Tuesday May 26th, 2020 3:39PM

Surge in US measles cases leads to extraordinary measures

By The Associated Press
Related Articles
  Contact Editor

NEW YORK (AP) — Quarantines in California. Fines in New York City. Orders for some people to avoid public places in Rockland County, New York.

As an outbreak of measles surges across the United States — with 704 cases this year and counting — some local health officials are trying to deal with contagion in unvaccinated communities by turning to extraordinary police powers from the past.

"Unfortunately, we are revisiting diseases from another generation," said Jason Schwartz, an assistant professor of health policy at the Yale School of Public Health.

"And now we are revisiting public health responses from another generation" in instances where vaccination programs have fallen short, he said.

Not long ago, measles was thought to be a problem that was mostly solved. The once-common disease became increasingly rare after a vaccine became available in the 1960s. In 2000, health officials declared the disease eliminated in the U.S., meaning that all new cases stemmed from infected travelers and not from homegrown transmission.

A decade ago, the cases numbered fewer than 100 a year. But they have been jumping since then, with the worst happening right now.

On Monday, U.S. health officials said the national tally already has eclipsed the total for any full year since 1994, when 963 cases were reported.

Twenty-two states have reported cases, but the vast majority have been in New York — mainly in New York City and in nearby Rockland County. Most of the New York cases have been unvaccinated people in Orthodox Jewish communities.

Three-quarters of those who caught the extremely contagious disease are children or teenagers.

No deaths have been reported this year, but 66 patients were hospitalized.

The Centers for Disease Control and Prevention says this year's count includes 44 people who caught the disease while traveling in another country. Some of them triggered U.S. outbreaks, mostly among unvaccinated people. That includes the largest outbreaks in New York.

Measles in most people causes fever, a runny nose, cough and a rash all over the body. A very small fraction of those infected can suffer complications such as pneumonia and a dangerous swelling of the brain. According to the CDC, for every 1,000 children who get measles, one or two will die from it.

The return of measles may be an early warning sign of a resurgences of other vaccine-preventable diseases such as rubella, chickenpox and bacterial meningitis, some experts say.

In recent decades, health officials have relied on doctors to prod families to vaccinate their children against measles and other diseases. That push has been bolstered by requirements in every state that children be vaccinated to attend public schools.

But as vaccination rates have fallen in some communities and cases exploded, officials recently have taken more dramatic steps. In Rockland County, officials last month banned all unvaccinated children from indoor public places.

In New York City this month, officials ordered mandatory vaccinations in four Brooklyn ZIP codes, threatening possible fines of up to $1,000 for noncompliance. City officials said 57 unvaccinated people have received summonses. The city also has shut down seven religious schools that failed to exclude unvaccinated children, though five were later allowed to reopen after submitting a corrective plan.

Last week in California, more than 1,000 students and staff at two Los Angeles universities were quarantined on campus or sent home after cases began to appear. It was a limited order, and half already are out of quarantine, officials said Monday.

Dr. Umair Shah, the head of Houston's county health department, said "we don't know" if these kinds of measures will become more common.

Health officials have had such measures available and have been prepared to use them in case of unusual and even exotic outbreaks — like a new flu pandemic or Ebola — "but here we are implementing them for measles," he said.

It's been more than 25 years since those kinds of measures were taken against measles, Schwartz said. The last similar instance occurred during a bad outbreak in Philadelphia in the early 1990s, when the city recorded more than 900 cases, most of them members of two fundamentalist church groups that did not accept vaccination or other kinds of modern medical care.

The use of quarantines and other orders are driven in part by a growing concern that outbreaks of measles and other diseases could get worse, despite the availability of effective vaccines, some health experts said.

"I think there's a sense of anxiety and even a little panic in the public health community" as officials see high levels of mistrust of government and science from a surprising number of people, said Lawrence Gostin, a Georgetown University public health law expert.

