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New York City on Tuesday declared a public health emergency and ordered mandatory measles vaccination in a part of Brooklyn that is home to a large Orthodox Jewish community.
The city has taken an unusual step with an upsurge of 285 measles cases in the city since September, most in a densely populated area where people have to be vaccinated or face a $ 1,000 fine.
In the United States, disease control and prevention centers have reported 465 cases so far this year, two-thirds of them in the state of New York. This compares to 372 cases in the United States for the whole of last year. In addition to New York, there have been outbreaks this year in the state of Washington, California. Michigan and New Jersey.
The disease was declared eliminated in the United States in 2000, which means that it was not transmitted to the country.
But cases have increased in recent years, partly because of the misinformation that some parents are hesitant about a crucial vaccine.
Most of the reported diseases are children. The CDC says that about 80% of American cases are 19 years old or younger.
Here are some questions and answers about measles:
Q: How dangerous is measles?
A: Measles usually starts with a high fever and a few days later a characteristic rash appears on the face and then spreads to the body. Among the serious complications, 1 in 20 patients have pneumonia and 1 in 1,000 have swelling of the brain that can lead to seizures, deafness or intellectual disability.
Although this is rare in the United States, about 1 in 1,000 children who contract measles die, according to the CDC.
Q: How does it spread?
A: By coughing or sneezing, a person can transmit the virus for four days before the onset of the revealing rash.
The virus can live up to two hours in the air or on nearby surfaces. Nine out of 10 unvaccinated people who come into contact with someone with measles will catch it. Dr. Anthony Fauci, head of infectious diseases at the National Institutes of Health, recently described it as "one of the most contagious viruses that man knows."
Q: Is this a problem outside of the United States?
A: Measles is much more prevalent in the world – the World Health Organization has reported killing 110,000 people in 2017. The WHO has announced a 30% increase in the number of measles cases these last years. Unvaccinated Americans traveling abroad, or foreign visitors here, can easily introduce the virus.
For example, a huge epidemic in Madagascar has caused more than 115,000 illnesses and more than 1,200 deaths since September. But it is not necessary to go as far as Madagascar: current tourist destinations such as England, France, Italy and Greece were affected by measles last year. Nearly 83,000 people in Europe contracted measles in 2018, the highest number in a decade.
Q: How many American children are vulnerable?
A: Overall, about 92% of American children received the combination vaccine that protects against measles, mumps and rubella, known as the MMR vaccine. Two injections are needed, one towards the first birthday and one between 4 and 6 years old. Complete vaccination is 97% effective in preventing measles.
But, according to the CDC, 1 in 12 children do not receive the first dose on time, and in some places, vaccination rates are well below the national average. For example, an epidemic in Washington State is linked to a community where only about 80% of children were properly immunized.
Q: Is the vaccine safe?
A: Yes In the late 1990s, one study linked MMR vaccine to autism, but this study turned out to be a fraud. Subsequent research has revealed no risk of autism badociated with the vaccine.
Q: Why is not everyone vaccinated?
A: Some people can not be vaccinated for medical reasons – including infants and people with weakened immune systems – and most states allow religious exemptions. However, while vaccination against a list of contagious diseases is mandatory to go to school, 17 states allow a type of non-medical exemption for "personal, moral or other beliefs," according to the National Conference of Physicians and Surgeons. state legislatures.
In Washington State, lawmakers are discussing lifting this personal or philosophical exemption, along with several other states. California ended a similar exemption in 2015 after a measles outbreak in Disneyland that sickened 147 people and spread to the United States and Canada.
Q: Why so many cases in Orthodox Jewish communities in New York?
A: Most families in the Orthodox enclaves of Brooklyn have their children vaccinated, and most rabbis say that there is no religious reason for not having them. But anti-vaccine propaganda has found an audience among a higher percentage than usual of parents in a community accustomed to cultural clashes with city officials. It is also a community whose members frequently travel to other countries where measles is more prevalent.
Image credit: Reuters
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