Citing pockets of resistance that are impeding Rockland's efforts to stem a measles outbreak that has risen to 153 cases since October, County Executive Ed Day declared a state of emergency Tuesday. Starting at midnight, anyone who is under 18 and not vaccinated against the measles was banned from public places. This ban will last until the declaration expires in 30 days or until people are vaccinated. Children with medical exemptions are not included in the ban. "Parents will be held accountable if they are found to be in violation of the state of emergency and the focus of this effort is on the parents of these children," Day said. "We are urging them, once again, now with the authority of law, to get your children vaccinated." Day said 72.9 percent of children between the ages of 1 to 18 in Rockland County were fully vaccinated against measles, according to the New York State immunization information system. Herd immunity is effective at 95 percent, according to health officials. Of the 153 people who have contracted measles, 83.7 percent or 128 people were 18 or younger, Day said. MEASLES: What you need to know, how to get vaccinated MEASLES BAN: Why infectious disease experts are concerned about Rockland ban PSA: Chris Day, Aron Wieder join forces to alert public of measles vaccinations MEASLES: Rockland County's newest outbreak; latest news Places covered under the ban include shopping centers, restaurants, schools and places of worship. Outdoor gathering places are not included. The county will be disseminating signs explaining the ban to be posted in public areas included in the ban. Although Rockland's outbreak has primarily affected members of the Orthodox Jewish community, Day said there’s no religious exemption. He said he has met with community leaders and stakeholders who supported the measures the county has taken to contain the outbreak. Some Jewish community leaders are concerned about the backlash from the emergency declaration. "I'm very concerned about it because there are folks in this community, in this county, who will use this as an opportunity to be prejudiced," said Gary Siepser, the CEO of the Jewish Federation and Foundation of Rockland County. "I'm very concerned at how people will be viewed and what could happen when people go into the mall or try to go into Target or wherever they want to go shopping and be out. That's my concern." In the 26 weeks since the outbreak began, health officials administered 16,958 vaccines, the majority by the Refuah Health Center in Spring Valley, Day said. County health officials will be holding a free MMR vaccination clinic Wednesday between 1 and 3 p.m. at the Robert L. Yeager Health Complex, 50 Sanatorium Road, on the second floor of building A. The county plans to hold more clinics for residents. Day cited pockets of resistance the county has begun to encounter in his declaration, as well as the upcoming major religious holidays of Easter and Passover. The county has decided to only make a single MMR mandatory in the emergency declaration. "We don't want to see a repeat of how this outbreak started, when we saw people gathered together and then fall ill last fall," Day said. "We want everyone to enjoy their friends and families, something quite difficult with the specter of measles hanging over their heads." Noncompliance will carry penalties of six months in jail or a $500 fine, although Day said law enforcement would not be deployed at any location seeking proof of vaccination. If a person is found to be in violation, the case would be referred to the county District Attorney's office. MEASLES: What to know about the Rockland County outbreak ROCKLAND: 5 locations for possible measles exposure revealed DENIED: Judge rejects request to let unvaccinated students return to class MEASLES IN WESTCHESTER: What you need to know EXPERTS WEIGH IN: Why they are concerned about Rockland measles ban The announcement comes days after county health officials announced six new exposure sites in Spring Valley and Monsey, including Target in Spring Valley Marketplace, All Fresh Supermarket, Atrium Plaza, Designer’s Spot, TOR bus loop 2 Eastbound and International Taxi. This was the first time the county released new exposure sites since Thanksgiving weekend, although new measles cases have continued. State health officials declined to declare a state of emergency in Rockland last month after measles got national attention due to an outbreak and emergency declaration in Washington state. Officials said they were holding regular emergency preparedness calls with local health departments since October after activating its incident management system. At the time there were 137 total measles cases in the county. Rockland's exposure sites have mostly been in Monsey or Spring Valley, and anti-vaccination advocates last fall used a phone hotline called Akeres HaBayis to tell parents to continue sending their children to school. But Rockland health officials caution that due to the small geographic size of the county, anyone who is unvaccinated is at risk for measles. Day said the county is also drafting a local law to protect residents and visitors in the event of an outbreak of a communicable disease. Rockland County Legislator Aron