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A county in the state of New York has declared a state of emergency following a serious measles outbreak.
Rockland County, on the Hudson River in northern New York, has banned unvaccinated children from visiting public spaces after 153 cases have been confirmed.
The violation of the order will be punished with a fine of 500 dollars (£ 378) and a maximum sentence of six months imprisonment.
The announcement follows further outbreaks of the disease in Washington, DC, Texas, and Illinois.
Vaccination rates have steadily declined in the United States. Many parents have opposed for philosophical or religious reasons, or because they believe that misleading information indicates that vaccines are causing autism in children.
"We will not sit idly by as long as the kids in our community are in danger," said Ed Day, Rockland County Manager.
"It's a public health crisis and it's time to sound the alarm bell."
Why did this county take action?
The outbreak in Rockland County is largely concentrated in the ultra-Orthodox Jewish community, the New York Times reported.
It is thought that it could have spread from other predominantly ultra-orthodox areas around New York that have already been affected by measles outbreaks.
Day said health inspectors met with "resistance" from some local residents, which he said was "unacceptable and irresponsible".
"They were told," We do not discuss this, do not come back "by visiting the homes of infected people as part of their investigations," he said.
Dylan Skriloff, editor of the local paper Rockland County Times, told the BBC that the number of measles cases in the county has been steadily increasing in recent weeks.
"The first reports arrived six months ago and every week we have a new one with more," he said.
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"It has become clear that this does not slow down, and the authorities … do not want to accept [this reality] like the new normal. "
Skriloff said the authorities had "progressed steadily" in encouraging religious communities to vaccinate children, but that communication had stopped last month.
"The vaccination rate in religious communities, among young people, is about 50% to 60%, which is far from enough."
Officials have stated that the order, which prohibits anyone under the age of 18 who has not been vaccinated from places such as schools, shopping malls, restaurants and places of worship, would enter effective Wednesday at midnight and in the last 30 days.
Rockland County has a population of more than 300,000.
What happened elsewhere with measles immunization?
Measles is a highly infectious disease that can lead to serious health complications, including lung and brain damage.
Despite the dangers, vaccination rates are falling in many countries.
In the UK, the government is seeking new legislation to force social media companies to remove content promoting false information about vaccines.
There were more than 82,500 cases in Europe in 2018 – the highest number in ten years and three times more than in 2017.
The World Health Organization said the anti-vaccine movement was one of the biggest threats to global health for 2019.
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