Mayor de Blasio, Health Officials Declare End of Measles Outbreak in New York City

September 3, 2019

After a major emergency response and extensive collaboration with community partners, active transmission of measles associated with the 2018-2019 outbreak stops and Emergency Order is rescinded

NEW YORK—Mayor de Blasio and Health Commissioner Dr. Oxiris Barbot today announced the end to the measles public health emergency declared on April 9 for parts of Brooklyn. Measles outbreaks are typically declared over when two incubation periods for measles (the equivalent of 42 days) have passed since the last infectious day of the last persons with measles in affected areas. That time period has now passed for the people most recently infected with measles and reported to the Health Department. 

“Ending the measles outbreak required extensive collaboration with community organizations and Jewish leaders. They helped encourage vaccinations and achieve record immunization levels in parts of Brooklyn,” said Mayor Bill de Blasio. “As we head back to school this week, we just remain vigilant. To keep our children and communities safe, I urge all New Yorkers to get vaccinated. It’s the best defense we have.” 

“Measles is one of the most contagious diseases on the face of the earth,” said Health Commissioner Dr. Oxiris Barbot. “There may no longer be local transmission of measles in New York City, but the threat remains given other outbreaks in the U.S. and around the world. Our best defense against renewed transmission is having a well immunized city. Vaccination coverage has increased significantly since the emergency order, which has been supported by community-led efforts. We are grateful to the New Yorkers who shared the truth about vaccines and protected the health of their friends and neighbors through this outbreak.”

Deputy Commissioner for the Health Department’s Division of Disease Control Dr. Demetre Daskalakis said, “Staying up to date on vaccines is the best way for people to protect the health and safety of New Yorkers. It only takes one case to start an outbreak. We will continue to urge everyone to confirm that they are immune to measles by looking at their vaccination histories or by consulting with a healthcare provider. Get vaccinated. It is safe and effective.”  

Ending this outbreak required a major public health response and extensive community collaboration. To battle the outbreak, the City spent over $6 million and dedicated more than 500 staff to the response; disseminated tens of thousands of pro-vaccination booklets; conducted multiple rounds of robocalls; sent letters and texts to local residents; published ads and distributed educational materials in English, Yiddish, and Spanish; launched an ad campaign that appeared at bus shelters, LinkNYC kiosks, and in newspapers as well as online; hosted a tele-Town Hall to counter anti-vaccination propaganda; visited doctor’s offices; and hosted and attended numerous community events, among many other activities. 

These efforts were supported by innovative strategies by community members, school and child care administrators and health care providers to counter local misinformation campaigns and stop the spread of measles. These efforts collectively made the community safer and increased vaccination coverage.

Since the outbreak in October 2018, ODA has administered more than 5,000 MMR vaccinations and continues to work to educate area residents about how essential timely vaccinations are to maintaining a healthy family and community.

This was the largest measles outbreak in New York City in nearly three decades. 

• Since the outbreak started in October of 2018, 654 individuals were diagnosed with measles. 
• There have been 52 measles-related hospitalizations and 16 admissions to intensive care due to measles complications since the beginning of the outbreak. 
• Most measles cases were diagnosed in people under 18 years of age (525 cases or 80%).
• Most measles cases were among unvaccinated (73%), incompletely vaccinated (7%) or individuals or persons who did not know their vaccination status (15%).            
• While there were cases of measles in all five boroughs, the majority of cases (72%) occurred in the Williamsburg neighborhood (ZIP codes 11205, 11206, 11211, 11249). 

In Williamsburg and Borough Park there have been 15,541 doses of the measles-mumps-rubella vaccine administered since the 4/9 Emergency Order, which represents a near 41% increase compared to the same time period last year.

While no new cases have been reported since mid-July, the Health Department will continue monitoring and may add cases retrospectively as they are identified. Those cases will be attributed to the month in which rash onset has occurred. Therefore, the total case count may increase even after the outbreak is declared over. In addition, New York City may see future measles cases not associated with this outbreak. 

Emergency Order Rescinded, Enforcement Continues Due to New State Requirement

Affected ZIP codes have been under an Emergency Order since April 9, requiring people who reside or work in these ZIP codes to be vaccinated or have immunity against measles or face potential fines. With the end of local, active transmission of measles, the April 9th Emergency Order has been rescinded.

