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farm




 
 
    
 

Post Tue, May 21 2013, 11:16 am
Update on Measles in New York City

1) 34 cases of measles have occurred in Borough Park and Williamsburg, Brooklyn. Additional cases will likely occur, because a large number of children and adults have been exposed to infectious cases.
2) Providers are reminded to consider the diagnosis of measles in clinically compatible cases, immediately report and isolate suspect cases, and vaccinate children and adults.
3) Children need to receive their first dose of MMR vaccine at 12 months of age. Older unvaccinated children should be immunized immediately.

Distribute to All Primary Care, Infectious Disease, Emergency Medicine, Internal Medicine, Pediatrics, Family Medicine, Laboratory and Infection Control Staff


Dear Colleague,

The measles outbreak in Brooklyn is continuing to grow. To date, there have been 34 confirmed cases, including 27 in Borough Park and 7 in Williamsburg. Additional suspected cases are being investigated. All cases are part of the Orthodox Jewish community and were unvaccinated at the time of exposure, including 5 cases too young to have been vaccinated, 23 cases who refused vaccine, and 6 cases whose vaccines were delayed. Cases range in age from 0 to 32 years (median 7 years), including 5 infants, 21 children, and 8 adults. Complications have included pneumonia, a miscarriage, and two hospitalizations. Measles is highly contagious. We have identified over 700 people who have been exposed, predominantly in health-care settings. Home isolation is required for up to 21 days for exposed persons without evidence of immunity to prevent further exposures. To interrupt the spread of measles in your community, we ask for your assistance regarding reporting, isolation, prophylaxis, te sting, and vaccination.
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Mimisinger




 
 
    
 

Post Tue, May 21 2013, 11:24 am
Why are people not vaccinating?????????????????

I understand people don't do it, but is the Brooklyn Ortho community such natural minded people? I don't think so. Why don't they vax?
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flowerpower




 
 
    
 

Post Tue, May 21 2013, 11:30 am
My neighbors whole family and their kids don't believe in modern medicine, vaccinations, and doctors. One mom had a miscarriage due to the measles. A few kids had it too including a little toddler. A few newborns who live near them had to get some treatment in the hospital because they were exposed. The mothers were mad. Its not right.
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paprika




 
 
    
 

Post Tue, May 21 2013, 11:32 am
Mimisinger wrote:
Why are people not vaccinating?????????????????

I understand people don't do it, but is the Brooklyn Ortho community such natural minded people? I don't think so. Why don't they vax?


Brooklyn consists of more than 34 people. Actually it could even be just 1 or 2 families. 1 grandmother that has 8 children who all have approximately 3 or 4, give or take for each family, and you already have 34 people.
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Cookies n Cream




 
 
    
 

Post Tue, May 21 2013, 11:37 am
paprika wrote:
Mimisinger wrote:
Why are people not vaccinating?????????????????

I understand people don't do it, but is the Brooklyn Ortho community such natural minded people? I don't think so. Why don't they vax?


Brooklyn consists of more than 34 people. Actually it could even be just 1 or 2 families. 1 grandmother that has 8 children who all have approximately 3 or 4, give or take for each family, and you already have 34 people.


It's not one or two families. I know of 4 families offhand (that are not related) that were affected. They total 6 of the cases.
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paprika




 
 
    
 

Post Tue, May 21 2013, 11:41 am
Cookies n Cream wrote:
paprika wrote:
Mimisinger wrote:
Why are people not vaccinating?????????????????

I understand people don't do it, but is the Brooklyn Ortho community such natural minded people? I don't think so. Why don't they vax?


Brooklyn consists of more than 34 people. Actually it could even be just 1 or 2 families. 1 grandmother that has 8 children who all have approximately 3 or 4, give or take for each family, and you already have 34 people.


It's not one or two families. I know of 4 families offhand (that are not related) that were affected. They total 6 of the cases.

It's so highly contagious, and not all family members are getting the disease? Only one or 2 in a family?
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Cookies n Cream




 
 
    
 

Post Tue, May 21 2013, 11:58 am
In three of the families that I know, the whole family was vaccinated and therefore had immunity. (The affected child was not, becase they were not of age yet.) And in the fourth family, three family members got it. Two of them were not vaccinated, and for some reason the third obviously did not have immunity, although she was vaccinated.
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Mimisinger




 
 
    
 

Post Tue, May 21 2013, 12:04 pm
Why is it that we keep hearing of measles in Brooklyn? You don't hear about measles outbreaks anywhere else. Why is that? Am I really just not up on the news coming out of North Dakota, or is there somethign truly ridiculous about Brooklyn (more than the usual).

