Measles, Currently the Most Contagious Virus and the Misinformation Spread to Insular Communities

FEAR, MISINFORMATION, AND MEASLES SPREAD IN BROOKLYN

IT WAS OCTOBER 31, a balmy day in Brooklyn, and Alexander Arroyo was walking around his neighborhood dressed as an octopus, pushing his 2-month-old daughter in a carriage, as his wife chased their toddler through the after-school Halloween trick-or-treat crowd. As the family filled their bags with candy, Arroyo’s phone rang and he stopped to answer it, trying to hear over the din of excited children. Arroyo is the director of the pediatric emergency department at one of the biggest hospitals in Brooklyn, Maimonides Medical Center, and two days earlier, a 15-month-old girl had come to the ER with a fever and a rash. He’d been waiting for a call to confirm the diagnosis, and this was it. The test had come back positive: The girl had measles.

 

WHEN THE GIRL had arrived at the ER, she was put in a busy area, where children with earaches or broken arms typically sit. No one suspected measles, because, thanks to routine childhood vaccination, the disease was declared eliminatedin the United States in 2000. Although there had been localized outbreaks since then—among the Amish in Ohio, visitors to Disneyland in California, and the Somali American community in Minnesota—neither Arroyo nor most of his staff had seen a case firsthand. Suspecting ­measles was like thinking “maybe that’s a unicorn,” Arroyo says. “It doesn’t really cross your mind, because measles shouldn’t exist anymore.”

Still, several measles cases had been reported in a different part of Brooklyn. And after a few hours, Arroyo’s team began to worry that the child in their care might be another. They put a mask over her face and wheeled her into an isolation room, with two sets of doors and air circulating under negative pressure to prevent airborne particles from escaping.

By then, however, “the bomb had gone off,” Arroyo says. Measles is considered one of the most contagious diseases in existence. If a person with measles walks through a room with a hundred people who are not immunized, up to 90 of them will get the disease. The virus is spread through coughs and sneezes and lingers in the air for up to two hours. Some 122,000 ­people come through the Maimonides emergency room every year. The hospital, located in Borough Park, serves one of the most diverse patient populations in the country, from ultra-Orthodox Jews to immigrants whose first language might be Mandarin, Russian, Hindi, Punjabi, Arabic, or Uzbek. Many are working-class cab drivers, manual laborers, and restaurant workers who bring their children to the ER at night, when their shifts are done.

Dr. Alexander Arroyo in the waiting room of Maimonides Medical Center.

NATALIE KEYSSAR

Standing in the street that Halloween, Arroyo thought about the dozens of patients who might have been exposed—in the waiting room, the hallway, the exam rooms—from the time the girl came into the hospital until she was placed in isolation. He looked down at his daughter in the carriage, dressed as a clown fish, and thought, “She’s not vaccinated.” She was still too young, as were other babies who might have been in the ER. He knew that his team would have to figure out right away who, exactly, had been breathing the same air as the infected girl. He waved down his wife, who had been making her way down the street with their toddler, and asked her to take the baby carriage. Then he headed home to make phone calls. “I saw my life falling into a pit of measles,” he says.

Arroyo is an amateur kickboxer, lanky and athletic. He hurried down the street, talking by phone with the hospital’s infection-control nurse and mapping out a plan. At home he changed out of the octopus costume and logged on to the hospital’s electronic medical records to check what time, exactly, the girl with measles had entered the ER. He called the other doctors who had been on duty to see if they remembered any pregnant mothers or immunocompromised children who would have been especially at risk.

He also called the hospital’s IT department to help backtrack through medical charts. His team generated names of 55 children who had potentially been exposed to the disease, then asked the New York City Department of Health to cross-reference it with vaccination records. For the MMR vaccine (against measles, mumps, and rubella) to be effective, the immune system has to be mature enough to produce antibodies to the virus. Young babies’ immune systems are not sufficiently developed, so children generally receive an MMR vaccine at 1 year old and another at age 4 or 5; those who had come through the hospital but had not completed both doses were considered at risk.

On the Maimonides list were a 12-month-old, a 10-month-old, and three babies younger than 6 months, including one who was just 17 days old. All were vulnerable, and Arroyo realized he was already running out of time. To prevent infection, the children needed to receive MMR shots within 72 hours, and young babies would have to be given immunoglobulin, a form of temporary protection, within six days. The infection-control nurse began making calls to those babies’ parents.

 

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Yeshiva Kehilat Pupa, NYC’s $2M Measles Bill and an Armed Anti-Vaxxer Movement

One Williamsburg school ‘ignited’ NYC’s measles crisis

The outbreak has cost the city roughly $2 million.

