With Global Measles Cases Rising, Rockland Offers Vaccine Reminder

ROCKLAND COUNTY, NY — With measles making a resurgence in the United States and around the world, Rockland County is urging residents to make sure their vaccinations are up-to-date against one of the most contagious viruses on earth.

The Centers for Disease Control and Prevention sent out a newsletter Jan. 25 reporting that between Dec. 1 and Jan. 23, the agency was notified of 23 confirmed U.S. cases of measles, including seven that were direct importations of measles by international travelers and two outbreaks with more than five cases each. Most of the cases were among children and adolescents who had not received a measles-containing vaccine, even if age eligible, the CDC said.

"As the disease spreads in the US, we are taking proactive measures to prevent Rockland County from enduring a repeat of the measles outbreak in 2018, when measles surfaced and a total of 312 cases were confirmed," County Executive Ed Day said in an announcement Friday.

Measles is one of the most contagious viruses on earth — 90 percent of unvaccinated people exposed to the virus become infected.

You can catch measles just by being in a room where a person with measles has been, up to two hours after that person is gone. You can catch measles from an infected person before they show a rash.

Symptoms include a fever, rash, cough, conjunctivitis, red, watery eyes, or runny nose. Symptoms usually appear 10-12 days after exposure but may appear as early as 7 days and as late as 21 days after exposure.

Prior to 1963, the year the measles vaccine was introduced, nearly all children got the measles by the time they were 15, according to the New York Health Department. In the decade before 1963, it is estimated that annually 400-500 people died, 48,000 people were hospitalized, and 1,000 people suffered brain swelling. In 2000, measles was declared eliminated from the United States, meaning an absence of endemic measles transmission for 12 months or longer.

The outbreak in 2018, centered in Rockland, was the largest in New York since the 1990s, according to the state Health Department. More than 30 schools, daycares, and nursery schools in the county had to enact exclusion policies to help stop the spread.

Afterward, New York passed a law eliminating the religious exemption from vaccines, and requiring children be vaccinated against measles and other diseases to attend either public, private or parochial school (for students in pre-kindergarten through 12th grade) or child day care unless they have a valid medical exemption.

The increased number of measles importations seen in recent weeks is reflective of a rise in global measles cases and a growing global threat from the disease, CDC officials said. Measles cases often originate from unvaccinated or undervaccinated U.S. residents who travel internationally and then transmit the disease to people who are not vaccinated against measles.

The World Health Organization described an "alarming" rise in Europe in 2023, the BBC reported. It also has led to recent alerts in Australia, sciencealert.com reported.

"Anyone who is not protected, through past infection or vaccination, is at risk of getting the disease, especially when traveling internationally," said Maria Souto, MPH, Coordinator of Communicable Disease for the Rockland County Department of Health. "The measles, mumps, rubella (MMR) vaccine remains the only safe and effective way to prevent the measles. We continue to urge residents to check their immunization status and get vaccinated if they are unimmunized. We can prevent cases of measles by keeping up-to-date with vaccinations."

The Rockland County Department of Health’s Immunization Action Program is in regular communication with the New York State Department of Health to ensure vaccine compliance with the NYSDOH Immunization Requirements for School Entrance/Attendance, county officials said.

The county health department recently acquired a mobile vaccination unit through grant funds in addition to an inflatable 2-lane trailer— both will be for vaccinations, Rockland health officials said.

CBS News published an in-depth investigative article about declining immunization rates across the country Jan. 30 that includes a database which allows you to look up the rates for your child and their friends' schools.

The CDC has told healthcare providers to be on alert for patients who have: (1) febrile rash illness and symptoms consistent with measles (e.g., cough, coryza, or conjunctivitis), and (2) have recently traveled abroad, especially to countries with ongoing measles outbreaks.

CDC recommendations for Healthcare Providers

1. Isolate: Do not allow patients with suspected measles to remain in the waiting room or other common areas of the healthcare facility; isolate patients with suspected measles immediately, ideally in a single-patient airborne infection isolation room (AIIR) if available, or in a private room with a closed door until an AIIR is available. Healthcare providers should be adequately protected against measles and should adhere to standard and airborne precautions when evaluating suspect cases regardless of their vaccination status.
2. Notify: Immediately notify local or state health departments about any suspected case of measles to ensure rapid testing and investigation. Measles cases are reported by states to CDC through the National Notifiable Diseases Surveillance System (NNDSS) and can also be reported directly to CDC at measlesreport@cdc.gov.
3. Test: Follow CDC’s testing recommendations and collect either a nasopharyngeal swab or throat swab for reverse transcription polymerase chain reaction (RT-PCR), as well as a blood specimen for serology from all patients with clinical features compatible with measles. RT-PCR is available at CDC, at many state public health laboratories, and through the APHL/CDC Vaccine Preventable Disease Reference Centers.
4. Manage: In coordination with local or state health departments, provide appropriate measles post-exposure prophylaxis (PEP) to close contacts without evidence of immunity, either MMR or immunoglobulin. The choice of PEP is based on elapsed time from exposure or medical contraindications to vaccination.
5. Vaccinate: Make sure all your patients are up-to-date on measles vaccine, especially before international travel. People 6 months of age or older who will be traveling internationally should be protected against measles.