I am particularly upset, because I was frantic before I got my baby vaccinated. Ordinarily, we rely on herd immunity, but we can't in the frum world. Not, if so many people get it. If I go to Brooklyn to go shopping or whatever, there's a real chance to catch it.
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Cookies n Cream




 
 
    
 

Post Tue, May 21 2013, 12:05 pm
Mimisinger wrote:
Why is it that we keep hearing of measles in Brooklyn? You don't hear about measles outbreaks anywhere else. Why is that? Am I really just not up on the news coming out of North Dakota, or is there somethign truly ridiculous about Brooklyn (more than the usual).

I am particularly upset, because I was frantic before I got my baby vaccinated. Ordinarily, we rely on herd immunity, but we can't in the frum world. Not, if so many people get it. If I go to Brooklyn to go shopping or whatever, there's a real chance to catch it.


Not necessarily, it was actually brought in from overseas.
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farm




 
 
    
 

Post Tue, Jun 04 2013, 10:39 am
Today's update:

ALERT # 15: Update on Measles in New York City: New Vaccine Recommendations

1) 48 cases of measles have occurred in the Orthodox Jewish community residing in Borough Park and Williamsburg, Brooklyn.
2) Because measles cases continue to occur, particularly among young infants, healthcare providers should now administer the first dose of MMR vaccine to all Orthodox Jewish children aged 6 months and older living in Borough Park, Williamsburg, and Crown Heights.

Distribute to All Primary Care, Infectious Disease, Emergency Medicine, Internal Medicine, Pediatrics, Family Medicine, OB/GYN, Laboratory and Infection Control Staff


Dear Colleague,

There continues to be ongoing measles transmission among the Orthodox Jewish communities in Borough Park and Williamsburg, Brooklyn. To date, there have been 48 confirmed cases, including 28 in Borough Park and 20 in Williamsburg. Additional suspected cases are being investigated. In recent weeks, cases have begun occurring in younger children. During the past month, the median age of cases has declined to 2 years (age range 10 months – 17 years) with 19% aged less than 12 months, 52% aged 12 months to 4 years, and 29% aged 5 – 18 years. All cases were in persons who were unvaccinated at the time of exposure, because they were too young to have been vaccinated or because their parents delayed or refused vaccine for their children. Over 2,000 identified people have been exposed to measles in households (through relatives or friends), apartment buildings, and medical provider offices.

Measles transmission has been sustained by two factors: a large pool of susceptible children under 12 months of age and large family and communal gatherings. To interrupt the spread of measles in this community, the Health Department recommends that the first dose of measles-mumps-rubella-vaccine (MMR) now be given at 6 months of age to all Orthodox Jewish children living in Borough Park, Williamsburg, and Crown Heights. Although cases of measles have not yet been identified in Crown Heights, we are extending this recommendation to this community to prevent introduction of measles. Further, non-Orthodox children receiving medical care in practices that serve predominantly Orthodox Jewish patients, should also receive MMR vaccine beginning at 6 months of age because of the increased risk of exposure.

A dose of MMR vaccine given prior to the first birthday (there is a 4 day grace period) will not be considered a valid dose in the Citywide Immunization Registry (CIR) or for daycare or school entry. Infants who receive MMR vaccine before their first birthday should receive an additional dose at 12 months of age as long as 28 days have passed after the initial vaccine dose. These children will still require a ‘second valid’ dose prior to school entry at 4 – 6 years of age.

In the setting of this outbreak, Orthodox Jewish children aged 12 months and older living in Borough Park, Williamsburg, and Crown Heights who have received their first dose of MMR should receive their second MMR dose now, as long as 28 days has elapsed after the first dose. This second dose will be considered valid and will count toward the school immunization requirements.

Vaccination at an earlier age is recommended by the Centers for Disease Control and Prevention for outbreak control when many cases are occurring among infants <12 months of age. This will increase the proportion of infants who are protected against measles. Ninety five percent of infants who were 6 months old at the time of vaccination demonstrated a response to the vaccine as measured by cell mediated immunity and/or seroconversion (Gans et al. JID 2004;190:83-90). The same study documented that an infant’s ability to respond to a second dose of MMR is not compromised by early administration of vaccine. MMR vaccination of children 6 – 11 months of age who will be traveling overseas is already a routine Advisory Committee on Immunization Practices recommendation and is considered safe.