That anxiety has led to what Gostin believes are missteps by officials.

It's one thing to isolate someone with measles or to quarantine someone who has been exposed, he said. Those people are infection risks, and short-term limitations of where they can go and who they can meet are legally and medically appropriate, Gostin said.

But it's another thing to take the kind of step Rockland County initially did, in which unvaccinated kids were placed under house arrest — not because they were infection risks, but because their parents weren't listening to public health officials, he said.

"That's overly punitive," he said.

Indeed, a judge struck down the initial emergency order.

One community had success without taking such measures. Officials in Vancouver, Washington, declared an end Monday to a measles outbreak that began in January but apparently stopped at 71 cases a month ago. It was a much smaller community than New York City or Los Angeles and was tamed by an intense investigation and vaccination campaign that involved 230 health workers tracking down infected people and those they had contact with, at a cost of about $865,000.

Meanwhile, there is a new wave of efforts in state legislatures to end philosophical and religious exemptions to vaccination requirements in schools.

Ed Day, a Republican who is the top elected official in Rockland County, on Monday joined Democratic state lawmakers to urge quick passage of a measure to eliminate religious exemptions for required vaccinations.

"This bill would be a godsend," Day said at a news conference in Albany. "To wait is a recipe for medical disaster."


Associated Press writers John Rogers in Los Angeles, Gillian Flaccus in Portland, Oregon, and Chris Carola in Albany, New York, contributed.


The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.

