(CNN) — Officials in Rockland County, New York, declared Wednesday that its measles outbreak is over.
The first measles case in Rockland County was identified October 1, 2018, with the last rash onset from measles identified August 13, 2019.
Since the start of the outbreak, there were 312 confirmed cases of measles in Rockland County, according to the Rockland County Health Department.
No new cases of the virus have been reported in the affected area since August 13. A measles outbreak is officially declared over 42 days after the last person infected by the disease develops a rash.
More than 80% of the cases were in people age 19 and younger, Dr. Patricia Schnabel Ruppert, the Rockland County health commissioner, said at a news conference Wednesday. The county saw acute complications with multiple hospitalizations, including care for pneumonia and preterm births.
“Since October, nearly 30,000 measles, mumps and rubella (MMR) vaccinations have been administered in Rockland County, which represents three times more than our annual baseline,” Ruppert said.
Along with the New York State Health Department and the US Centers for Disease Control and Prevention, county health officials actively monitored 1,195 people who had or were exposed to measles. People with measles or who were exposed were voluntarily quarantined.
“That number is staggering, and it shows just how hard we’ve worked over the last year,” said Rockland County Executive Ed Day.
As summer camp season approached, it was important to the county that children be able to attend, Ruppert said. Health officials reviewed 18,791 immunization records of both staff and campers, so all camps in Rockland County received their permits and opened on time. Two MMR vaccines were required for campers and camp staff.
“I want to sincerely thank our community partners, including our local hospitals, urgent care facilities, health centers and primary care providers,” Ruppert said. “This was a true team effort.”
Challenges to overcoming the outbreak
Reasons for the outbreak include people who refuse to vaccinate, anti-vaxxers and, largely, parents who “create their own immunization schedules by delaying vaccinations” — all of which leave children vulnerable to vaccine-preventable disease, according to Ruppert.
The outbreaks in Rockland County were largely among children in the Orthodox Jewish communities whose parents refused to vaccinate them. Living in clusters, which is common in the Orthodox Jewish community in New York, helps encourage measles to spread.
Of the confirmed and reported measles cases as of August 26, 91% of the people infected had either not received the MMR vaccine or had no record of receiving one. Two doses of MMR are 97% effective against measles, according to the CDC.
The state was having trouble communicating effectively with its Orthodox Jewish community about the dangers of the measles outbreak. The New York State Health Department spent tens of thousands of dollars creating and distributing measles information sheets in Yiddish to hang on the doors of more than 45,000 homes in those communities.
But the Yiddish was mangled. The effort to present important measles information to this community in different ways, such as through WhatsApp and news phone lines, came six months after the outbreak.
It wasn’t until June that New York Gov. Andrew Cuomo signed legislation that removed nonmedical exemptions from school vaccination requirements.
Another challenge to the measles crisis was anti-vaxxers who specifically targeted the Orthodox Jewish community, spreading claims that vaccines caused conditions such as autism and sudden infant death syndrome.
“Vaccines have been thoroughly tested and are safe, effective and lifesaving,” Ruppert said. “To prevent possible future outbreaks, it’s essential that all children who will receive vaccinations receive them on time.”
Rockland County health officials urged that in addition to vaccination, people should heed the CDC’s plan for travel to ensure protection against measles, which means knowing which countries are having measles outbreaks and the symptoms to watch for.
“Measles is one of the most contagious diseases on this planet,” Day said. “That has driven every decision during this outbreak, and despite setbacks, this outbreak has shown what we can accomplish with local, state and even federal levels of government when we work together.”