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Rockland: Largest NY measles outbreak in decades reaches 68 cases
Rockland County's measles outbreak has reached 68 cases, with another 11 cases under investigation — the largest in New York state in decades — county officials said Tuesday morning.
The outbreak, which originated in Israel, has mainly affected the Orthodox Jewish community, primarily in New Square, Monsey and Spring Valley.
There are also 11 confirmed cases in Lakewood, New Jersey, and 24 in Brooklyn: four in Borough Park and 13 in Williamsburg, according to health departments in New York City and New Jersey.
The last large outbreak in the state was in 2013 with 58 cases when a teenager brought measles from London to New York City.
The New York City Health Department said all the Brooklyn cases affected children who were mostly unvaccinated or too young to be vaccinated, while Rockland health officials said the patients were adults, teens and children.
Rockland has a 94 percent vaccination rate, according to county officials.
Non-immunized children are banned from attending Rockland schools that have less than an 80 percent vaccination rate, which includes 34 local private Jewish schools.
Rockland health officials, with the assistance of state health officials, do daily checks at the schools to ensure that non-immunized children are not attending, officials said. The children will not be allowed to return until 21 days after the last known case of measles have passed.
County and state health departments, along with local physicians and health centers, administered more than 6,100 doses of the measles, mumps, rubella vaccines since the outbreak began in early October. Nearly 3,000 of those were given by the Refuah Health Center in Spring Valley.
Refuah, which has a large Orthodox Jewish clientele and whose name is the Hebrew word for healing, has been working with the county and state health departments since the outbreak began.
The health center has been offering a daily “newborn mobile” parked outside the building for babies under the age of 6 months who are too young for their first shot, and a front-door triage where patients are checked for measles symptoms before entering the center to prevent exposure to other patients.
Symptoms, which usually appear 10-12 days after exposure but may appear as early as seven days and as late as 21 days after exposure, include a fever, rash, cough, conjunctivitis (red, watery eyes) or runny nose. People are considered infectious from four days before to four days after the appearance of the rash.
Refuah has also been providing community education and outreach to residents about measles and vaccinations.
How it started
The first cases of measles came from three groups of travelers: one person visiting from Israel, one person coming home from a visit to Israel and three others traveling together after a visit to Israel.
Israel is in the middle of a measles outbreak with more than 1,500 confirmed cases, according to the nation’s minister of health. One child has died there from measles.
The U.S. Centers for Disease Control and Prevention showed 142 cases of measles and 11 outbreaks in 25 states and the District of Columbia as of Oct. 6, shortly after this outbreak began. An outbreak is defined as three or more linked cases.
Other recent outbreaks include one in 2015 when a visitor to Disney theme parks in California spread measles to seven other states and two other countries. There were 147 confirmed measles cases in that outbreak.
The year before had the largest outbreak in the country in more than two decades, when there were 383 cases among the largely unvaccinated Amish community.
Outbreaks are costly. The 2013 outbreak in New York City cost nearly $400,000 and took a total of 10,054 hours of manpower, according to a report by Dr. Jennifer Rosen published in JAMA Pediatrics, a medical journal from the American Medical Association.
What is measles?
- Measles is a highly contagious respiratory disease caused by a virus that is spread by direct contact with nasal or throat secretions of infected people.
- Measles can be dangerous, especially for babies and young children, as it can lead to pneumonia, brain damage, deafness, and death. About one out of four people who get measles will be hospitalized.
- There have been hospitalizations in this outbreak, including one child in Rockland who was in the pediatric intensive care unit, according to health care officials.
- Others who are at high risk for complications include pregnant women who are not immune, as well as those who are immunocompromised or immunosuppressed (when your body can't fight disease).
- Individuals are considered protected or immune to measles: if they were born before 1957; had two doses of the MMR vaccine; had a physicians or provider confirm measles; or have a lab test confirming immunity.
- The MMR vaccine is 97 percent effective after two doses. Those who are immunized but still get measles have much milder cases, according to county health officials. Typically the first MMR vaccine is given at 12 to 15 months of age and the second dose at four to six years. Vaccinations can also be given later or in the case of an outbreak, as early as six months old.
- Anyone who is unsure of their vaccination status should contact their health care provider. There are currently no MMR clinics scheduled. To receive a dose of the vaccine, contact your local health care provider.
- Residents can get more information about measles by visiting www.health.ny.gov/publications/2170.pdf and by calling the state Department of Health toll-free Measles Information Line at 888-364-4837.