Doc: Response to measles outbreak out of proportion

By Becca Tucker
A six-month measles outbreak has Rockland County in a state of emergency, with unvaccinated kids barred first from school and then, in a move that made international headlines, from public places.
Rockland County Executive Ed Day and health officials say the extraordinary measures are necessary to protect the public from a highly contagious and potentially dangerous disease.
A growing group of concerned parents is suing, saying the county’s strong-arm tactics are out of proportion and imperil families’ rights to make appropriate medical choices for their children.
Dr. Hendrieka Fitzpatrick, a general practitioner in New Jersey with an expertise in women’s and children’s health, is one of those people who say the county has gone too far. “We can’t start taking people’s choice away” over the measles vaccine.
Regarding measles itself, Fitzpatrick said: “I’m not saying it’s not miserable, but it’s not life threatening” in the Western world. “It’s probably milder in children than the flu,” she said.
The last measles death in the U.S. occurred in 2015, according to the Centers for Disease Control and Prevention.
Severe measles, the kind that can kill you, “is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases,” the World Health Organization says on its website. “More than 95 percent of measles deaths occur in countries with low per capita incomes and weak health infrastructures.”
Still, there are health risks for Rockland residents. Of the county’s 157 reported cases from the fall through March 29, “a small number … about 10 percent” resulted in “more serious complications,” said County Commissioner of Health Dr. Patricia Schnabel Ruppert.
Those ranged from respiratory difficulty, ear infections and pneumonia to a pregnant mother with measles who at 34 weeks delivered prematurely.
Her baby was born with measles.
Nobody in Rockland County has gotten encephalitis, the brain swelling that is among the most serious potential complications of viral illnesses like measles.
The risks of measles also include developmental issues years down the road, like impaired hearing or blindness, health commissioner Ruppert told a scrum of media outside a free vaccination clinic last week.
Thirteen cases in Orange CountyThis measles outbreak originated in late September with Orthodox Jews returning from Israel and has been almost exclusively contained within the Orthodox community.
It’s the longest outbreak since measles was declared eradicated in the United States in 2000.
In November it spread to Orange County, where there have been a total of 13 confirmed cases since the fall, said Orange County Deputy Commissioner of Health Chris Ericson.
As of April 2, there were “one or two cases in the few past weeks” that they were still following up on, he said.
There are currently eight outbreak associated cases in New Jersey: six in Ocean County and two in Monmouth County.
Last Tuesday, County Executive Day, a former police detective, announced the emergency order banning unvaccinated minors six months to 18 years old from public indoor places like grocery stores until April 25, unless they have a medical exemption or are already immune.
When the order went into effect, there were under 10 active measles cases in Rockland, Commissioner Ruppert told the Journal News.
Religious exemptionsFitzpatrick, who holds a BA in medical ethics, wrote an affidavit for a group of private school parents who are suing the Rockland health department for banning their kids from attending their Waldorf school, where there have been no cases of measles.
The parents are going by their initials in the lawsuit, an indication of how toxic the vaccination issue has become.
“Kids shouldn’t be left out of school because they aren’t immune to measles,” said Fitzpatrick.
New York is one of 47 states that allow parents to claim a religious exemption for their children’s vaccines. That freedom of choice, already tenuous, is in “precarious danger,” said Michael Sussman, the lawyer for the group of about 20 Waldorf parents.
Sussman is planning to file an additional lawsuit on Thursday in response to the county’s ban on minors going out in public. The plaintiffs are the Waldorf parents and another 30 or so people who came forward after the ban.
“We feel quite confident – and we felt previously – that this is an overreach,” Sussman said.
'Fears that grips the population'Rockland’s measures come as a jurisdiction across the country has taken things a step farther.
In Phoenix, Arizona, police with guns drawn took three unvaccinated kids from their home in February, after the parents visited a clinic with their feverish two-year-old.
The state has charged the parents with child abuse and the children were taken into foster care. The toddler was found to have a respiratory infection.
“This is one of those things that can imperil liberty: a feeling of fear that grips the population,” said Sussman.
County Executive Day says parents will not be asked to show documentation proving their kids are vaccinated.
But if an unvaccinated child is proved to be the source of a measles outbreak, the parent or guardian may be held liable, legally punishable by a $500 fine or even jail time.
The road we’re on is “scary to me,” said Fitzpatrick. “We can’t start taking people’s choice away, one thing then another.”