Wieder, D-Spring Valley, said he reserved comment until he's heard more details. He was unaware of the planned state of emergency until a press announcement was issued. "Overall, I think that people should be mindful about this terrible disease," said Wieder, who is Hasidic. "I think there is a false perception that people in the Orthodox Jewish community are not vaccinated. That’s not the case. I'm vaccinated. All my children are vaccinated." Potentially unprecedented Infectious disease experts described broadly banning unvaccinated minors from public places as a potentially unprecedented government action in combating a measles outbreak. “It’s not something that I’ve seen before in my professional experience,” said Dr. Jeffrey Duchin, a top public-health officer in Seattle, Washington. “What that says to me is that the local public-health people feel that they have an extraordinary outbreak on their hands,” he added. Enforcing a community-wide ban on access to public places presents a variety of challenges, experts said, citing the difficulty in monitoring the movements of a select group. Earlier order affecting schools This ban supersedes an order issued Dec. 5 by Rockland County Health Commissioner Dr. Patricia Schnabel Ruppert that mandated that schools in the 10952 and 10977 ZIP codes with vaccination rates under 95 percent had to ban unvaccinated children from attending. Under the emergency declaration, no unvaccinated student can attend school, regardless of the school's vaccination rate, Day said. Nine yeshivas were fined in November for not reporting unvaccinated students. A federal judge denied a temporary injunction to allow unvaccinated students to return to class at the Green Meadow Waldorf School after parents brought a lawsuit against the county. In a letter sent out to public school parents late this afternoon, Rockland County BOCES CEO Mary Jean Marsico said that "any individual under 18 and unvaccinated against measles will be barred from public places." Marsico says the responsibility for enforcement is on the parents. County health officials are expecting to say that parents and guardians "will be held accountable." For Green Meadow Waldorf School, will "comply with the terms" of the emergency, said Vicki Larson, the director of communications and marketing. "Green Meadow Waldorf School remains under the county Department of Health exclusion order that prohibits students who are unvaccinated or under-vaccinated for measles from being in attendance at our school," Larson said. New York City's health department has reported 181 measles cases as of March 19. A new outbreak with eight measles cases in New Jersey began earlier this month after an outbreak linked to the one in New York was declared over in January. The original measles cases in New York and New Jersey in October came from travelers visiting from or traveling home from Israel, which is experiencing a measles outbreak that has affected more than 3,400 people and caused at least two deaths. The Centers for Disease Control and Prevention listed 314 measles cases in 2019 as of March 21 in 15 states, including New York, New Jersey and Washington.<doc-sep>A county in New York has declared a state of emergency after more than 100 people have been diagnosed with measles. Rockland County officials announced that starting at 12 a.m. on Wednesday, anyone under 18 who has not yet been vaccinated will be barred from public places until they receive the MMR vaccine or until the emergency declaration expires in 30 days. Public places are being defined by county officials as "any place where people get together for civic or social reasons," such as shopping centers, schools and restaurants. Outdoor areas, such as playgrounds, are not included, according to county officials. Law enforcement will not be asking people for vaccination records, but if parents are found to be in violation, their cases will be forwarded to the district attorney, Rockland County Executive Ed Day told reporters in a news conference Tuesday. Violations will be charged as misdemeanors punishable by up to six months in jail and a $500 fine. "We must do everything in our power to end this outbreak," Day said. Those unable to be vaccinated due to confirmed medical reasons are exempt from the declaration, Day said. The Rockland Department of Health will be holding free vaccination clinics all week for residents. Health officials have confirmed 153 reported cases of measles in Rockland County, Day said. Day admonished some residents for not cooperating with health inspectors going door to door to investigate the outbreak. "This type of response is unacceptable, and, frankly, irresponsible," he said. Measles outbreaks in the state of New York began in October and have gone on longer and infected more people than any other current outbreak in the country, according to Kaiser Health News. Through the first week of March, 275 cases had been confirmed statewide, but that number has likely risen since. Much of the measles cases in New York have been concentrated among children of Orthodox Jewish families, many of whom attend religious schools where the vaccination rates are below 95 percent, which is the threshold considered necessary to maintain