The number of cases of measles this year in the United States is nearing the total for all of last year, with five states reporting outbreaks in 2019, according to the Centers for Disease Control and Prevention.
An outbreak, defined as three or more cases, has been reported in New York state, New York City, Washington, Texas, Illinois and California.
The 314 cases nationwide as of March 21 is inching closer to the 372 for all of last year.
In Rockland County, just north of New York, where 155 cases have been confirmed as of Wednesday, County Executive Ed Day declared a state of emergency this week, banning any unvaccinated person under 18 from appearing in a public place. Violations are punishable by a $500 fine or six months in jail.
The ban, which will be in effect for 30 days, prompted a backlash from a small group of anti-vaccination advocates, who protested Thursday at the Palisades Center mall in West Nyack in what they dubbed on Facebook a "Rockland County — Unvaccinated Civil Disobedience."
"This is about healthy people being quarantined and barred from public places," said Rita Palma, one of the protesters. "People have a right to choose for their own children and make their own decisions."
Rockland County says the outbreak can be traced to September, with the arrival of an international traveler with a suspected case.
Infectious-disease experts described such broad bans of minors from public places as a potentially unprecedented government action in combating a measles outbreak.
“It’s not something that I’ve seen before in my professional experience,” said Dr. Jeffrey Duchin, a top public-health officer in Seattle, Washington. “What that says to me is that the local public-health people feel that they have an extraordinary outbreak on their hands."
The CDC blames the outbreaks across the country on two factors: an increase in the number of travelers who bring measles back from abroad, notably Israel and Ukraine, and what it calls the "further spread of measles in U.S. communities with pockets of unvaccinated people."
New York City Health says most of the 214 confirmed cases of measles in Brooklyn and Queens involved members of the Orthodox Jewish community. Many of the children from Orthodox Jewish families attend religious schools where vaccination rates may have been below the 95 percent threshold considered necessary to maintain immunity, according to Kaiser Health News.
NYC health says the initial case that triggered the outbreak in the area involved an unvaccinated child who picked up the disease on a visit to Israel, where a large outbreak of the disease is occurring.
Before the measles vaccine program began in the United States in 1963, measles infected as many as 4 million people a year. Nearly 50,000 were hospitalized and between 400 and 500 people died each year. In 2000, after almost 40 years of the vaccine program, measles was declared eliminated in the U.S., the CDC reports.
Now, people choosing not to vaccinate have become a global health threat, the WHO reported. The CDC says that the number of children who aren't being vaccinated by 24 months old has been gradually increasing.
Many anti-vaccination activists believe there is a link between the vaccine and autism. Others believe that a decision on vaccination is up to parents, not the government.
A new decadelong study in Denmark of more than half a million people found that the measles vaccine does not increase the risk of autism, further reinforcing what the medical community has long been saying about preventive shots.
Before the latest report, the autism-vaccine link has long been discredited, as official groups including the CDC reported no proven link and no ingredients in vaccines that could cause autism. Still, a minority of parents have chosen not to vaccinate their children. And legislation continues to be introduced in favor of the anti-vaxx movement.
Major health and medical organizations, including the American Academy of Pediatrics, support vaccines as safe and effective.
“While these parents undoubtedly have their children’s best interests at heart, they are putting them, and everyone else at risk, and there are public health consequences,” according to a statement from Dr. Aaron Glatt, an Infectious Diseases Society of America spokesman.
Contributing: Ashley May; Rochel Leah Goldblatt, Nancy Cutler, David Robinson and Matt Spillane, Rockland/Westchester Journal News
This article originally appeared on USA TODAY: 'Extraordinary': 5 states fight measles outbreak as N.Y. county bans unvaxxed minors in public