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.

 

Continue reading

Measles in NYC Spreads Outside Community – Sunset Park

Measles spreads to Sunset Park as confirmed cases rise to 466

The measles outbreak has spread to Sunset Park with three non-Jewish individuals, including two public school students, contracting the disease. AP Photo/Seth Wenig

2 public school students among those infected

New York City’s measles outbreak, mostly contained to the Orthodox Jewish community in Williamsburg, has now spread to Sunset Park as three people outside the Orthodox community — including two students — have contracted the disease.

Neither child was vaccinated, but they were allowed to attend school due to religious exemptions, according to the Health Department. They did not, however, go to school while infectious, and both had spent time in areas rife with measles.

Deputy Commissioner Dr. Demetre Daskalakis sought to assure the community that public school students are not at an increased risk of getting the disease.

“We are confident there is no increased risk of exposure at New York City public schools both because the recently diagnosed children from Sunset Park were not in school while infectious and because of the high vaccination rates of students in these and all NYC public schools,” Daskalakis said.

“This is the time to act. Measles is a highly contagious disease. If you are spending time in Williamsburg, Borough Park or other areas with measles activity in or around NYC confirm that you are immune to measles by looking at your vaccination history or by consulting with your healthcare provider.”

Daskalakis urged anyone living, working, studying or playing in areas with measles like Williamsburg and Borough Park to get vaccinated.

The total number of confirmed cases across the city has risen to 466 — 43 more since April 30 — and an additional 181 since Mayor Bill de Blasio declared a public health emergency on April 9.

To continue reading click here.

Williamsburg, Brooklyn and a Passover Plague – Get Your Children Vaccinated or Don’t Attend Seders with Others

Signs warn of the dangers of a persistent measles outbreak in Williamsburg.

A measles outbreak is dividing families in this Orthodox Jewish community. Passover could make it worse

 

New York (CNN)As one of the holiest Jewish celebrations of the year arrives, families in the Hasidic section of Williamsburg, Brooklyn, face a dilemma.

“Say you have six kids that want to come to the Seder, with all the grandchildren,” said Eli Banash, 32, a member of the Orthodox community who works in Williamsburg.

“Grandmother wants everybody to come. One family didn’t vaccinate the kids. Five did. The five families are saying, ‘We’re not coming unless they don’t come!’ With Passover, it’s going to intensify.”

persistent measles outbreak has hit this ultra-Orthodox enclave and led city officials to declare a public health emergency.

Passover, which begins at sundown Friday and ends April 27, marks the Exodus story from the Bible and is celebrated with large gatherings and ceremonial meals. But community leaders and health officials fear the holiday may further fuel the spread of the highly contagious disease.

Already, 359 cases of measles have been confirmed in Brooklyn and Queens since October, mostly in Williamsburg. The outbreak began when, according to health officials, an unvaccinated child became infected with the illness while visiting Israel.

“The concern is that with Passover and increased travel, we’re going to be putting more people at risk,” said New York City’s health commissioner, Dr. Oxiris Barbot.

Across the country, measles cases have jumped to the second-highest level in a quarter century, with 555 cases confirmed in 20 states, according to the US Centers for Disease Control and Prevention.

“Because of measles’ long incubation period, we know this outbreak will get worse before it gets better,” Barbot said in a statement this week.

A pamphlet directed at Orthodox communities helped fuel the fear of vaccines

In Hasidic Williamsburg, bearded men walk hurriedly in long frock coats crowned by black hats. Women in ankle-length skirts push strollers on crowded sidewalks and Hasidic boys with spiraling side curls dart through the streets in bunches.

In an insular community where some don’t take kindly to intrusion, residents blame the outbreak largely on a hardline minority opposed to vaccinations, or anti-vaxers. The close-knit neighborhood — where residents explain the insularity as a way of preserving the community’s identity — has seen heightened tension in some families, especially as Passover preparations got underway.

Blima Marcus, a nurse and past president of the Orthodox Jewish Nurses Association, has been holding small workshops with the nurses in Brooklyn and New Jersey to educate members of the ultra-Orthodox community who are fearful of vaccines.

The fears were fueled in part by a slick 40-page booklet being distributed in Orthodox enclaves about the dangers of vaccines. The booklet is directly aimed at the Orthodox community, partly written in Hebrew and filled with snippets from the Torah. Yet Marcus and Orthodox Jewish leaders say there is nothing in Jewish law that prohibits vaccinations.

To continue reading on CNN click here.