immunity among the community, known as herd immunity, according to Kaiser Health News. There is "no such thing" as a religious exemption from being immunized, Day said, adding that just 72 percent of the those under 18 in Rockland County are vaccinated. The measles vaccination is 97 percent effective, according to health officials. High-risk groups include pregnant women, children under 6 months and those who are immunocompromised or immunosuppressed. Before the vaccine program began in the 1960s in the U.S., four million people were infected with measles every year, resulting in about 50,000 hospitalizations and 500 deaths annually, according to Kaiser Health News. In 2018, 349 individual cases of measles were confirmed in 26 states, according to the Centers for Disease Control and Prevention. So far in 2019, 314 cases of measles have been confirmed in 15 states. Measles cases have increased in recent years in part because of fears fanned by anti-vaccine activists, according to Kaiser Health News.<doc-sep>A county in New York City’s northern suburbs declared a state of emergency over a measles outbreak that has infected more than 150 people. It hopes a ban against unvaccinated children in public places wakes their parents to the seriousness of the problem. “It’s an attention grab, there’s no question about it,” Rockland County Executive Ed Day said at a news conference, noting that he didn’t believe such a drastic step has ever been tried in the US before. EXTRAORDINARY MEASURES Day said he was taking the action in hopes of reversing a recent uptick in cases amid disturbing reports that health workers were encountering resistance when investigating cases. Rockland’s outbreak has most heavily affected Orthodox Jewish communities, in which vaccination rates tend to be lower. Under the declaration, which lasts for at least 30 days, anyone under 18 who is not vaccinated against measles is barred from public gathering places, including shopping malls, civic centres, schools, restaurants and even houses of worship. Those in violation could be charged with a misdemeanour punishable by up to six months in jail. But Day acknowledged that there will be no concerted enforcement effort and that the intent is not to arrest people but to emphasise the seriousness of the situation. “There will not be law enforcement or deputy sheriffs asking for vaccination records. That is ridiculous,” Day said. “However, parents will be held accountable if they’re found to be in violation of this emergency declaration.” DISEASE RESURGENCE The county is experiencing New York state’s longest measles outbreak since the disease was declared officially eliminated from the United States in 2000. Health officials say the best way to stop the disease’s spread is a vaccination rate in the community of 92 to 95 per cent. Day said only 72.9 per cent of people under 18 have been vaccinated against measles in Rockland County, which has more than 300,000 residents. Civil rights lawyer Michael Sussman, who represents the parents of 44 unvaccinated children who were barred from a Waldorf School in the county, said he would discuss a possible challenge to the emergency declaration in a meeting with his clients. “It’s irrational,” Sussman said. “You’re punishing people who don’t have the illness rather than quarantining people who are sick.” Sussman said a quarantine of measles patients and those close to them would quickly stop the disease’s spread. BELIEF BACKLASH This month, a federal judge, citing the “unprecedented measles outbreak,” denied the parents’ request to let unvaccinated children return to the Waldorf School. The lawsuit said the county’s order banning unvaccinated children from schools regardless of religious or medical exemptions violated their constitutional rights. The outbreak began in the Rockland area when seven unvaccinated travellers diagnosed with measles entered the county last October. There have been 153 cases to date, Day said. In the early days of the outbreak, people were cooperating with health officials and getting children vaccinated, he said, but that has changed. “Our health inspectors have been hung up on and told not to call again. They’ve been told, ‘We’re not discussing this, do not come back,’ when visiting the homes of infected individuals as part of their investigations,” Day said. “This type of response is unacceptable and frankly irresponsible.” DEADLY IGNORANCE On the same day as the federal judge’s ruling on the schoolchildren, paediatric organisations expressed support for state legislation that would allow minors to get vaccinated without parental consent. The state legislation’s Democratic sponsors said too many parents believe unsupported claims that vaccines are unsafe and cause autism or other conditions. Day echoed that message, noting celebrities who have spoken out against vaccines. “If you’re going to People magazine and Jenny McCarthy and Robert De Niro for your medical advice, you need to re-evaluate your life,” he said. AN AGNOSTIC VIRUS The Centres for Disease Control and Prevention lists six measles outbreaks, defined as three or more cases, around the country in 2019, including Rockland County’s. The CDC said the outbreaks are linked to travellers who brought the disease back from other countries, such as Israel and Ukraine, where large measles outbreaks are occurring. There have been 181 confirmed cases of measles in Brooklyn and Queens since October, most of them involving members of the Orthodox Jewish community, according to the CDC. Day said the emergency order was timed with the upcoming religious holidays of Easter and Passover in mind. “We want people to be able to celebrate,” he said. “We don’t want to see a repeat of how this outbreak started when we saw people gathered together and then fall ill last fall.” The CDC says 15 states have had at least one case of measles confirmed in 2019, for a total of 314 cases to date. In 2014, 667 cases were confirmed nationwide and there were 372 cases in 2018.<doc-sep>
