessment and risk mitigation, an employee may be protected for refusal to work: “If the employee, with no reasonable alternative, refuses in good faith to expose himself to the dangerous condition, he would be protected against subsequent discrimination.”

Americans with Disabilities Act (ADA) Illnesses like the measles are typically transitory and minor, and generally would not be covered by the ADA. This is not an absolute, and you should consult Employment Law Services for specific guidance. The analysis can vary due to state or local laws and other factors.

For employees without a disability, the ADA also regulates when and how employers may require medical examinations. Fitness-for-duty certifications are permitted if job-related and consistent with business necessity and based on objective evidence that the employee’s medical condition impairs their ability to perform essential functions of the job OR poses a direct threat to other employees. Suspicion is not enough to justify inquiry or a medical exam. As with FMLA, be aware that it may be difficult for employees to comply if medical facilities are overcrowded.

Privacy Keep health information about employees private and confidential, even if your organization is not covered by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Employers are allowed to communicate about health-related threats and provide information on controlling and/or containing employee exposure. You should not name specific employees as the source of infection. Communications are available from local public health officials and national organizations such as the CDC.

For information on other elements of Emergency Preparedness such as Safeguarding Assets and Business Continuity, please check under the Health/Safety Resources section of our website. This information is general guidance, and should not be construed as legal advice pertaining to every situation. For questions related to your specific industry, jurisdiction, or policy, please contact your Employers Council staff member.