June 25, 2019 Scott Enman
Yeshiva Kehilath Yakov Pupa in Williamsburg failed to bar unvaccinated children from attending class, Health Department officials said. Image via Google MapsYeshiva Kehilath Yakov Pupa in Williamsburg failed to bar unvaccinated children from attending class, Health Department officials said. Image via Google Maps

A single school’s decision to allow an unvaccinated child to attend class led to more than 40 measles cases and the eventual proliferation of the disease across New York City, a top health official said on Monday.

Demetre Daskalakis, deputy commissioner of the city’s Department of Health, revealed at a conference hosted by NYU Langone that Yeshiva Kehilath Yakov Pupa in Williamsburg was the catalyst for what would become the worst outbreak in decades — with 609 confirmed cases as of Monday.

“One school failed to exclude people in Williamsburg,” Daskalakis said. “We had one measles case in that school, and subsequently every unvaccinated child who was not excluded came down with the measles, creating really the spark that ignited Williamsburg and created a true fire of measles in that neighborhood.”

The infected child had the disease but had not yet begun showing symptoms when he showed up for class at the yeshiva, an ultra-Orthodox Jewish private school, in late January.

The school did not immediately respond to a request for comment.

The outbreak began spreading in the fall of 2018, when Health Department officials announced that six Brooklyn children had contracted the disease. The initial Brooklyn case was acquired by a child on a visit to Israel, where a large outbreak was taking place.

The epidemic has been contained mostly to the Orthodox Jewish communities of Williamsburg and Borough Park, with more than a dozen confirmed cases also in Sunset Park among the Latino population.

Mayor Bill de Blasio declared a public health emergency on April 9 requiring mandatory measles-mumps-rubella vaccinations for residents who live in the northern Brooklyn ZIP codes of 11205, 11206, 11211 and 11249.

Gov. Andrew Cuomo signed a bill on June 13 banning any non-medical exemption to vaccinations, including religious exemptions.

The outbreak has cost the city roughly $2 million, according to Daskalakis. He said that despite their greatest efforts to send out exclusion letters, monitor schools and audit them, the disease has still led to dire consequences, including 50 hospitalizations and 18 ICU visits.

“We’ve had a lot of close calls with kids who have been very very sick,” he said.

The panel on measles was held at NYU Langone. Eagle photo by Scott Enman
The panel on measles was held at NYU Langone. Eagle photo by Scott Enman

As of June 14, 11 institutions had been shuttered by the city for failing to adhere to the emergency order. (UTA of Williamsburg – Yeshiva Torah V’Yirah at 590 Bedford Ave. was closed twice.)

Daskalakis said that further exacerbating the outbreak, and likely influencing the operators of lone wolf yeshivas, was a highly sophisticated campaign of anti-vaxxersseeking to undermine the city’s order through misinformation.

Some residents were also deliberately attempting to have their children contract measles to build up a natural immunity to the infection. “Rather than the spark igniting the kindling, we had the kindling actually looking for the spark,” Daskalakis said.

Although the disease is primarily affecting the Orthodox Jewish community, Daskalakis wanted to break the myth that the general Orthodox Jewish community is resistant to vaccines. “It’s not true,” he said, citing the fact that after the outbreak was announced, vaccination rates in Williamsburg rose from around 70 percent to about 92 percent.

Pro-Vax Mom Ensnared in Measles Law When Youngest Not Medically Cleared to Vaccinate

NYC’s Measles Crackdown Snares Pro-Vax Mom With Sick Baby

On Tuesday, April 30th, at around 10 p.m., armed officers with the Kings County sheriff’s department showed up at the door of a Williamsburg apartment to serve an Orthodox Jewish woman with a summons for failing to vaccinate one of her nine children.

The woman, identified as Jane Doe at an administrative trial Wednesday morning, is the first person to appear before a judge since the city declared a public health emergency 11 weeks ago. The declaration required everyone over the age of six months who lived, worked, or attended school in four Brooklyn zip codes, including the one where Doe lives, to be vaccinated against measles or show that they are already immune.

But even though much of the blame for the city’s measles outbreak has fallen on people who refuse to vaccinate their children, Doe is pro-vaccine. She testified at the hearing that all of her other eight children are vaccinated for measles. The summons she received that night was for her youngest, her eight-month-old son, who’d been sick for several weeks with fevers and ear infections.

I’m a very responsible mother…I was very hurt about this whole thing,” she told Gothamist/WNYC. “I feel they’re coming very strong on me because of the public and because of the anti-vaxxers.”

Doe submitted medical records to Administrative Law Judge Didi Skaff showing she’d taken her son repeatedly to the doctor’s office in late March and April. Her pediatrician had recommended postponing the shot until he recovered, Doe testified. The baby was finally given his first dose of measles, mumps, and rubella vaccine last week, she said.