Also lifted are the exclusion requirements for unvaccinated children that have been in effect for Williamsburg and parts of Borough Park since December 2018. 
While DOH is lifting the exclusion requirements that have been in effect for Williamsburg and parts of Borough Park since December, the effect of the recently enacted State law ending non-medical exemptions for required vaccinations is that children enrolled in school or day care will continue to require the MMR and other vaccines unless they have a valid medical exemption. 

Multiple letters have been sent from the City and State to public and private schools, child care facilities, and parents to publicize the new standards. 

With schools on notice about the new standards, the Health Department will be rigorously enforcing against non-medical exemptions to ensure that students who can receive the vaccine have done so. 

Warning Still in Effect

The threat of measles remains. There are large outbreaks of measles in Europe and Israel, as well as in countries in South America, Africa, and Asia. To protect themselves, New Yorkers should check with their medical provider prior to international travel to make sure they are immune to measles or have been adequately vaccinated before traveling. Infants ages 6 to 11 months should also be vaccinated prior to international travel.

New Yorkers who believe they may have been exposed to measles or who have symptoms of measles should contact their health care provider by phone before seeking care to prevent potentially exposing other patients in healthcare settings.

New Yorkers can call 311 to access a list of facilities that can provide MMR vaccine at low or no cost.

The Health Department is also reminding New Yorkers about the importance of vaccines with a new ad campaign: “Don’t Hesitate. Vaccinate!” The campaign reminds parents and guardians to get their children vaccinated on time. The campaign will run online, in bus shelters, subways, and in local newspapers in English (PDF), Spanish (PDF), Yiddish, and Traditional (PDF) and Simplified Chinese (PDF). A video version of the campaign featuring Health Commissioner Dr. Oxiris Barbot will run online in English and Spanish.

“Today’s announcement that the measles outbreak is effectively over in New York City is wonderful news and could not come at a better time as students head back to school,” said Council Member Mark Levine, Chair of the Health Committee.  “This success was made possible by aggressive action on the part of DOHMH, as well as bold leadership in the Jewish communities most directly impacted by this outbreak. But our fight against the science denial fueling the anti-vaccine movement continues. Our message is clear: we implore New Yorkers to make sure they and their children are up-to-date on vaccinations.”

“I applaud the Department of Health and Mental Hygiene and community leaders for ending the measles outbreak in New York City,” said Council Member Stephen Levin. “This is great news and thanks to a close public health and community-led partnership. Williamsburg residents can now breathe a sigh of relief, but it is critical we remain vigilant. Measles is an extremely contagious disease and we need to monitor the situation closely as students go back to school. I look forward to continuing to work with stakeholders to ensure New Yorkers have comprehensive information and full access to vaccines; in the midst of ongoing measles outbreaks in the United States and abroad, we cannot be too careful.”

“The Orthodox Jewish community takes health seriously. While its vaccination rates have always been high, international travel and a close-knit, family-centered structure left our community particularly vulnerable to the measles, a highly contagious disease,” said Agudath Israel of America Chief of Staff, Avrohom Weinstock, Esq.  We needed to do more. Agudath Israel, and many other dedicated Orthodox Jewish groups and health professionals, took a lead in facilitating public access to vaccines and health information. The redoubling of the community’s efforts toward enhancing our already high vaccination rates, while conveying and implementing leading health practices, have helped end this outbreak.”   

“The measles outbreak highlights how critically important receiving timely vaccinations is to maintaining public health and underscores the vital role community health centers serve in responding to public health emergencies,” said Joseph Deutsch, Chief Executive Officer, ODA Primary Health Care Network. “We are grateful to our partners at New York City Department of Health and Mental Hygiene who worked tirelessly with our front line staff to address the current outbreak.”

Dr. Maureen Nemetski from the Jewish Orthodox Women’s Medical Association (JOWMA): “We at the Jewish Orthodox Women's Medical Association are delighted to hear that the measles outbreak in New York City is now over and are glad we were able to do our part to encourage vaccination among the Jewish community. Of course, the threat of re-emergent infections remains present, and we will remain vigilant in our efforts to promote vaccination and vaccine education. In collaboration with the NYC Department of Health and Mental Hygiene and other community partners, we will continue to work tirelessly to safeguard the health of our community and its children.”