With 105 confirmed cases of measles in Rockland County and Brooklyn, New York is going through the worst outbreak in two decades. There are 76 confirmed cases of measles in Rockland County and 29 in Brooklyn.

Highly contagious, the disease can be dangerous, especially for babies and young children, as it can lead to pneumonia, brain damage, deafness and death.

It’s the most measles cases since the epidemic of 1990-91 which was centered in New York City, according to the state’s Communicable Disease Surveillance Report. In 1991, 2,306 cases of measles were confirmed in New York State.

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The state’s measles cases have been largely confined to the Hudson Valley, New York City and Long Island over the past decade, according to the most recent data from the state health department.

Nationally, the rates of people vaccinated against measles have been very stable since the vaccines for children program began in 1994, said Kate Fowlie at the Centers for Disease Control. In 2016, the overall national coverage for MMR vaccine among children aged 19—35 months was 91.1 percent. However, she said, at the county or lower levels, vaccine coverage rates may vary considerably.

This outbreak in the fall of 2018 is concentrated in the Orthodox Jewish communities of Brooklyn and Rockland.

Rockland health officials put restrictions on schools where the vaccination rate is less than 80 percent, requiring un-vaccinated students to stay home. The mandate affects more than 1,000 students in 34 private schools, and will apply until 21 days after the last measles case is confirmed in the county. Officials acknowledge that that could be months away.

In Brooklyn, health officials have reached out with notifications to schools, hospitals and ads and posters in the community.

“As the measles outbreak continues to spread relentlessly,” said Rabbi Avi Greenstein, Executive Director of the Boro Park Jewish Community Council, “It is imperative that every member of our community protect themselves and their families by getting vaccinated. It is equally imperative to understand that prevention is key. As such, we need to take away the lesson of how important it is for every one of us to avail ourselves of modern medicine and not to trust in herd immunity, but rather to follow the vaccination schedule recommended by medical professionals to protect our families and our entire community.”

The 2013 measles outbreak that hit Orthodox Jewish communities in Williamsburg and Borough Park, begun by a resident who had visited London, cost the city almost $400,000 to contain, a recent study found.

“Vaccine refusals and delays appeared to have propagated a large outbreak following importation of measles,” researchers wrote in the Journal of the American Medical Association. “The United States remains at continued risk for importations of measles resulting in outbreaks.”

With the 2018 outbreak this big, Rockland County officials warn people previously considered immune — that is, anyone born before 1957 or anyone who has receive two doses of measles vaccine — could catch the highly contagious disease.

Neighboring counties are watching developments closely.

Westchester County Health Commissioner Sherlita Amler recommended county residents verify their own measles vaccine status, and assured them in a press release Tuesday that the Health Department is closely monitoring the situation.

Highly contagious, measles is transmitted by airborne particles, droplets, and direct contact with the respiratory secretions of an infected person.

Measles typically is characterized by fever and rash. The rash usually starts on the face, proceeds down the body, and may include the palms and soles. The rash lasts several days. Symptoms can also include high fever, cough, runny nose and red, watery eyes.

Infected individuals are contagious from four days before rash onset through the fourth day after rash appearance, health officials said.

If you think you were exposed to measles, contact your health care provider before seeking care to prevent exposure to other patients. Tell the medical staff if you have fever and a rash and about any known exposures or international travel.

While this outbreak began due to visits between un-vaccinated members of Orthodox Jewish communities in Brooklyn, Rockland and Israel, there are large outbreaks around the globe.

“Measles remains a common disease in many parts of the world, including areas in Europe, Asia, the Pacific, and Africa,” Fowlie said. “Worldwide, 19 cases of measles per 1 million persons are reported each year; about 89,780 die. In the United States, most of the measles cases result from international travel. The disease is brought into the United States by unvaccinated people who get infected in other countries.”

Before any international travel—

You can find measles-specific travel notices here.

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