“I do think I got the summons very unfairly,” she said at the hearing. “All my children are vaccinated.”

In order to attend day care or nursery school, babies are required to get their first dose of the measles vaccine when they turn one year old, according to New York State’s immunization requirements. But the city’s emergency order in April applied to everyone above the age of six months. The change in the minimum age has also confused some day care facilities that said they were not directly notified about it.

Doe said until the sheriffs showed up at her door, she was not aware that children in her Williamsburg neighborhood younger than 12 months old were supposed to be vaccinated.

“We watch no TV. Most of [us] have no internet connection,” she said, speaking of her religious Orthodox Jewish community in North Brooklyn.

“None of my friends knew, none of my sisters knew,” she said. Nor did her doctor mention it when she took her baby there on April 20, 11 days after the emergency order went into effect, she said.

For days after she was issued the summons, her children were still asking why people had shown up at her apartment with guns.

“It’s ridiculous that you have sheriffs knocking at your door in the middle of the night,” she told the hearing officer. “The children were all really terrified.”

She eventually quelled their fears by telling them the men had come to sell furniture, she said: “That’s how I got them not to be afraid.”

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The Surrogate’s Court Race in Brooklyn – Why it Matters and Why You Should Vote For Someone Not Beholden

The Democratic primary is on June 25. Eagle file photo by Ned Berke

Why surrogate judges matter: A voter’s primer

 

Brooklynites will head to the polls on June 25 to vote in a primary for a number of lesser known judgeships, including for a seat on the the Surrogate’s Court in Brooklyn. Before filling out those bubbles, it might help to know: what is Surrogate’s Court?

Surrogate’s Court is for the dead — mostly. When someone dies, they usually leave things behind, namely: money and property. Whether or not they have made out a will before they die, in New York, their estates are handled in Surrogate’s Court.

There is a Surrogate’s Court in each borough of New York City. They are overseen by elected judges known as — you guessed it — surrogates. In Manhattan and Brooklyn, there are two surrogates. In the other boroughs, there is just one. Surrogate’s Court judges serve 14-year terms in New York City.

[The Democratic primary for Brooklyn’s Surrogate’s Court election is on June 25. Find your polling site here.]

The Surrogate’s Court handles the probate of wills — meaning, when someone dies and leaves a will, it must be proven valid in Surrogate’s Court before the estate can be dispersed among heirs. This can be a simple process, say, if a single parent dies and bequeaths their estate to an only child. Or it can be complicated, say, if a father who bore an illegitimate son gives his estate to his two children born during his marriage. If the illegitimate son wants to challenge to get part of the estate, that dispute over the will would be handled in Surrogate’s Court.

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Arson Suspect May Have Been Abused Which May Have Been Impetus for Fire

Midwood arson suspect had tattoo reminder to kill rabbi

 

A Pennsylvania man with a vendetta against a Midwood rabbi was accused in court Sunday night of setting fire to the man’s home in order to kill him — and burning down two other houses in the process.

Matthew Karelefsky was charged with arson and attempted murder for starting the fire on Rabbi Jonathan Max’s porch on Thursday around 4 a.m. The raging fire sent 13 people to Maimonides Medical Center and New York Community Hospital, including one who was critically injured.

Karelefsky has a tattoo on his arm that reads, “Never let go of the HATRED — KILL Rabbi Max YEMACH SHMO,” according to a criminal complaint filed in Brooklyn Criminal Court. Yemach shmo means “may his name be erased,” in Hebrew.

Karelefsky hated the rabbi, and posted about it on social media, according to prosecutors. In court Sunday night, the defendant smiled widely as a judge ordered him held without bail, according to the New York Post.

NYC Scanner@NYScanner

SHOCKING: The suspect that authorities are looking at in regards to the home set ablaze in this morning, allegedly has this tattooed on his arm

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The fire started at 1492 E. 17th St. between Avenue N and Avenue O, and quickly moved to the houses on either side, according to FDNY. Firefighters worked for three hours to put out the three-alarm blaze.

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As Brooklyn Rabbi’s House Burns and a Potential Arsonist May Also Be a Victim

To the Community Looking for the Alleged Arson Suspect

We are asking, imploring upon you the readers and the law enforcement community, to please treat the suspect with care, kindness and compassion. If, with emphasis added, he was the victim of some wrongdoing, and that drove him to a breaking point, he has lived a lifetime of trauma.

There is little justification for committing crimes, but there may be mitigating circumstances.

There would be no justice for anyone if he is not given the opportunity to defend any actions he may or may not have taken in the fire as suspected.

