By Sabina Mollot
Despite some pretty stringent rules about immunization in schools, measles has made its comeback. So far, cases have been reported in 10 states, including New York, where there have been over 200 reported cases, all in Orthodox Jewish enclaves upstate as well as in Brooklyn.
According to the New York City Health Department, there have been 67 cases of measles since last October, all in Brooklyn.
To keep the disease from spreading in the city, mandatory school exclusions are currently in effect for children attending yeshivas or yeshiva-based childcare centers in the neighborhoods of Williamsburg and Borough Park. This means the students must remain home from school while the outbreak is ongoing, including children who have religious exemptions or valid medical exemptions.
Meanwhile, upstate, Rockland County has seen 130 cases, Orange County 10 cases and Monroe County seven, according to the State Department of Health. In response to the outbreak there, Rockland County has excluded approximately 6,000 unvaccinated children at schools that are either located in close proximity to cases or that have vaccination rates below 95 percent. State health officials have also met with local rabbinical leaders, parents and pediatricians on school exclusions and on getting children vaccinated.
With the local cases being linked back to the Orthodox community, it’s suspected (though unconfirmed) that the first case may have come from traveling back from Israel.
In New York City, NYU Langone’s new Hassenfeld Children’s Hospital has seen a couple of patients with measles. While doctors wouldn’t comment on those specific patients, they are stressing that it is still a local concern given that some children haven’t been vaccinated due to their age – vaccines are given after a child turns one — or because they are immune compromised. There is also the issue of exemptions made for children based on religious reasons, which are granted by schools or school districts.
Dr. Adam Ratner, director of the Division of Pediatric Infectious Diseases at Hassenfeld, said it’s been a challenge to fight an ongoing campaign against vaccination, which began with a now debunked report from 1998 linking the vaccine to autism as well as anti-vaccination websites.
“There’s a social media movement about toxins and use of fetal cells and things that are not true,” said Ratner. “It’s preying on people who have kids and are scared and for the most part want to do the right thing for their kids. They end up on official-sounding sites and get terrible information. The anti-vaccination movement now seems to be targeting cloistered, religious communities. The MMR vaccine has been used for decades. Nothing is 100 percent, but it is much, much safer than getting actual measles. It has a fantastic safety record.”
The other problem, he said, is exemption policies for the requirement of vaccinations for schools, which in some areas can be philosophical as well as religious.
“And this is a problem,” said Ratner. “In California there was a big outbreak due to under-vaccination in pockets of the population and the laws were changed to restrict exemptions.”
When there was widespread measles in the U.S., prior to the vaccine, there were around 500 deaths a year.
“There was no way to prevent the measles prior to the 60s, so basically everybody got the measles during childhood,” Ratner said. “People say, ‘My grandmother or my grandfather got it and they were okay.’ Well if they weren’t okay, they wouldn’t have lived on to become your grandparents, but at the time it was something parents were frightened of and rightly so.”
If a child seems to be at high risk of getting the disease, doctors will vaccinate him or her under the age of one. The reason this isn’t typically done is because the vaccine isn’t believed to be as effective in children until the age of one.
Measles starts with a fever, runny nose, cough, red eyes and sore throat. It’s followed by a rash that spreads over the body. It is spread through coughing and sneezing.
Because the symptoms can also turn out to be conditions other than measles, Ratner recommends taking a child to a doctor before bringing him or her to the emergency room. But if doing the latter, “Ideally, they’d know you were coming,” said Ratner, “because if you’re worried about measles, they would want to put you in a room and get masks on as early as possible.”
Another concern of the medical community, Ratner added, is that parents may not understand how easy it is to get the highly contagious condition or know how dangerous it can be for children.
“The majority of people get sick for a few days, then get well,” said Ratner. “This is a good thing.”
But, he added, around 5 percent of measles cases will go on to become something more complicated like pneumonia or less commonly an inflammation around the brain. It has also been shown to have longterm effects, he said, like an increase in mortality from other conditions.
“Someone’s going to die at some point,” said Ratner. “It makes kids sick. The thing about measles is it’s so contagious… it’s much harder to get rid of than it is to prevent before it’s there. Parents should seek information from a pediatrician and reliable sources like the Center for Disease Control and they should vaccinate their kids.”
According to the CDC, other states where measles cases have been reported are California, Colorado, Connecticut, Georgia, Illinois, New Jersey, Oregon, Texas, and Washington.