Measles has been diagnosed in 17 children in the Orthodox Jewish community in the Williamsburg and Borough Park neighborhoods in Brooklyn, the New York City Department of Health stated Friday.
Some of the infected children, who range in age from 7 months to 4 years, have experienced complications including hospitalizations, but there have been no deaths. Three of the children were infected on a visit to Israel, where there is a large outbreak of the disease, the department stated.
As of Sunday, Israel’s Ministry of Health counted 1,334 measles patients, including a toddler who died from the illness last week. The ministry believes that the disease was imported by tourists and visitors who infected an unvaccinated population, largely among the nation’s ultra-Orthodox Jewish communities.
Preventing the illness
Measles is a highly contagious disease that is transmitted by sneezing and coughing as well as direct contact with an infected person, according to the US Centers for Disease Control and Prevention. Symptoms include fever and rash, usually lasting several days. Infected people are contagious from four days before through four days after the rash appears. Young children and pregnant women are among those at highest risk for severe complications, which can lead to death.
For every 1,000 children who get measles, one or two will die from it, according to the CDC.
In Brooklyn, most of the children probably acquired the infection in school, according to the Department of Health. Spokeswoman Danielle De Souza wrote in an email that “14 of our 17 cases were unvaccinated at the time of exposure.”
When a large percentage of the population is vaccinated, “herd immunity” will protect against the spread of disease among the unvaccinated or partially vaccinated, including babies. The CDC recommends the measles, mumps, and rubella (MMR) vaccine for all children at age 12 months, with a second dose at 4 to 6 years old.
The problem in the Brooklyn outbreak is delayed vaccination or children not receiving the MMR vaccine at 12 months old, De Souza said: “This outbreak would not have happened if the children had been vaccinated on time.” However, she also noted that “overall in NYC, our vaccine coverage is high as is compliance with the school immunization requirements.”
The CDC also recommends that everyone, including infants 6 to 11 months old, should be vaccinated before international travel.
Europe is also experiencing a rise
Europe is also experiencing high numbers of measles cases, according to the European CDC. As of October 5, most of the cases in the EU were reported from Romania (5,088 cases, with 33 deaths), France (2,702, with 3 deaths), Greece (2,289, cases with 2 deaths) and Italy (2,248 cases, with 6 deaths). Outbreaks continue to affect Greece, Ireland, Romania and Slovakia, according to the ECDC.
Poland’s Ministry of Health reported 128 cases of measles this year as of October 15, a sharp increase from the 58 cases reported during the same period in 2017. The agency believes that the outbreak has been controlled and that the nation’s population is adequately vaccinated against the disease.
Ukraine, which is not part of the European Union, is also experiencing an outbreak, with over 31,000 cases reported in 2018, including 14 deaths. Serbia, also not part of the EU, has seen 5,741 cases, including 15 deaths. An ongoing outbreak has also been reported in Russia.
In 2017, the World Health Organization European Region, which includes Russia, Serbia and Ukraine, reported more than 24,000 cases of measles, compared with just 5,000 cases in 2016. During the first six months of 2018, more than 41,000 children and adults have been infected with measles. WHO is concerned that low vaccination rates are to blame for the record number of measles cases across the European region.
In the United States, a rise in unvaccinated children was reported by the CDC last month. Unvaccinated children under age 2 rose from 0.9% among those born in 2011 to 1.3% among those born in 2015, according to one report. By comparison, only 0.3% of kids between 19 and 35 months had received no vaccine doses in 2001.
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“None of the Brooklyn cases has as of yet, caused any cases outside of Brooklyn,” De Souza said. Meanwhile, NYC’s Health Department is raising awareness in the Orthodox Jewish communities of Brooklyn by sending notifications to religious schools, placing ads in newspapers and distributing health care posters and literature. Additionally, local health care providers and hospitals have been notified of the outbreak, and vaccine doses have been provided to doctors and clinics.
Between June 2009 and June 2010, the US experienced an outbreak of mumps affecting 3,502 people, most of them students and most Orthodox Jews in New York City, two upstate counties and one New Jersey county. In that outbreak, a majority of the students with documented vaccine status had received both doses of the MMR vaccine, so health officials suggested that intense, face-to-face interactions in classrooms enabled the spread of disease.
Rabbi David Niederman, president of the United Jewish Organizations of Williamsburg and North Brooklyn, made clear in a Friday statement that the Torah, the Old Testament that serves as a guiding practice in Judaism, says people must guard their health. “It is abundantly clear on the necessity for parents to ensure that their children are vaccinated, especially from Measles.”
Correction: This article previously included a photograph of a child with a rash linked to a vaccination. The image has been removed.