Mayor Bill de Blasio declared a public health emergency for parts of New York City on Tuesday in the midst of an expanding measles outbreak, and doctors and public health officials on Long Island asserted they're on the lookout for signs of the respiratory illness.
"Everybody has been on heightened alert," said Dr. Bruce Farber, chief of infectious diseases for the Northwell Health system, which has major medical centers in Nassau and Suffolk counties.
"It's really sad when you see an infection that can be prevented by a vaccine spreading again," Farber said.
Measles is one of the most infectious viruses known to medicine -- and it spreads like wildfire, Farber and other infectious disease experts said.
His colleague, Dr. Eric Cioe-Penã, director of global health for the health care system, said if one person with measles coughed in a room and someone entered two hours later, there is close to 100 percent certainty the latecomer would get infected.
Measles has spread through several Brooklyn-area schools in an outbreak that has affected more than 200 students. No end to the epidemic is yet in sight.
Long Island so far has remained measles-free, public health officials said Tuesday, crediting a high vaccination rate in both counties.
Data from the State Department of Health show the last confirmed instances of measles in Nassau were in 2013, when two cases were traced to exposures outside the country. A Suffolk County infant, also exposed to measles abroad, was treated in 2017 at Good Samaritan Hospital in West Islip.
As part of his state of emergency, de Blasio is requiring vaccination with the mumps-measles-rubella vaccine -- MMR -- for unvaccinated children. The mayor said the city would issue violations and possibly levy fines of $1,000 for parents who fail to comply.
To date, there have been 285 measles cases that have been concentrated largely in Brooklyn's Orthodox Jewish community, where infections have been smoldering since late last year. Many of the infected children were students at yeshivas -- Orthodox schools -- in Williamsburg.
City health officials had issued a series of warnings for weeks and had asked parents to vaccinate their children or face closure of the schools. Earlier demands by the health department went unheeded as measles transmission continued, city health officials said.
The Brooklyn outbreak -- and declaration of a public health emergency -- mirror an ongoing measles epidemic involving 153 residents, predominantly children, in Rockland County. That outbreak also has been concentrated in the Orthodox Jewish community.
Although Rockland in late March banned unvaccinated children from public places -- schools, restaurants, parks and airports -- the ban was declared illegal Friday by a state court judge.
Dr. Aaron Glatt, chairman of medicine at South Nassau Communities Hospital in Oceanside, told Newsday two weeks ago there is nothing in Jewish religion that prohibits vaccination. "The religion was in place long before vaccines were developed," said Glatt, who is also a rabbi.
He blamed the outbreaks on well-meaning parents who have been duped by rampantly spreading pseudoscience, which links the MMR vaccine to autism. Vaccine hesitancy is also common among a growing number of people who aren't Jewish, Glatt added.
"Misinformation is very, very dangerous," Glatt said, "and there is no evidence whatsoever that vaccines cause autism."
A study published last month in the Annals of Internal Medicine involving more than 600,000 people proved again that MMR vaccine does not cause autism. The study was the largest, but one of dozens that have found no links between vaccines and the neurodevelopmental disorder.
Measles is a respiratory illness that produces a rash, Farber said, noting that a vaccination rate of 95 percent is needed to secure "herd immunity," the safety net that blankets a community when a sufficient number of people are vaccinated.
"As a society, we need to decide if vaccination is truly optional," Cioe-Penã said. He asked whether people who use public spaces are free to spread a highly contagious virus.
De Blasio's declaration of an emergency arrived one day after the Centers for Disease Control and Prevention announced measles infections had skyrocketed nationwide. The agency confirmed 465 cases in 19 states in 2019. That compares with 63 in 2010. Measles was declared eradicated in the United States by the CDC in 2000.
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