NEW YORK: A New York suburb has banned children not vaccinated against measles from public spaces, such as schools and shopping malls, as it fights the state’s worst outbreak in decades of the potentially deadly disease.

Rockland County declared a state of emergency on Tuesday and said the ban would remain in place for 30 days or until unvaccinated children get the measles, mumps and rubella (MMR) shot.

The Rockland announcement follows measles outbreaks in California, Illinois, Texas and Washington and is part of a global resurgence of the viral infection, according to the US Centers for Disease Control and Prevention.

“We will not sit idly by while children in our community are at risk,” County Executive Ed Day said in a statement. “This is a public health crisis, and it is time to sound the alarm.”

Unicef says complacency, misinformation driving resurgence of measles

There have been 153 confirmed cases of measles in Rockland County, about 18 km north of Manhattan, mostly among children who have not been vaccinated.

The ban begins at midnight after which unvaccinated children will not be permitted in locations such as places of worship, schools and shopping malls. Outdoor spaces like playgrounds are excluded from the ban. People medically unable to get vaccinated are exempt.

The outbreak began when a traveller visited Israel and returned to a predominantly ultra-Orthodox Jewish neighbourhood of Rockland County. There have also been at least 181 confirmed cases of measles in the New York boroughs of Brooklyn and Queens since October, mostly among Orthodox Jews, according to the city’s health department.

The New York and Washington outbreaks began after US travellers picked up measles in foreign countries, where the disease was running rampant, and brought it back to places where vaccination rates were too low by US public health standards.

The disease has spread mostly among school-age children whose parents declined to get them vaccinated, citing reasons such as philosophical or religious beliefs, or concerns the MMR vaccine could cause autism, authorities said.

Large scientific studies have demonstrated that there is no link between vaccines and autism.

Officials say the measles outbreaks offer a lesson about the importance of maintaining a minimum 95 per cent “herd” level of immunisation against dangerous, preventable diseases such as measles. Rates as low as 60 per cent were found in parts of New York where measles spread, State Health Commissioner Howard Zucker said in February.

Why is the once-eliminated disease on the rise again?

Measles is an airborne infection causing fever, coughing and rashes that can be deadly in rare cases. It is more contagious than tuberculosis or Ebola, yet is easily preventable with a vaccine that costs pennies. The UN says worldwide cases of measles jumped by more than 30 per cent in 2017, and infections continued to rise last year. Just 10 countries were responsible for the surge in cases in 2018, according to the UN children’s agency. While most of the countries that experienced large spikes in cases are beset by unrest or conflict, several wealthier nations also saw their caseloads soar.

The UN children’s fund has warned that complacency and misinformation were driving the resurgence of measles among richer nations. “Measles may be the disease, but all too often the real infection is misinformation, mistrust and complacency,” Unicef head Henrietta Fore said this month.

Measles cases more than tripled across Europe in 2018, according to the WHO, with notable outbreaks in Romania, Italy and France.

In other parts of the world, many people lack access to the vaccines and clean sanitation needed to keep measles at bay. The WHO recommends a 95-per-cent vaccination rate to prevent mass hospitalisations and fatalities.

At least 800 children have died from measles since September in Madagascar, where rampant malnutrition and a historically poor vaccine rate are driving the world’s worse current outbreak. Yemen also figures on Unicef’s “top 10” list of countries showing the largest increases in measles cases last year with a 316 per cent hike, from 2,101 cases in 2017 to 8,742 cases in 2018.

Published in Dawn, March 28th, 2019