LM

Brooklyn Rabbi’s House Burns Down in Suspected Arson, 13 Injured

Photo from Wikimedia Commons.

 

The home of a Brooklyn rabbi erupted in fire early Friday in what investigators suspect was an arson attack by a man who accused the rabbi of being a pedophile.

Thirteen people, including a 6-week-old baby, were injured. None of the injuries were life-threatening, although 12 people were sent to the hospital, including nine civilians, two firefighters and an EMS medic.

The blaze erupted in a car outside a home in the Midwood neighborhood and spread to three others, including that of Rabbi Jonathan Max, the New York Daily News reported. 

Investigators are looking into Menachem Karelefsky as a suspect, according to the Daily News. The Pittsburgh resident, who also goes by Matthew, on his LinkedIn profile accused Max, a teacher at the Chaim Berlin Yeshiva, of being a pedophile.

A phone number listed on Karelefsky’s LinkedIn profile leads to a voicemail message in Hebrew that says “May the name and memory of Rabbi Max be erased, simply, really, forever.”

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Credit Card Swiping Schemes – The Trade for Points, Is this Points Laundering?

Collecting Points for Charges Without Providing any Services or Items for those Charges

NATURE OF ACTION (Directly From the Complaint)

1. This action arises from certain of the defendants (hereinafter the “Merchant
Defendants”) fraudulent charging of the American Express, Visa, MasterCard and Discover branded credit and charge cards previously issued to the Plaintiffs (hereinafter the “Cards”) by American Express, Chase and certain other defendants (the “Card Issuer Defendants”), which  fraudulent payment card transactions (the “Card Transactions”) were electronically processed by other defendants (the “Card Processor Defendants”). The Merchant Defendants provided no goods, services or anything of value to the Plaintiffs with respect to the Card Transactions. Instead, the  Merchant Defendants fraudulently induced the Plaintiffs to allow the Merchant Defendants to utilize the Plaintiffs’ Cards to ostensibly purchase goods that the Merchant Defendants were planning to re-sell, with the promise that the Merchant Defendants were then going to use the proceeds from the sale of the goods to pay the full amount of the balances due to the Card Issuer Defendants for those Card Transactions prior to the payment due date.

2. The Plaintiffs understood the Card Transactions to be a proper use of their Cards
for the purchase of cash or cash equivalents from the Merchant Defendants, consistent with the  manner that the Merchant Defendants had been utilizing other cardholders’ cards for many years  (which prior transactions had significantly benefited the Card Issuer Defendants and the Card  Processor Defendants, who received substantial revenue in the form of processing fees for the prior
transactions). Indeed, virtually all of the Plaintiffs had previously engaged in virtually identical payment card transactions with the Merchant Defendants, for which previous card transactions the  Merchant Defendants had in fact paid cash or cash equivalents to the Plaintiffs themselves or on  behalf of the Plaintiffs to the Card Issuer Defendants.

3. Despite due demand therefor, the Merchant Defendants have failed and refused to provide the Plaintiffs with cash or cash equivalents for the Card Transactions. The Merchant  Defendants have also failed and refused to provide the Plaintiffs with the goods ostensibly bought for resale by the Merchant Defendants via the Card Transactions. Many of the Plaintiffs were assured by the Merchant Defendants that the use of their Cards for the Card Transactions by the Merchant Defendants were secured by those goods, which would be the property of the Plaintiffs
until resale and could be claimed (and resold for more than the amount of the Transactions) by the  Plaintiffs in the event that the Merchant Defendants failed to timely provide to Plaintiffs the cash or cash equivalents for the Card Transactions.

4. Accordingly, having not received anything of value from the Merchant Defendants  in connection with the Card Transactions, the Plaintiffs attempted to utilize the protections afforded them by and through the payment card networks and to dispute the charges for the Card  Transactions with the Card Issuer Defendants, protections extended to the Plaintiffs through their
agreements with the Card Issuer Defendants. The Plaintiffs expected that this chargeback process  would result in the Merchant Defendants – and/or those who aided or abetted the Merchant defendants’ fraud and/or guaranteed the Merchant Defendants’ compliance with the Visa, MasterCard, American Express and Discover rules, being held responsible for the Card  Transactions. The Merchant Defendants have instead resisted the Plaintiffs’ attempts to dispute the charges, at times misrepresenting to the payment card networks the nature of the relationship
between the Plaintiffs and the Merchant Defendants and at other times misrepresenting the nature of the Card Transactions. Even when accurate information regarding the Plaintiffs and the Card Transactions have been conveyed to the Card Issuer Defendants, the chargebacks have usually been reversed, and the charges to the Plaintiffs for the Card Transactions have been reinstated on
the Plaintiffs’ account statements for the Cards.

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