NEW YORK (AP) – Quarantines in California. Fines in New York City. Commands for some people to shun public places in Rockland County, New York.
When there was an outbreak of measles in the United States – 704 cases this year and more – some local health officials are trying to address infections in unvaccinated communities by turning to the extraordinary police forces of the past.
"Unfortunately, we are referring to diseases of another generation," said Jason Schwartz, assistant professor of health policy at the Yale School of Public Health.
"And now we return to the public health responses of another generation," he said. "The vaccination programs were unsuccessful."
It has recently been suggested that measles is a problem that has been mostly solved. The once-common disease became more rare when a vaccine became available in the 1
A decade ago, it was less than 100 cases a year. But they have jumped since then, with the worst happening right now.
On Monday, US health officials said the nationwide record since 1994, when 963 cases were reported, has exceeded the total for a whole year.
Twenty Two states have reported cases, but the vast majority were in New York – mainly in New York City and nearby Rockland County. Most cases in New York have been unvaccinated in orthodox Jewish communities.
Three-quarters of those who contract the extremely contagious disease are children or adolescents.
No deaths were reported this year, but 66 patients were hospitalized.
The Centers for Disease Control and Prevention said the count this year includes 44 people who contracted travel to another country. Some of them triggered US outbreaks, especially in unvaccinated people. These include the biggest outbreaks in New York.
Measles cause fever, runny nose, coughing and rashes throughout the body in most people. A very small proportion of the infected can suffer from complications such as pneumonia and dangerous brain swelling. According to the CDC, one in two will die for 1,000 children who get measles.
The return of measles can be an early warning sign of the revival of other vaccine-preventable diseases such as rubella, chickenpox and bacteria Some experts reported meningitis.
Over the last few decades, health officials have relied on doctors to persuade families to vaccinate their children against measles and other diseases. This push was fueled by the requirement that in every state children should be vaccinated to attend public schools.
But as immunization rates have plummeted in some communities and the cases have exploded, the authorities have taken more dramatic steps lately. In Rockland County, officials banned all unvaccinated children from public interiors last month.
In New York City, officials ordered compulsory vaccinations in four Brooklyn zip codes this month and threatened with fines of up to $ 1,000 for non-compliance. City officials said 57 unvaccinated people received summonses. The city has also closed seven religious schools, which could not exclude unvaccinated children. Later, five were allowed to reopen after a correction plan.
Last week in California, more than 1,000 students and employees at two Los Angeles universities were quarantined on campus or sent home after cases emerged. It was a limited order, and half is already out of action, officials said Monday.
Dr. Umair Shah, head of the Houston Department of Health, said, "We do not know", if this type of action will become more common.
Health authorities had such measures available and were willing to use them in case of an unusual one, and even exotic outbreaks, such as a new flu pandemic or Ebola, "but here we implement them for measles," he said.
More than 25 years have passed since such measles measures were taken, said Schwartz. The last similar case occurred during a devastating outbreak in Philadelphia in the early 1990s, when the city recorded more than 900 cases, most of which were members of two fundamentalist church groups that did not accept vaccination or other modern medical care.
The use of quarantine and other missions will be partially addressed A growing concern Some outbreaks of measles and other diseases may worsen despite the availability of effective vaccines, some health experts said.
"I believe there is a sense of anxiety and even a bit of panic in public health," as officials see a high level of distrust toward government and science of a surprising number of people, said Lawrence Gostin, an expert for health law at Georgetown University.
These feelings of anxiety have led to what Gostin considers missing from officials.
It's one thing to isolate someone with measles or quarantine someone who has been exposed, he said. These people are at risk of infection, and short-term restrictions on where they go and who they can meet are both legally and medically appropriate, Gostin said.
But it's another thing to do the kind of move that Rockland County did originally. Unvaccinated children were placed under house arrest – not because they posed an infection risk, but because their parents were not listening to public health officials.
"That's overly punishable," he said.
A judge defeated the original emergency decree.
A church was successful without taking such measures. Officers in Vancouver, Washington, declared an end to the measles outbreak on Monday, starting in January but apparently stopping a month ago in 71 cases. It was a much smaller community than New York City or Los Angeles and was tamed by an intensive investigative and vaccination campaign in which 230 health professionals were tracking down infected people and people they were in contact with, which cost caused about $ 865,000.
Meanwhile, there is a new wave of efforts in the legislatures of the state to end the philosophical and religious exemptions from the immunization requirements in the schools.
Ed Day, a Republican elected senior official in Rockland County, joined the Democratic state legislator on Monday to urgently press for adoption of a measure to eliminate religious exceptions for required vaccinations.
"This bill would be a godsend," said Day at a press conference in Albany. "Waiting is a recipe for a medical disaster."
Associated Press writer John Rogers of Los Angeles, Gillian Flaccus of Portland, Oregon, and Chris Carola of Albany, New York contributed to it.
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