Keeping measles out of Manhattan

Manhattan Borough President Gale A. Brewer would support a requirement that every child in NYC schools be vaccinated. Photo courtesy Gale A. Brewer, via flickr
An outbreak of the infectious disease in Brooklyn sounds an alarm that shouldn’t be ignored, experts and officials say
By Emily Higginbotham

In the first three months of 2019, New York City has had to confront the worst measles outbreak it has seen in decades. The number of cases has risen to over 150 in Brooklyn, and more specifically, in Orthodox Jewish enclaves in Williamsburg and Borough Park where vaccine hesitancy has made inroads in the community.

The public health crisis raises questions of whether such an outbreak might be possible in Manhattan.

“If you have groups of people who are not immunized and someone comes in with measles — you’re going to have an outbreak. It’s a virtual certainty,” said Stephen Morse, a professor and epidemiologist at Columbia University.

Officials have traced the Brooklyn outbreak back to travelers coming from Israel and Europe, where measles had been spreading, Morse explained. But the infection spread when those infected spent time in community spaces where people were unvaccinated, particularly in the religious day schools known as yeshivas.

Vaccination is the Answer

It’s this fact that worries Manhattan Borough President Gale Brewer. “I go to a lot of schools and talk to a lot of parents, and I think there are kids in Manhattan public schools who are not vaccinated,” Brewer said.

While there is not an outbreak in Manhattan currently, Brewer said, the best way to prevent one is to ensure every kid who comes to school is immunized. Although that is the case for most students, parents or guardians are able to exempt their children because of their religious beliefs, which creates a pool of susceptible children.

“There is not an exemption based on personal, moral or secular beliefs,” Brewer said, adding that, in terms of a possible policy solution to prevent widespread measles outbreaks, she would support a requirement that every child be vaccinated.

A Dangerous Movement

The anti-vaccine movement is not a new phenomenon, but Morse fears that it is growing. “We’re all very worried about it because these are vaccine-preventable diseases, and we’ve taken them for granted,” he said. “It worries me because it seems like we’re going to see more and more of this. If there are large enough parts of the population that are not immunized we will see bigger outbreaks. I don’t think we’ll ever see several million cases again, but I do think we will see a few hundred or maybe a few thousand. That would be a very sad thing because there would be consequences to that.”

Measles is one of the most contagious infections, ten times more contagious than the flu, according to Morse. It can spread from an infected person breathing, coughing and sneezing. Traditionally, it’s been known as a childhood disease. Its symptoms include fever and a red blotchy skin rash all over the body, as well as a cough and runny nose. The vast majority of cases are not fatal, but the effects of a measles infection can be very serious.

Staying Safe

Families can protect themselves from measles by getting their children immunized at the appropriate times, Morse said.

For parents who have infants not yet old enough for the MMR vaccination (between 6 and 11 months old) and are worried that they may catch measles, Morse said there’s really only way to protect them: keep them away from those who might have the infection. If parents are able to do that, and the rest of the family members are immunized, the child should be safe from measles. Additionally, newborns should be protected through maternal immunity. Antibodies from the mother’s breast milk should remain in the child’s bloodstream until they are six months old.