Measles Outbreak: Uncooperative Rocklanders Lead To More Cases

NEW CITY, NY — Rockland County officials say some people infected with measles are refusing to cooperate with the Health Department. The county is now up to 151 confirmed cases in its 25-week outbreak, which has primarily affected the Ultra-Orthodox communities of Monsey, New Square and Spring Valley, and there could be many more unreported cases.

At a Thursday afternoon press conference, Dr. Patricia Schnabel Ruppert, the county health commissioner, talked about the outbreak and the people affected, including those who have not acted responsibly.

"It's almost half a year that we've been fighting this and its very frustrating," she said, acknowledging that most people had been cooperative.

In one of the most recent cases, the infected person was willing to say what days she had been shopping at the Target in Spring Valley while contagious, but when health officials tried to narrow down the time, she refused to cooperate, Ruppert said.

Between March 10 and 13, anyone who visited the following locations in Spring Valley and Monsey may have been exposed to measles:

• Target in Spring Valley Marketplace, 50 Spring Valley Market Place, Spring Valley, NY 10977, between Sunday 3/10/19 at 8:00 am and Monday 3/11/19 at 1:00 am, and between Monday 3/11/19 at 8:00 am and Tuesday 3/12/19 at 2:00 am. (The RCDOH has been unable to narrow the time of possible exposure at the Target in Spring Valley Marketplace despite multiple attempts to reach the infected individual).
• All Fresh Supermarket, 19 Route 59, Monsey, NY 10952 on March 12, 1:30 pm – 4:30 pm
• Atrium Plaza, 401 Route 59, Monsey, NY 10952, on March 12 between 2:30 pm – 5:45 pm
• Designer's Spot, 401 Route 59, Monsey, NY 10952, on March 12 between 2:30 pm - 5:45 pm
• TOR Bus – Loop 2 Eastbound that traveled on March 12 between 3:55 pm and 6:06 pm from the Atrium Plaza in Monsey, NY
• International Taxi that drove from near 5 Twin Avenue in Spring Valley, NY to near the intersection of Sunrise Drive and Monsey Blvd. in Monsey, NY on March 13 between 3:15 pm and 5:30 pm

The measles virus is so highly contagious that an un-vaccinated or -immune person who shares close space with an infected person who sneezes or coughs has a 90 percent chance of contracting the illness.

The measles virus lives in the nose and throat mucous of an infected person. The virus is hearty, and can live for up to two hours in an airspace where an infected person coughed or sneezed. And people who have measles can spread it from four days before a rash appears to four days after it has cleared.

In several cases for which Rockland investigators have tried to track the case history (so they could notify anyone who was exposed), Ruppert said, "we have had people hang up, or close the door to staffers and say don't come back."

Also, health officials think many people in the community where measles infected family members have not gone to doctors.

"We know infected people have been to homes with unvaccinated people for measles parties," she said.

And, she said, some people who have reported cases have not been willing to say where the infection originated. "After the fact people are reluctant to admit who was most responsible."

So while officials know that there have been more measles cases in the county than the 151 confirmed so far, "We don't know how many more," she said in response to a question from a reporter.

On average, a person infected with measles gives it to 18 people, she said.

She said she thought people may have become complacent as they haven't experienced these diseases that have been successfully fought with modern vaccines. "These are people who are well intended I'm sure but they do not know the facts."

One of the facts they don't know is how dangerous the disease is. Globally, measles cases saw a 30 percent uptick in 2017 and killed an estimated 110,000 people, according to the World Health Organization.The main reason for the increase in Europe, where 41,000 people were infected in the first six months of 2018, was the refusal by parents to have their children vaccinated, the global health agency said.

So far during the Rockland outbreak, there have been multiple cases of pneumonia in measles victims, Ruppert said. Both children and adults have had to spend time in local intensive care units. A baby was born premature with congenital measles to a mom infected during her pregnancy who did not notify her obstetrician.

Children under two are most at risk of later developmental issues, including vision, hearing and encephalitis, which could occur months to years after they recover from measles.

In this outbreak, even those born before 1957, and those who have received two doses of measles, mumps, rubella vaccine, might get measles, though they have always been considered immune. It's a very small chance, and it would lead to a much less severe case that would be much less likely to spread to others, she said.

The way to prevent measles is vaccination and isolation. County health officials immediately began offering free vaccine clinics in partnership with community health centers. They asked anyone who might be infected to call the doctor before going in for a check-up. They placed restrictions on schools in the geographic center of the outbreak as well.

Ruppert said she was concerned that cases could start climbing again that spring is here and the holiday season is starting, so people are gathering together for events.

"My biggest fears are that we are going to see deaths, that we are going to see complications," she said. "We worry about the things we're going to see for years to come."

SEE:

• Measles Virus Taken Shopping By Bus, Taxi In Rockland: New Cases
• Parents Fight Measles Outbreak Rules In Rockland, Brooklyn