The number of measles cases in the United States is now at 839 for the year, according to the US Centers for Disease Control and Prevention's weekly measles update.
That's 75 more cases than the agency reported last week, inching closer to the 963 reported in 1994, which is the highest number of cases in a year in the past 25 years.
This includes cases reported to the CDC as of Friday but does not include any cases identified or reported since then.
Last month, the number of cases this year became the highest number in a single year since the virus was declared eliminated in the United States in 2000. The designation means measles was no longer being transmitted within the country.
Some good news this week is that no new states reported cases, leaving the number unchanged at 23. The states that have reported measles cases this year are Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oregon, Pennsylvania, Texas, Tennessee and Washington.
But still troubling: Sixty-six of the 75 new cases were in New York, according to a source familiar with the measles situation in the United States. Of those, 41 were reported by New York City, and 25 were reported by Rockland County. These areas are home to the Orthodox Jewish communities that have been reporting an increasing number of cases since October.
The outbreak there began when an unvaccinated child traveled to Israel and returned home with the highly contagious disease, New York City health officials have said. That child infected others, and the number of cases grew.
An infected person from New York visited Detroit and unknowingly spread the virus, which led to an outbreak in Michigan.
State health officials in Connecticut said one case there was a resident who had visited New York.
Seven months in, New York City and state health officials have failed to contain the outbreak, as indicated by the number of cases continuing to be reported.
As of Monday, the New York State Department of Health reported 274 cases of measles since the outbreak began in October; 164 of those cases have been reported this year. An additional 498 cases as of Monday evening have been reported in New York City, according to health officials, 442 of which have been reported this year. In all, New York state has reported 606 cases of measles in 2019.
New York City and Rockland County have taken separate steps to contain the outbreak.
As of Monday, New York City health officials said that 98 summonses had been issued for violations by people who are "non-compliant with the Emergency Order since the City began issuing summonses last week." That includes those in the ZIP codes of the outbreak who remain unvaccinated and cannot provide proof of vaccination or measles illness.
"Any person receiving the summons is entitled to a hearing, and if the hearing officer upholds the summons, a $1,000 penalty will be imposed. Failing to appear at the hearing or respond to the summons will result in a $2,000 fine," a statement from the health department said.
This week, a new awareness campaign is set to be released by the New York City health department, with ads on bus shelters, in publications and elsewhere targeting the communities in English and Yiddish.
Since October 1, health officials there say they've administered nearly 23,000 doses of the measles, mumps and rubella, or MMR, vaccine and that more than 11,000 of those doses were administered in Williamsburg, where 80% of the New York City cases have occurred.
According to the Rockland County Health Department, more than 20,000 doses of the MMR vaccine have been administered there since October.
The vaccine is 93% effective against measles after one dose and 97% effective after two doses.
The CDC recommends two doses of the MMR vaccine: the first dose for children when they are between 12 and 15 months old and the second when children are 4 to 6 years old.
Babies between 6 months and 12 months should be vaccinated before international travel or if they live in a community experiencing an outbreak. That dose may not offer lasting protection, so the other two doses should be administered as recommended for routine vaccination.
Babies who are traveling to or living in an area with an ongoing outbreak who have had a first dose at 12 months to 15 months do not need to wait until age 4 for that second dose; rather, they can and should get it anytime after 28 days from the first vaccination.
As for adults, the CDC recommends that those who were born during or after 1957 who do not have evidence of immunity against measles should get at least one dose of MMR. Those born before 1957 are assumed to have had measles and are therefore immune and don't need to be vaccinated.
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