Playing with Human Life, Biological Warfare and the Ultra-Orthodox – Lawsuit for the Right Harm Others

Biological warfare: Williamsburg residents sue city for right to not vaccinate

Five Williamsburg residents are fighting for the right to not vaccinate themselves and their children amid a growing measles outbreak in Brooklyn, filing suit against the Department of Health in an effort to quash an emergency health declaration that slaps unvaccinated locals with stiff fines.

The plaintiffs, who filed a complaint in Brooklyn Supreme Court on Monday, argued that the roughly 300 known cases of the potentially fatal illness do not justify the city’s decision to override their religious objections to the MMR vaccine, according to their lawyer.

“We don’t think the so-called ‘outbreak’ has reached a level that requires the extreme response of forcing vaccinatio­ns,” said Robert Krakow, a Manhattan attorney specializing in vaccine injury lawsuits.

Mayor Bill de Blasio and city Health Commissioner Dr. Oxiris Barbot announced on April 9 that unvaccinated residents of four Williamsburg zip codes — where some 250 of the total 285 measles cases had been identified — would be subject to fines of up to $1,000 in response to the outbreak, which has exclusively affected members of the borough’s Orthodox Jewish communities.

And while Krakow’s clients represent a mix of Jewish and Gentile Williamsburg residents, they all object to vaccination on religious grounds and claim the city’s latest move to stem the virus’ spread constitutes a gross overreaction, and that less drastic measures, such as quarantining infected individuals, should have been explored first.

“We don’t think the city should be in the business of forcing people to vaccinate,” said Krakow. “Quarantine can be imposed for the people with active infections.”

The measles virus can be contagious for weeks before symptoms show, and the attorney said he was not aware that several Williamsburg yeshiva’s had been cited by the city for admitting unvaccinated students amid an ongoing exclusion order, including one school where more than 20 students were infected, according to the Health Department.

The plaintiffs further allege that measles can be actually be contracted and spread by the inoculation, and that vaccinating “[enhances] the risk of harm to the public” through a process referred to as viral shedding.

“That’s something that happens, and we don’t know a lot about it,” Krakow said.

Viral shedding refers to the process by which viruses spread, but is a term used by members of the anti-vaccination movement to propagate the myth that vaccines cause outbreaks, according to a Science-Based Medicine report.

To continue reading click here.

NYC Yeshivas Face Closure if Children are Not Vaccinated – Williamsburg, NY

BREAKING: NYC Health Dept Orders Williamsburg Yeshivas to Ban Unvaccinated Children OR FACE CLOSURE

The NYC Health Department announced today it has issued Commissioner’s Orders to all Yeshivas in Williamsburg affected by the school exclusion mandate. This means that any school out of compliance will immediately be issued a violation and possible closure.

  • In December, the Health Department ordered yeshivas and childcare centers serving the Orthodox Jewish community in the affected ZIP codes in Brooklyn to exclude all unvaccinated students from attending school or daycare until the measles outbreak is declared over.
  • In January, one yeshiva in Williamsburg fell out of compliance with the Department’s exclusion mandate, allowing unvaccinated children back into school or daycare. This single yeshiva is connected to more than FORTY CASES, resulting in a large increase in measles cases and the continuation of the outbreak.
  • The Health Department has since issued Commissioner’s Orders to all yeshivas in Williamsburg to comply with the mandatory exclusion of unvaccinated children or face violations subject to fines and possible school closure.

The measles outbreak in the Orthodox Jewish community continues to increase at an alarming rate. To date, 285 cases have been confirmed since the beginning of the outbreak in October, with many of these new cases being confirmed in the last 2 months. The vast majority of cases are children under 18 years of age (246 cases), and 39 cases are adults. Most of these measles cases were unvaccinated or incompletely vaccinated individuals. There have been no deaths associated with this outbreak, although there have been complications, including 21 hospitalizations and five admissions to the intensive care unit.

Ahead of Passover, the Health Department is urging all New Yorkers—especially those in the Orthodox Jewish community—to get the measles-mumps-rubella (MMR) vaccine to prevent further spread of the virus. Individuals traveling to areas with ongoing large outbreaks, including Israel, Europe, Upstate New York, and other parts of the United States should make sure they and their children are appropriately vaccinated with MMR.

“As a pediatrician, I know the MMR vaccine is safe and effective. This outbreak is being fueled by a small group of anti-vaxxers in these neighborhoods. They have been spreading dangerous misinformation based on fake science,” said Health Commissioner Dr. Oxiris Barbot. “We stand with the majority of people in this community who have worked hard to protect their children and those at risk. We’ve seen a large increase in the number of people vaccinated in these neighborhoods, but as Passover approaches, we need to do all we can to ensure more people get the vaccine.”

Continue reading on Yeshiva World News by clicking here.