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NEW YORK (AP) – Quarantine in California. Fines in New York. Order for some people to avoid public places in Rockland County, New York.
While the measles epidemic is raging across the United States – with 704 cases registered this year – some local health officials are trying to fight contagion in unvaccinated communities by appealing to extraordinary police powers from the United States. past.
"Unfortunately, we are revisiting the diseases of another generation," said Jason Schwartz, assistant professor of health policy at the Yale School of Public Health.
"And now we are revisiting the public health responses of another generation" in cases where immunization programs have been inadequate, he said.
It was not so long ago that measles was thought to be largely a problem. The once common disease became increasingly rare after the development of a vaccine in the 1960s. In 2000, health officials said the disease had been eliminated in the United States, which means that all new cases were due to infected travelers and not to locally transmitted transmission.
Ten years ago the number of cases was less than 100 per year. But they have jumped since then, with the worst happening right now.
On Monday, US health officials said the national total had already exceeded the total for a full year since 1994, when 963 cases were reported.
Twenty-two states reported cases, but the vast majority of them traveled to New York, mainly to New York and nearby Rockland County. Most cases in New York involve unvaccinated people in Orthodox Jewish communities.
Three-quarters of people who have contracted the highly contagious disease are children or teenagers.
No deaths have been reported this year, but 66 patients have been hospitalized.
According to the Centers for Disease Control and Prevention, this year, 44 people caught the disease while traveling to another country. Some of them have triggered epidemics in the United States, mainly among unvaccinated people. This includes the biggest outbreaks in New York.
Measles in most people causes fever, a runny nose, a cough and a rash all over the body. A very small fraction of infected people may suffer from complications such as pneumonia and dangerous swelling of the brain. According to the CDC, for every 1,000 children with measles, one or two will die.
The return of measles could be a harbinger of a resurgence of other vaccine-preventable diseases, such as rubella, chickenpox and bacterial meningitis, say some experts.
In recent decades, health officials have relied on doctors to encourage families to vaccinate their children against measles and other diseases. This effort has been reinforced by the need in each state for children to be vaccinated to attend public schools.
But as immunization rates have declined in some communities and cases have exploded, officials have recently taken more dramatic steps. In Rockland County, the authorities last month banned all unvaccinated children from covered public places.
This month, in New York, officials ordered mandatory vaccination in four Brooklyn postal codes, threatening possible fines of up to $ 1,000 for non-compliance. City officials said 57 unvaccinated people received summonses. The city also closed seven religious schools that did not exclude unvaccinated children, but five were allowed to reopen after submitting a correction plan.
Last week in California, more than 1,000 students and staff from two Los Angeles universities were quarantined or sent home after cases began to appear. It was a limited order, and half of them are already out of quarantine, officials said Monday.
Dr. Umair Shah, head of the Houston County Department of Health, said "we do not know" if this type of measure will become more commonplace.
Health officials have such measures and are ready to use them in case of unusual or even exotic epidemics – such as a new influenza pandemic or Ebola – "but we are applying them here for measles," he said. declared.
It has been more than 25 years since this type of measure was taken against measles, said Schwartz. The last similar case occurred during a severe epidemic in Philadelphia in the early 1990s when the city recorded more than 900 cases, most of them members of two fundamentalist religious groups. who did not accept vaccination or other types of modern medical care.
The use of quarantine and other orders is partly due to growing concern over measles and other disease outbreaks despite the availability of effective vaccines. some health experts.
"I think there is a sense of anxiety and even a bit of panic in the public health community," as officials see large numbers of people wary of government and scientists, said Lawrence Gostin. expert in public health law at Georgetown University.
This concern led to Gostin's belief that he was on the wrong side of the officials.
It's one thing to isolate someone with measles or to quarantine someone who has been exposed, he said. These people are at risk of infection, and short-term limitations on where they can go and whom they can meet are legally and medically appropriate, Gostin said.
But it's another thing to do what Rockland County did at the beginning, where unvaccinated children were placed under house arrest – not because they were at risk of infection, but because that their parents were not listening to public health officials, he said.
"It's too punitive," he said.
Indeed, a judge canceled the initial emergency order.
A community has been successful without taking such steps. Officials from Vancouver, Washington State, said Monday the end of a measles outbreak that began in January but which apparently stopped a month ago at 71 times. It was a much smaller community than New York or Los Angeles and it was tamed by an intense investigation and vaccination campaign involving 230 health workers tracking infected people and those with whom they were in contact, for a cost of about $ 865,000.
In the meantime, state legislatures are making further efforts to end philosophical and religious exemptions from school vaccination requirements.
Ed Day, a Republican who is the highest elected official of Rockland County, joined Legislators of the Democratic State on Monday to insist on the swift adoption of a measure to eliminate religious exemptions. for compulsory vaccinations.
"This bill would be a boon," Day said at a press conference in Albany. "Waiting is a recipe for a medical disaster."
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