With New Measles Cases, Rockland Imposes New Rules For Children

NEW CITY, NY — Rockland County health officials have issued new orders to fight their continuing measles outbreak, targeting both parents and school administrators. County Executive Ed Day and Health Commissioner Patricia Ruppert said Tuesday that while the county continues to fight anti-vaxxers in court, they are shifting focus to the children, who so far account for more than four out of five confirmed cases.

As of April 15 the county has 186 cases, "with many more that are unreported," she said at a press conference. That's up 33 cases since the state of emergency was declared at the end of March. Officials said they still see the trajectory they called attention to then, with an increase in cases and an increase in resistance to health department efforts to track and warn of exposure.

Ruppert is invoking a different area of state law to implement these exclusion orders, said County Attorney Thomas Humbach.

The first targets parents.

1. Any person diagnosed with the measles or exposed to a person diagnosed with the measles as evidenced by laboratory evidence or a measles tracing investigation conducted by RCDOH must be excluded from indoor and outdoor places of public assembly located in Rockland County for a period of up to 21 days.
2. The individual is prohibited from going to or being present at any place of public assembly for any period of time with exceptions for medical care, emergency situations and court appointments.
3. Individuals are required to cooperate with RCDOH public health authorities by providing information regarding details of one’s illness, exposures and contacts.

"We're doing everything we can when we say to a parent, 'you have to keep your child home,'" Ruppert said. County health officials delivered its first order under that new rule late Friday. It was personally delivered by health staff to the parents, Ruppert said.

The second targets school administrators in schools in the 10952 and 10977 zip codes, where the measles outbreak has been centered geographically.

The second Order involves students who are required to have the proper MMR immunizations and to date have not demonstrated that the vaccines have been administered. New York State (NYS) Public Health Law Section 2164 and New York Codes, Rules and Regulations (NYCRR) Title 10, Subpart 66-1 requires mandatory immunizations to be in school unless the student has a medical or religious exemption.

1. Pursuant to an audit conducted by NYSDOH/RCDOH, students have been identified as having neither a valid certificate of immunization on file for MMR vaccine or laboratory evidence of immunity against measles, mumps and rubella, nor a valid medical or religious exemption on file.
2. A notarized affidavit sworn under penalty of perjury or if unable to take an oath, a notarized affirmation affirmed under penalties of perjury, identifying students who have been excluded from the school/day care is required according to this order.

Failure to comply can result in a $2,000 fine per violation per day. These Orders to affected schools were delivered as of April 16, 2019.

County officials said the original orders are still in effect, requiring schools in those two zipcodes with a lower than 95% immunization rate to continue excluding unvaccinated non immune students and turn over to the health department all vaccination records weekly.

"The schools that have cooperated, their efforts have gone a long way," Ruppert said.

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.

The new orders apply not only to measles. The requirement is for the MMR vaccine, which combines measles, mumps and rubella.

As with previous orders, Day said, Rockland law enforcement will not be out searching for or arresting people.

"What it's about is re-emphasizing the importance," he said. “In 2017, measles killed 110,000 people worldwide, mostly children under the age of 5. And while we have thankfully not seen a death here in Rockland we have seen multiple hospitalizations, including an infant and even a premature birth caused by measles.”

"Need we wait for someone to die?" he asked before answering his own question. "We will not quit. We will not take a back seat. We will use every tool at our disposal regardless of opposition or distraction."

While Rockland's measles outbreak is concentrated in the Ultra-Orthodox Jewish community, the county is small enough geographically that everyone is at risk of exposure in public places such as restaurants, parks, and stores.

Meanwhile, a childcare facility in Brooklyn is the first to be shut down by New York City officials for not following their issued orders during a measles outbreak that has now reached 329 cases in the neighborhood's Orthodox Jewish community.

SEE ALSO:

• Measles Outbreak: Uncooperative Rocklanders Lead To More Cases
• Rockland Offers Measles Shot As State Of Emergency Starts
• Measles Outbreak Is 2nd Biggest Since U.S. Eradicated Virus: CDC
  
• More Measles Cases Reported In NJ As Numbers Jump Nationwide