Adeel Hassan and Richard A. Oppel Jr.

In the first week of April, the country added 78 new measles cases, according to the Centers for Disease Control and Prevention, with Florida, Indiana, Massachusetts and Nevada confirming their first patients. Two weeks ago, the country added 73 new cases, which was the most for the year until last week.

The dozens of new infections take the count to 465 confirmed cases this year, the second-greatest number of reported cases in a year since 2000, when measles was declared eliminated in the United States.

At the current rate, the country would surpass by midyear the number of measles cases in 2014, when an outbreak among unvaccinated Amish communities in Ohio helped drive the total to 667 reported cases, the high mark for this century.

Fifteen other states have also reported cases this year: Arizona, California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Michigan, Missouri, New Hampshire, New Jersey, New York, Oregon, Texas and Washington.

Daniel Salmon, director of the institute for vaccine safety at the Johns Hopkins Bloomberg School of Public Health, cautioned against reading too much into the weekly data.

“Maybe it’s getting worse,” he said, but he emphasized that measles vaccination coverage is strong at the national and state levels — more than 90 percent of children are immunized, according to CDC tracking — which has kept the outbreaks mostly isolated to geographic and social pockets.

In Brooklyn, a large outbreak in the Orthodox Jewish community prompted New York City to declare a public health emergency Tuesday. Mayor Bill de Blasio said that the city would require unvaccinated people living in select ZIP codes in the Williamsburg neighborhood to receive the measles vaccine.

The largest outbreak has been in the northern suburbs of New York City, with 167 cases in Rockland County as of Friday.

A judge there put a hold last week on a county order that had barred children and teenagers who were not vaccinated against measles from public places. Public health experts said that they could not recall any action like what the county tried to do in recent years.

Rockland County is home to a large ultra-Orthodox Jewish community where there has been some resistance to vaccinations.

The vast majority of states allow families to opt out of getting vaccinated if they object on religious grounds.

Most of the U.S. cases since 2000 have been the result of people traveling to or from countries where measles is endemic because there is little vaccination. The outbreak in Rockland County has been traced to an annual Hasidic pilgrimage from Israel to Ukraine.

Last week, the University of California, Davis, sent letters to about 200 people warning them that they and anyone who had accompanied them to a Sacramento emergency room March 17 had encountered a “possible exposure” to the measles virus. A young girl who is believed to have contracted the virus on an overseas trip had visited the UC Davis Medical Center that day.

“At that time, we didn’t suspect that they had measles,” Dr. Dean Blumberg, the chief of pediatric infectious diseases at UC Davis Health, told KCRA-TV in Sacramento.

Officials did not realize that the girl, who was unvaccinated, had measles until two days after she visited the hospital. The girl was from Calaveras County, southeast of Sacramento.

This article originally appeared in <a href="https://www.nytimes.com/2019/04/09/us/measles-outbreak.html" id="dffd7068-94aa-3ed2-a6ca-3c1cbb2b1a04">The New York Times</a>.

Reports of New Measles Cases Reach Weekly High for 2019

There were more new cases of measles reported last week in the United States than in any other week of 2019, new government data show, with the outbreak spreading to four states that recorded their first cases of the virus for the year.

Daniel Salmon, director of the institute for vaccine safety at the Johns Hopkins Bloomberg School of Public Health, warned not to read too much into the weekly data.

“Maybe it’s getting worse,” he said, before emphasizing that measles vaccination coverage is strong at the national and state levels, and that the outbreaks were mostly isolated to geographical and social pockets.

In the United States, measles immunization is stable and high — more than 90 percent of children — according to CDC tracking.

“Getting rid of non-medical exemptions might make a little difference,” he said. “If that little bit is what it takes, then maybe it’s necessary.”

Although even that was not a panacea, he said.

Rockland County is home to a large ultra-Orthodox Jewish community where there has been some resistance to vaccinations. The outbreak has been traced to an annual Hasidic pilgrimage from Israel to Ukraine.

Most of the U.S. cases since 2000 have been the result of people traveling to or from countries where measles is endemic because there is little vaccination.

In the United States, measles immunization is stable and high — more than 90 percent of children — according to CDC tracking, but there are a small number of people in scattered pockets who remain unvaccinated.

Last week, the University of California, Davis, sent letters to about 200 people warning them that they and anyone who had accompanied them to a Sacramento emergency room March 17 had encountered a “possible exposure” to the measles virus. A young girl who is believed to have contracted the virus on an overseas trip had visited the U.C. Davis Medical Center that day.

In the first week of April, the country added 78 new measles cases, according to the Centers for Disease Control and Prevention, with Florida, Indiana, Massachusetts and Nevada confirming their first patients.

Last week, the University of California, Davis, sent letters to about 200 people warning them that they and anyone who had accompanied them to a Sacramento emergency room on March 17 had encountered a “possible exposure” to the measles virus. A young girl who is believed to have contracted the virus on an overseas trip had visited the U.C. Davis Medical Center that day.

“At that time, we didn’t suspect that they had measles,” Dr. Dean Blumberg, the chief of pediatric infectious diseases at U.C. Davis Health, told KCRA-TV in Sacramento.

4 States Report First Measles Cases of 2019 as Illness Spreads

A measles outbreak that has sickened hundreds of people continues to spread throughout the United States, new government data show, with four states recording their first cases of the virus for 2019.

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Adeel Hassan and Richard A. Oppel Jr.

Articles written by the author

Reports of New Measles Cases Reach Weekly High for 2019

Reports of New Measles Cases Reach Weekly High for 2019

Reports of New Measles Cases Reach Weekly High for 2019

4 States Report First Measles Cases of 2019 as Illness Spreads