  • Associated Categories: U.S. News, Associated Press (AP), AP National News, AP Online National News, Top U.S. News short headlines, Top General short headlines, AP Online Headlines - Washington, AP Online Congress News, AP Health, AP Health - Children's Health
© Copyright 2020
All rights reserved. This material may not be published, broadcast, rewritten, or redistributed without permission.
John Singleton, maker of 'Boyz N the Hood,' dies at 51
Director John Singleton, who made one of Hollywood's most memorable debuts with the Oscar-nominated "Boyz N the Hood" and continued over the following decades to probe the lives of black communities in his native Los Angeles and beyond, has died
4:29PM ( 8 minutes ago )
Surge in US measles cases leads to extraordinary measures
Surge in US measles cases leads to extraordinary measures
4:29PM ( 9 minutes ago )
Under fire from all sides, NRA considers leadership changes
Beset by internal strife and facing scrutiny by law enforcement, the National Rifle Association is facing a push to change its leadership and direction
4:26PM ( 12 minutes ago )
Associated Press (AP)
Residents of Oklahoma town demand answers in police shooting
Residents of an Oklahoma town are demanding answers after police opened fire on a truck, wounding three children and a robbery suspect
3:55PM ( 43 minutes ago )
Huffman's guilty-plea hearing in admissions case is moved up
Felicity Huffman to plead guilty May 13 to college admissions charges; not guilty pleas formally entered for Lori Loughlin, husband
3:54PM ( 43 minutes ago )
Student protesters occupy fraternity house, want it closed
Students at a suburban Philadelphia college have occupied an on-campus fraternity house in an effort to get it shut down and the chapter closed
3:52PM ( 45 minutes ago )
AP National News
Trump says NRA 'under siege' by New York investigation
President Donald Trump says the National Rifle Association is "under siege" in New York after state Attorney General Letitia James announced an investigation into the group
3:01PM ( 1 hour ago )
Beluga whale with Russian harness raises alarm in Norway
A beluga whale found with a tight harness that appeared to be Russian made has raised the alarm of Norwegian officials and prompted speculation that the animal may have come from a Russian military facility
2:56PM ( 1 hour ago )
IS leader appears in video for first time in 5 years
The leader of the Islamic State group has appeared for the first time in 5 years in a video released by the extremist group's propaganda arm
2:54PM ( 1 hour ago )
Top General short headlines
South Bend's Buttigieg, civil rights activist Sharpton meet
Democratic presidential hopeful Pete Buttigieg met with civil rights activist Rev. Al Sharpton as he steps up his outreach to African Americans
3:18PM ( 1 hour ago )
Prosecutors sue feds to stop courthouse immigration arrests
Prosecutors and public defenders in Massachusetts are suing to block federal authorities from arresting people in and around courthouses for civil immigration violations
3:09PM ( 1 hour ago )
Avenatti pleads not guilty on charges of cheating, lying
Attorney Michael Avenatti has pleaded not guilty to charges that he stole millions of dollars from clients, cheated on his taxes and lied to investigators
3:03PM ( 1 hour ago )
AP Online Headlines - Washington
Some 2020 Democrats work with GOP more than you think
Elizabeth Warren has a habit that she doesn't talk about a lot on the campaign trail: working with the GOP.
11:27AM ( 5 hours ago )
Some 2020 Dems work with the GOP more than you might think
Elizabeth Warren has a habit that she doesn't talk about a lot on the campaign trail: working with the GOP. The Massachusetts Democrat is running for the White House as a liberal
11:25AM ( 5 hours ago )
GOP warnings about Democratic socialism tap voter unease
Many voters in southern stretches of Colorado don't seem to be too concerned by the Republican cry that Democrats are shoving the country toward socialism
10:10AM ( 6 hours ago )
AP Online Congress News
More than half quarantined by LA universities are cleared
More than half of the nearly 800 students, faculty and staff members who were quarantined following exposure to the measles virus at two Los Angeles universities have been cleared to resume their normal activities
3:24PM ( 1 hour ago )
Nearly 700 from LA universities still in measles quarantine
Nearly 700 people possibly exposed to measles at two Los Angeles universities are still quarantined three days after health officials ordered the precautions to contain the spread of the highly contagious disease
4:25PM ( 2 days ago )
Lead from Notre Dame fire dictates area health precautions
Paris police say areas near Notre Dame Cathedral with elevated lead levels after the fire that ravaged the famous monument will remain closed to the public until they are deemed safe
11:57AM ( 2 days ago )
AP Health
California vaccine rules advance over emotional opposition
California lawmakers are advancing tougher rules for vaccinations despite hearing hours of testimony from hundreds of opponents
11:27PM ( 4 days ago )
Opponents spar over California vaccine exemption bill
Hundreds of opponents of mandatory vaccines are opposing a California proposal to give state public health officials instead of local doctors the power to decide which children can skip their shots before attending school.
6:14PM ( 4 days ago )
UN: No screen time for babies; only 1 hour for kids under 5
The World Health Organization has issued its first-ever guidance for how much screen time children under five should get: not very much
2:23PM ( 5 days ago )
AP Health - Children's Health
John Singleton, maker of 'Boyz N the Hood,' dies at 51
Director John Singleton, who made one of Hollywood's most memorable debuts with the Oscar-nominated "Boyz N the Hood" and continued over the following decades to probe the lives of black communities in his native Los Angeles and beyond, has died
4:29PM ( 9 minutes ago )
Under fire from all sides, NRA considers leadership changes
Beset by internal strife and facing scrutiny by law enforcement, the National Rifle Association is facing a push to change its leadership and direction
4:26PM ( 12 minutes ago )
Bellafina 2-1 early favorite for Kentucky Oaks for fillies
Bellafina is early 2-1 favorite from No. 4 post for the Kentucky Oaks for fillies at Churchill Downs
4:25PM ( 13 minutes ago )
Gay BYU student comes out in valedictorian speech
A gay student who came out during a valedictorian speech at Mormon-owned Brigham Young University is earning applause and admiration from fellow students and figures like actress Kristin Chenoweth
4:22PM ( 16 minutes ago )
The Latest: Biden holding 1st campaign rally in Pittsburgh
Joe Biden is holding his first public rally as a 2020 presidential candidate, appearing at a Pittsburgh union hall
4:08PM ( 30 minutes ago )