Could North Jersey be next for a measles outbreak?

With measles outbreaks virtually at our doorstep, North Jersey medical practitioners are fielding calls from anxious patients and urging everyone to vaccinate their children against the highly contagious illness. 

"Everyone is extremely concerned and calling to ask for guidance," said Dr. Suraj Saggar, chief of infectious disease at Holy Name Medical Center in Teaneck. "This is extremely contagious. We are doing our best to educate the public and let people know that they should be vaccinated."  

As of Tuesday morning, there were 11 confirmed cases and an additional seven cases that are under investigation in Ocean County, said the Ocean County Health Department.

There were also 68 confirmed cases and 11 suspected cases of measles as of Tuesday morning in nearby Rockland County, New York, where the Department of Health has been offering free measles vaccines to residents 6 months of age and older. 

In addition, measles has been diagnosed in 17 children in the several mostly Orthodox neighborhoods in Brooklyn. Health officials there have reported an increased demand for vaccinations.  

Thus far, no cases have been reported in Bergen or Passaic counties, but there is growing concern because of proximity and intermingling with the other affected communities in Lakewood and Rockland County. Both also have large Orthodox Jewish populations.  

"Measles is highly transmissible. So it absolutely has the potential to spread, especially when people are not vaccinated," said Dr. Aryeh Baer, a pediatric infectious disease specialist at Hackensack University Medical Center. He noted that people should take all precautions, because one in every 1,000 people who get measles die from it. 

"Vaccination provides lifelong immunity. As a society, we should be helping to make sure everyone else is covered," he said.  

Bergen County has a higher-than-average rate of vaccine exemptions among schoolchildren. For the 2017-18 school year, a combined 1,772 children in public and private schools were not fully vaccinated because of medical or religious exemptions, state data show. 

Several prominent ultra-Orthodox rabbis in Israel and in Brooklyn — including Rabbi David Niederman, a Hasidic rabbi and president of the United Jewish Organizations of Williamsburg and North Brooklyn — have urged followers to vaccinate their children, and some schools and synagogues have said that only those who are vaccinated may attend.   

And on Wednesday, the Orthodox Union and the Rabbinical Council of America released a joint statement urging all parents to vaccinate their children on the timetable recommended by their pediatrician.  

What are symptoms of measles?

Measles is transmitted by sneezing and coughing as well as direct contact with an infected person, according to the federal Centers for Disease Control and Prevention. Symptoms include a high fever and rash, a runny nose, and red runny eyes. In some cases, the virus can lead to serious impairment or death. 

Most people born after 1957 received a measles vaccine, but some have not, either for medical reasons or because they came from a country where it wasn't routinely done. 

Because of gaps in vaccine overage, various regions of the world have been hit in recent years with measles outbreaks, said the World Health Organization, which found that the number of people sickened with the virus in 2018 has exceeded the 2017 total. 

The World Health Organization recommends that adults or adolescents unsure of their immunity status get a dose of measles vaccine before traveling overseas. 

The recent outbreaks in Lakewood, New York City and Rockland County are linked to people who traveled abroad. In Rockland County, the cases have spread beyond the Orthodox community where they originated.

Outbreaks have been reported in other 25 other states this year, including California, Florida, Nevada and Texas. There also has been a measles outbreak in Europe. 

L'via Weisinger of Teaneck, a founder of the Orthodox Jewish Nurses Association and a school nurse who has worked at several yeshiva day schools in Bergen County over the past 18 years, said she's worried that measles will spread to Bergen County.   

"We have a large population of Rockland County students in our yeshiva day schools," she said, adding that she wants religious schools to ban families who refuse to vaccinate (for philosophical reasons), because it could harm students with immunity problems.

"The schools should kick out the anti-vaxxers because this puts everyone at risk," she said, explaining that religious schools are not required to accept philosophical or religious exemptions, which could place the community at risk. She hopes that all schools will advise parents that their children cannot be admitted without proof of immunization and refuse to accept any exceptions. 

Dr. Maury Buchalter, a pediatrician at Tenafly Pediatrics, a practice with offices in Fort Lee, Paramus, Clifton and other locations, agreed. The problems arise, he said, when schools allow exemptions for parents who don't want to vaccinate their kids.

"As a practice, we recommend that if patients don't want to be vaccinated, they don't stay here," he said. "It's a state law. People need to be vaccinated." 

State law permits unvaccinated children to be excluded from schools and child-care centers during outbreaks.

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When he gets calls from worried parents, he explains that as long as their children are up to date on vaccines, there's nothing to worry about.

Siggy Berger, a social worker and mother of 11 who lives in Passaic, said people in her predominantly Orthodox neighborhood are especially concerned about elderly adults and infants being harmed.

"People have stopped grocery shopping in Monsey [New York] because they are afraid," she said, referring to those who trek to other religious neighborhoods to buy kosher food. "Some are fearful of going to Lakewood."

In her own family, she made sure to vaccinate all of her children long ago, but she's concerned about her son, who has a lower immunity due to a disability. 

Everyone who knows her is aware of her stance about anti-vaxxers, she said, adding: "I'm so against people who don't vaccinate, because they hurt the rest of us."