Rockland Regional Commissioner for Health, Dr. Patricia Schnabel Ruppert, gives an update on the outbreak of measles in the Rockland County area Wednesday, October 17, 2018
Peter Carr, [email protected]

On Tuesday, health officials confirmed 74 cases of measles in Rockland, another 24 in Brooklyn, and 14 in Lakewood, New Jersey.

The current outbreak was traced to Israel, which has more than 1,500 cases of measles and one child fatal for complications from the virus.

Israel's explosion can be traced to people who have traveled to other areas where the outbreak occurred, especially in Ukraine, where the World Health Organization said it affected more than 23,000 people. Many Orthodox Jews traveled to Ukraine on Jewish holidays in September.

New York health officials add that in addition to outbreaks of the epidemic in Israel, there are large epidemics in Europe, more than 41,000 cases of measles and 40 fatalities reported this year.

The European Center for Disease Prevention and Control stated that the vaccination rate is lower than 95 percent in most countries in the region. The World Health Organization sets 95 percent as the number of effective so-called herd immunity that stops the spread of cases.

Since the end of September, when passengers brought the first cases of measles into the area, health officials tried to prevent an outbreak of the epidemic. This includes administering vaccination, educating the public and physicians and addressing schools.

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Rockland was exposed to measles at the beginning of October, when five passengers arrived from Israel, mostly local residents, two passengers individually and three other passengers together. Most of the exposure sites were in New Square, Monsey and Spring Valley, but because Rockland is a small county, health officials said that anyone who was not vaccinated in the county is at risk of catching measles.

The probes are highly contagious, with a 90% probability that the susceptible person captures the virus that spreads through airborne particles from breathing, coughing and sneezing and can remain in the air for up to two hours after exposure.

The first Israeli visitor came during the Jewish holiday of Sukkot and visited the synagogue, a rural building beside the school and the Refuah Health Center. Other people who visited Israel and contracting tendons visited the synagogue, the gym and the reflection center and shopping malls at the beginning of October. The following cases were agreed upon by the initial visitors or the exposition in the places where they were visited.

Sick people are children, adolescents and adults, and according to health officials in the district, they were hospitalized, including a child in the intensive care unit for children.

Rockland County has a total vaccination rate of 94 percent and the state of New York is 98 percent.

In order to increase the vaccination rate, especially in the Orthodox Jewish community, where a large part of the outbreak occurred, district and state health officials held vaccination clinics to vaccinate against measles, mumps and rubella (MRD).

Together with the Refuah Medical Center in Spring Valley and private doctors, health care providers have provided more than 6,100 MMR vaccines since the outbreak.

Health Commissioner at Rockland Dr. Patricia Schnabel Ruppert also ordered that non-immunized children stay at home from schools in New Square and from schools that have less than 80% of their vaccinations. This concerns 34 private schools in the county. Health officials carry out day-to-day school checks to ensure compliance.

Students will be able to return 21 days after the last case of measles has been documented.


The focus was mainly on children in Orthodox Jewish communities in Borough Park and Williamsburg. The first exposure occurred when the three unvaccinated children returned to Israel home. Other expositions come from visitors from Lakewood and Rockland, according to medical experts.

All patients are between 7 months and 4 years, according to healthcare professionals. New York Department of Health and Mental Hygiene Assistant Commissioner for Immunization Office Dr. Jane R. Zucker said the age factor may be a contributing factor for why there are so many more cases in Rockland than other areas of outbreak.

"We have a good immunization of school-age children," Zucker said. "What he sees (Rockland) is different from what we see."

There have also been hospitalizations associated with this outbreak, officials said.

Health officials work with local health care providers and hospitals to raise awareness of measles and examine how to treat and suppress this disease. The strategies include providing doctors and clinics with vaccinations, sending notifications to religious schools, placing advertisements in newspapers, and distributing health posters and literature.

The Department of Health and Mental Hygiene in New York recommends that anyone aged six months and older receive or complete their MMR vaccination before traveling abroad.

Health officials recommend that non-immunized students stay home from school during the outbreak of measles. They require all non-inoculated children to stay at home when a student is confirmed by measles – regardless of a medical or religious exception. Students can return to school 21 days after the last known exposition.

Immunization rates have emerged since the outbreak, with more than 600 vaccines being administered in Williamsburg in October, according to the Department of Health.

Officials also urge parents to follow the vaccination plan. Zucker said that what he sees is "vaccination hesitation" when parents delay vaccination until the children begin to begin, but it is problematic and could contribute to outbreaks.

"This outbreak would not happen if the children were vaccinated in time," she said of the first-time children.


