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Rockland Measles Report and Recommendations

Update 3/26: Rockland has declared a state of emergency due to the measles outbreak. Starting at 12a, those under the age of 18 who are not vaccinated against the disease will be banned from public places for 30 days or until they are vaccinated.  

What is measles?

Measles is a highly contagious respiratory disease (in the lungs and breathing tubes) caused by a virus that is spread by direct contact with nasal or throat secretions of infected people (when a person infected with the measles virus breathes, coughs, or sneezes). Measles is one of the most contagious viruses on earth; one measles infected person can give the virus to 18 others. In fact, 90% 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. And you can catch measles from an infected person even before they have a measles rash.

Common symptoms

Symptoms usually appear 10-12 days after exposure but may appear as early as seven days and as late as 21 days after exposure. Measles typically begins with

  • high fever,
  • cough,
  • runny nose (coryza)
  • red, watery eyes (conjunctivitis).

Then:

  • Two or three days after symptoms begin, tiny white spots (Koplik spots) may appear inside the mouth.
  • Three to five days after symptoms begin, a rash breaks out. It usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs, and feet. Small raised bumps may also appear on top of the flat red spots. The spots may become joined together as they spread from the head to the rest of the body. When the rash appears, a person’s fever may go up to more than 104° Fahrenheit.
  • After a few days, the fever subsides and the rash fades.

The following statistics were taken from a 2018 – 2019 Measles Outbreak in Rockland County report.

  • As of March 21, 2019, there are 151 confirmed reported cases of  measles in Rockland County.
  • Vaccination rates for confirmed measles cases in Rockland County:
    • 82.1% have had 0 MMRs
    • 4.0% have had 1 MMR
    • 4.0% have had 2 MMRs
    • 9.9% unknown status
  • Age groups for the confirmed measles cases in Rockland County
    • Less than 1 year old: 15.0%
    • 1-3 years: 23.8%
    • 4-18 years: 45.7%
    • 19+ years: 15.2%

People are considered infectious from four days before to four days after the appearance of the rash.
measles can be serious infographicMeasles can be dangerous, especially for babies and young children. Others who are at high risk for complications if they get the measles include pregnant women who are not immune, as well as those who are immune-compromised or immunosuppressed (when your body can’t fight disease).

Common Complications

  • Common complications include ear infections and diarrhea.
  • Ear infections occur in about one out of every 10 children with measles and can result in permanent hearing loss.
  • Diarrhea is reported in less than one out of 10 people with measles.

Severe Complications

Some people may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain). They may need to be hospitalized and could die. Here are some facts about complications in children and pregnant women:

  • As many as one out of every 20 children with measles gets pneumonia, the most common cause of death from measles in young children.
  • About one child out of every 1,000 who get measles will develop encephalitis (swelling of the brain) that can lead to convulsions and can leave the child deaf or with intellectual disability.
  • For every 1,000 children who get measles, one or two will die from it.
  • Measles may cause pregnant woman to give birth prematurely, or have a low-birth-weight baby.

Rare Long-term Complications

Subacute sclerosing panencephalitis (SSPE) is a very rare, but fatal disease of the central nervous system that results from a measles virus infection acquired earlier in life. SSPE generally develops seven to 10 years after a person has measles, even though the person seems to have fully recovered from the illness.
For more information click here.

The Measles Outbreak in Rockland County

At the end of September 2018, an international traveler arrived in Rockland County with a suspected case of the measles. Per protocol, the Rockland County Department of Health (RCDOH) was notified and immediately activated its Communicable Disease Team to investigate. There have been additional cases of measles from international travelers to Rockland, exposing more people to measles. People who are unvaccinated risk getting infected with measles and spreading it to others.
These cases are presently clustered in eastern Ramapo (New Square, Spring Valley, Monsey), however due to Rockland County’s small geographic size, exposure to the measles may occur anywhere in the county.
Since measles is highly contagious, the Health Department, with additional support from the New York State Department of Health and local partners, is working to limit exposures and is offering a free vaccine to boost the county’s immunization rate and protect its residents from the harmful effects of the measles virus.
The RCDOH, Refuah Health Center, and private pediatricians and family doctors have administered over 16,000 doses of MMR vaccine.
To prevent the spread of illness, the Department is advising individuals who may have been exposed and who have symptoms consistent with measles to contact their health care provider, a local clinic, or a local emergency department before going for care. This will help to prevent others at these facilities from being exposed to the illness. Residents who have been asked by a health care provider to “watch for measles,” or who are otherwise ill–including flu-like symptoms–are advised to stay home and not go out in public.

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The Measles Vaccine

A safe and effective measles vaccine that can prevent suffering and death has been available for more than 50 years. For more information click here.
High community vaccination rates help protect people who cannot get vaccinated because they are too young or have specific health conditions. Free MMR vaccines are available by calling:

  • The Rockland County Department of Health at 845-364-2497 or 845-364-2520 to schedule an appointment to get a free MMR vaccine at the Pomona health complex.
  • The Rockland County Department of Health Spring Valley Family Planning Clinic is also providing MMR vaccines, by appointment to Family Planning patients. Family Planning Clinic patients can call 845-364-2531 to schedule an appointment.

In addition, MMR vaccines are available at local health care providers or by calling a local federally qualified health center, such as Refuah and Hudson River Health Care. The federally qualified health centers see patients on a sliding fee scale and by appointment. They may require patients new to their centers to have a well visit first, before a vaccine can be given.

Measles Vaccine Recommendations:

Two doses of the MMR vaccine are recommended for maximum protection. One dose of the MMR vaccines can offer 93% protection from the measles. Two doses of the MMR vaccine can offer 97% protection from the measles. Typically, the first dose of MMR vaccine is given at 12-15 months of age and the second dose is given at four to six years of age (age of school entry), although individuals may also be vaccinated later in life.
Due to a measles outbreak in Rockland County, the Rockland County Department of Health recommends the following:

  • Children six months through 11 months of age get an MMR vaccine now. Getting an MMR vaccine now will help give them some protection against measles. They will still have to get a vaccine at 12 to 15 months of age and again at four to six years of age.
  • Children one through three years of age who have already received their first MMR vaccine should get a second MMR vaccine now, as long as 28 days have passed since the first MMR vaccine was given to them. This second MMR vaccine will count for school entry.
  • Any adult who has not received their first MMR vaccine yet should get their first MMR vaccine now.

There may be medical reasons not to get the MMR vaccine, speak to your health care provider.

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