ROCKLAND COUNTY, New York (WABC) -- Rockland County has declared a state of emergency over the ongoing measles outbreak, with Executive Ed Day announcing that non-vaccinated minors are now barred from public places.Now in effect, anyone who is under 18 years of age and is not vaccinated against the measles is prohibited from public places until the declaration expires in 30 days or until they receive the MMR vaccination.Officials said law enforcement will not be patrolling the streets or asking for vaccination records, but if someone is found in violation of the declaration, their case will be referred to the district attorney's office.Parents will also be held accountable for their children if they are found in violation of the state of emergency, and could face fines and possible jail time.Officials say there are no religious exemptions, and that they have been working with area rabbis who have been encouraging their members to get vaccinated.According to the emergency declaration, public places are defined as a place where more than 10 persons are intended to congregate for purposes such as civic, governmental, social, or religious functions, or for recreation or shopping, or for food or drink consumption, or awaiting transportation, or for daycare or educational purposes, or for medical treatment.A place of public assembly shall also include public transportation vehicles, including but not limited to, publicly or privately owned buses or trains, but does not include taxi or livery vehicles.There are currently 156 confirmed reported cases of measles in the county, according to health officials. "As this outbreak has continued, our inspectors have begun to meet resistance from those they are trying to protect," Day said. "They have been hung up on or told not to call again. They've been told, 'We're not discussing this, do not come back' when visiting the homes of infected individuals as part of their investigations. This type of response is unacceptable and irresponsible. It endangers the health and well-being of others and displays a shocking lack of responsibility and concern for others in our community. "Day said the intention of the state of emergency isn't to arrest people, but to educate the community and gain compliance. "This is an opportunity for everyone in their community to do the right thing," Day said. "We must do everything in our power to end this outbreak and protect the health of those who cannot be vaccinated for medical reasons and for the children too young to be vaccinated. "Day said he recognizes there are religious holidays coming up soon, but if people immediately comply with the state of emergency and vaccinate their children now, they will still be able to enjoy Easter and Passover with their friends and family. "We want people to be able to celebrate," he said. "We don't want to see a repeat of how this outbreak started when we saw people gathered together and then fall ill last fall. We want everyone to enjoy their friends and families, something quite difficult with the specter of measles hanging over their heads. "Some community leaders are urging vaccination and say resistance is not about religion, but a lack of education. They applaud the state's efforts thus far, but many have real fears about this latest step. "Describe a B misdemeanor and someone can get arrested, that just sounds very scary to me," community activist Rivkie Feiner said.Others worried normal people would be demonized. "I'm very concerned about how people will be viewed and what will happen when people go to the mall and try to go to the Target or wherever they want to go shopping or be out," said Gary Setzer, of the Jewish Federation and Foundation of Rockland County.Meanwhile, other leaders say the problem is the numbers. "This community has a boatload of children," said Yossi Gestetner, of the Orthodox Jewish Public Affairs Council. "To give you context, Manhattan, less than 9 percent of the population is under the age of 10. New Square, the Hasidic village, 40 percent. "The Rockland County Department of Health held a free MMR vaccination clinic Wednesday afternoon. Free MMR vaccines are available by calling:--The Rockland County Department of Health at 845-364-2497 or 845-364-2520 to schedule an appointment to get a free MMR vaccine at the Pomona health complex.--The Rockland County Department of Health Spring Valley Family Planning Clinic is also providing MMR vaccines, by appointment to Family Planning patients.