The latest exposure to measles in Lakewood occurred at the beginning of November, when the infected person visited a doctor's office, according to the regional health department.

This outbreak is associated with those in Rockland and Brooklyn, and also comes from an adult traveler from overseas. Ocean County health officials have listed exhibitions such as the synagogue, Kosher restaurants, grocery stores and health centers from mid-October to early November.

Several businesses, including a restaurant and a gym with separate hours for men and women, have asked non-immunized people not to come to their premises, and Lakewood Jewish paediatricians have come together to sign a vaccination letter.

Some schools have prevented non-immunized children from participating in the epidemic. Medical clinics and non-profit organizations also released thousands of vaccines in November. Brian E. Rumpf, Director of Administration and Program Development for the Health Department of the Region, said that 12,000 doses of MMR vaccines had been dispatched to the region since the beginning of October 24th.

Ocean County has a 93 percent overall vaccination rate for school children, according to New Jersey State Department of Health.

Monsey and Lakewood had a certain anti-vaccine from a small number of communities. The Orthodox Jewish Hotline for Women called Akeres HaBayes had a recording that invited parents to send their non-immigrant children to school regardless of the outbreak and received a long and detailed letter from a lawyer supporting their cause.

There is also published against the vaccine information circulating around from the organization called PEACH (Parents Education and Defend Children's Health).

Other groups present post-study studies that revelations claim there is a link between vaccination and autism. The American Academy of Pediatrics said in its statement that "they claim that vaccines are associated with autism or are dangerous when administered according to a recommended plan are being refuted by a strong body of medical literature."

The Orthodox Union and the Rabbi Council of America issued a joint statement on the promotion of vaccination and stated that Jewish law presupposes that a person is required to take care of their own health and to take measures to prevent harm to others, including vaccination.


Although Israel has a high rate of vaccination, according to the Israeli Ministry of Health there are "pockets" of unvaccinated communities that have very low rates that contribute to outbreaks.

"The primary site of the disease is in Jerusalem, where 60 percent of patients are there, and we also identified" pockets "in which people were not vaccinated," said Moshe Bar Siman Tov, Director General of the Department of Health, in a statement. "We have succeeded in increasing the rate of vaccination in Jerusalem to very high numbers, and we have succeeded in bringing Jerusalem very close to national coverage by vaccination."

The ministry allocates resources to address the epidemic and said the percentage of vaccination in these communities rose from 55 percent to more than 80 percent.

She also maintained family care centers open in the evenings, broadcast mobile units to address the outbreak and vaccinate, hire more healthcare workers, and reduce access for unvaccinated people to hospitals and schools.

Approximately 650 confirmed cases of measles occurred in children under 4 years of age. Another 500 children and youth; the rest is in adults.

About the Ossuary:

  • The donuts can be very dangerous. About one in four people who receive relief will be hospitalized, one in 1000 cases may cause brain swelling and one or two in 1,000 people may die, according to the Center for Disease Control and Prevention.
  • It is especially dangerous for children and young children, as well as pregnant women who are not immune, and those who are immunologically affected or suppressed by immunosuppression, such as cancer patients.
  • Symptoms of measles include fever, cough, runny nose, red eyes and rash. Symptoms usually occur 10 to 12 days after exposure, but may occur within seven days. The whole incubation period is 21 days. People are infected four days before and after the rash.
  • Common measles complications that affect about 1 in 10 include ear infections that could cause permanent loss of hearing and diarrhea. Major complications include pneumonia and encephalitis or brain swelling that can cause convulsions or mental disabilities.
  • Residents are advised to check their immunization status. If you have symptoms of measles, call your health care provider or local emergency care before entering to minimize exposure. Residents who have symptoms are asked to stay at home and not go public.
  • Physicians and health care providers will ensure that the measles vaccine is safe and effective. It has a 97% protection rate with two MMR images. One dose offers 93% measles protection.
  • The first dose is usually given to children aged 12 to 15 months and the second dose is given between 4 and 6 years of age or before school attendance. During the onset of the illness, the child may receive the first dose for six months but will need the next two doses as is usually planned. If the children have only one dose, they should get the second dose as soon as 28 days after the first dose. The second dose will be counted towards the school entrance.
  • People are considered to be protected or immune to measles if they were born before 1957, received two doses of MMR vaccine, had a measles vaccine, or confirmed the immune response provided by a physician or had a laboratory test that confirmed the immunity. If someone is immunized and gets measles, it is often a much milder case and is less likely to spread to others.

Asbury Park Press reporter Stacey Barchenger contributed to this report.

To learn more about measles in Rockland and other stories of this reporter, visit

Twitter: @ReporterRox

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