This outbreak goes way beyond the 70 cases. If measles is diagnosed in a school, anyone — student or teacher — who does not have proof of vaccination is kept out. Students are struggling to keep up at home, parents are juggling child care and teachers have to shift duties.

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In the Washington county that is home to one of the nation’s largest measles outbreaks, the effects go far beyond the 70 confirmed cases there.

More than 800 students considered exposed to the highly contagious disease in Clark County have been ordered to stay away from classrooms for up to three weeks. Since early January, field trips, after-school activities such as family nights, even an assembly honoring Martin Luther King Jr. have been canceled or postponed. Some students are doing homework off prepared handouts; others are using their school-issued laptops to keep up.

If just one child in a school is diagnosed, all are considered exposed — and any student whose parents cannot prove their child was vaccinated is kept away.

“School exclusions are a critical tool and public health strategy to control outbreaks of disease in school settings,” state health department epidemiologist Dr. Scott Lindquist said in a statement. “… We have to be aggressive in identifying cases, isolating them and reducing public exposure to slow the spread and protect Washington residents.”

Measles is a potentially serious disease that causes fever, rash and cough. It is mainly spread through the air after a person with measles coughs or sneezes. Those most at risk for complications  — which can include ear infections, diarrhea and pneumonia — are infants and children under 5, adults over 20, pregnant women, and people with weakened immune systems.

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More than a dozen Clark County schools — most in Vancouver — had students sit out of class after a directive from health officials. After the date of exposure, students are supposed to be kept out for 21 days, but in many cases, schools don’t know of the exposure until days or weeks later, which shortens the amount of time children have to stay out of school.

As students have been kept away from school buildings for anywhere from several days to several weeks, the result has been “certainly disruptive,” says William Beville, president of the Evergreen School District’s Education Association.

“You’re not going to get the education you will by being here with your peers and colleagues and my other teaching professionals,” Beville said, noting that schools are required to provide education in spite of the exclusions. “It’s like if that were the case, why wouldn’t all the kids stay home and just do their work remotely? It’s not the same experience.”

Sixty-six of the Clark County cases were found in people 18 and younger and the vast majority were not immunized, according to the county’s public health department. Health officials are currently investigating three suspected cases.

River Homelink, in the Battle Ground School District, had the most students excluded, with 243 students kept out for about a week in late January, but most students there are home-schooled and spend little to no time on campus, according to a district spokeswoman. Last school year, nearly a quarter of River Homelink students had vaccine exemptions to the measles-mumps-rubella (MMR) vaccine filed with the school.

Similarly, 55 students were kept away at Vancouver’s Lieser Campus, many of whom were already in home-school or online-learning programs, says Pat Nuzzo, a spokeswoman for the district.

Two fourth-grade field trips to Clark Public Utilities for about 40 Eisenhower Elementary students in the Vancouver School District were canceled, according to Nuzzo. Eisenhower also had to cancel its Jan. 18 Martin Luther King Jr. assembly.

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The effects have been eased in Vancouver public schools because each student in grades three through 12 is issued a laptop or iPad that helps them keep up with schoolwork.

Image Elementary in the Evergreen School District has had to keep out at least 60 students during two separate stretches totaling five weeks, according to a Clark County Public Health spokeswoman. Evergreen High School, the only high school affected, was forced to exclude 65 students from Jan. 20 to Jan. 30, according to district spokeswoman Gail Spolar.

Students at Pacific Middle School, where 40 students were expected back Thursday after being excluded since Feb. 17, and Evergreen have take-home computers, which makes staying up to date easier, but, Spolar says, it’s hard to provide “robust enough” handouts for elementary school students.

In the Evergreen district, which includes 37 schools and about 26,000 students, only one school is still excluding students. Most classes just had one or two kids missing, so the difference wasn’t noticeable as winter-related colds and other illnesses can keep them out during this season anyway, according to Spolar.

Beville, who taught for more than 20 years, says that at least 30 teachers had to be excluded in the Evergreen School District, as well, because they couldn’t provide proof of immunity to measles. They either had to spend time finding decades-old records, get medical procedures to test immunity or receive a booster dose, forcing them to spend time away from school. In the early days of the outbreak, substitute teachers also had to be tested, so some physical education or music instructors were shifted to teach their classes.

“Of course there’s an impact, but again, you know, they’re continuing on and providing education for the vast majority of students that are there,” Spolar said. She added later: “Yes, it’s an inconvenience, but, again, our staff has really pulled together.”

She says that while blood tests for immunity may have taken up to a week in the past, local clinics are reporting results in as little as four hours in response to the outbreak.

Nuzzo, of the Vancouver School District, says about 10 teachers missed one day of work in her district.

Additionally, parents have had to juggle child care as kids miss school.

“The impact of children being excluded from schools goes beyond just the kids missing classroom time,” a Clark County Public Health spokeswoman said in an email. “It also affects parents who may have to take time off of work to stay home with kids. We, as a department, recognize that impact.”

Clark County Public Health Director Dr. Alan Melnick said recently that the outbreak will not be considered over until 42 days, or two full incubation periods, pass without any new cases.

Meanwhile, the state House approved a ban on the personal or philosophical exemption to the measles, mumps and rubella vaccine with a primarily party-line vote late Tuesday night and the Senate could vote on a broader measure to eliminate the same exemption for all vaccines required for school entry Friday.