Providers who need additional MMR vaccine should place an order with the Vaccines for Children (VFC) Program through the Online Registry as per current procedures. Practices in the affected neighborhoods will be able to order the quantity of vaccine required to implement this recommendation. For questions or assistance with ordering VFC vaccine, please call 347-396-2400. Providers will need to purchase additional vaccine for their privately insured patients. The Health Department will communicate with the New York State Insurance Department to prevent problems with insurance claims. If you have trouble with reimbursement, please notify the Bureau at the number above or by e-mailing nycimmunize@health.nyc.gov.

Information about reporting suspect cases of measles, laboratory testing, isolation of suspected or confirmed cases, or post-exposure prophylaxis recommendations have been previously sent and are available at http://www.nyc.gov/html/doh/ht.....shtml

Please call DOHMH if you have questions at 347-396-2402 (weekdays 9-5pm) or 212-764-7667 (after hours and weekends). Your cooperation is appreciated


What a chillul Hashem Sad
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gp2.0




 
 
    
 

Post Tue, Jun 04 2013, 11:03 am
Why is it a chillul hashem? What I'm seeing here is that because these places have many more babies than any other community, they have many more unvaccinated people.

ETA: and BH lots of simchos which is where so many people can be exposed at once.
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amother


 

Post Tue, Jun 04 2013, 11:28 am
Quote:
Ninety five percent of infants who were 6 months old at the time of vaccination demonstrated a response to the vaccine as measured by cell mediated immunity and/or seroconversion (Gans et al. JID 2004;190:83-90). The same study documented that an infant’s ability to respond to a second dose of MMR is not compromised by early administration of vaccine. MMR vaccination of children 6 – 11 months of age who will be traveling overseas is already a routine Advisory Committee on Immunization Practices recommendation and is considered safe.

I'd love a link to the above study. Anybody?
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amother


 

Post Tue, Jun 04 2013, 11:36 am
I just though of something after reading this thread. I am pregnant, B"h, but it was a long and difficult journey of IVF. We don't live in BP, but are planning on going in for Shabbos to visit family. I will check that the children in the family are immunized, but should I be nervous about going in? I know there's only so much hishtadlus you can do, but this pregnancy is too precious to me to take any risks...
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Cookies n Cream




 
 
    
 

Post Tue, Jun 04 2013, 11:38 am
amother wrote:
I just though of something after reading this thread. I am pregnant, B"h, but it was a long and difficult journey of IVF. We don't live in BP, but are planning on going in for Shabbos to visit family. I will check that the children in the family are immunized, but should I be nervous about going in? I know there's only so much hishtadlus you can do, but this pregnancy is too precious to me to take any risks...


Take a blood test to see if you have immunity.
If you have immunity,there's no reason to worry.
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amother


 

Post Tue, Jun 04 2013, 11:43 am
Cookies n Cream wrote:
amother wrote:
I just though of something after reading this thread. I am pregnant, B"h, but it was a long and difficult journey of IVF. We don't live in BP, but are planning on going in for Shabbos to visit family. I will check that the children in the family are immunized, but should I be nervous about going in? I know there's only so much hishtadlus you can do, but this pregnancy is too precious to me to take any risks...


Take a blood test to see if you have immunity.
If you have immunity,there's no reason to worry.

And if you are vaccinated (or have had the disease itself), you "should" be immune. Vaccines work, don't they?
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amother


 

Post Tue, Jun 04 2013, 11:46 am
amother wrote:
Cookies n Cream wrote:
amother wrote:
I just though of something after reading this thread. I am pregnant, B"h, but it was a long and difficult journey of IVF. We don't live in BP, but are planning on going in for Shabbos to visit family. I will check that the children in the family are immunized, but should I be nervous about going in? I know there's only so much hishtadlus you can do, but this pregnancy is too precious to me to take any risks...


Take a blood test to see if you have immunity.
If you have immunity,there's no reason to worry.

And if you are vaccinated (or have had the disease itself), you "should" be immune. Vaccines work, don't they?


It is people like you that I am scared of. Vaccines are not guaranteed to last forever, there is a principle of herd immunity, and if a mild strain enters my body I will be okay, but my unborn baby who is not vaccinated may not be okay.
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amother


 

Post Tue, Jun 04 2013, 11:48 am
amother wrote:
amother wrote:
Cookies n Cream wrote:
amother wrote:
I just though of something after reading this thread. I am pregnant, B"h, but it was a long and difficult journey of IVF. We don't live in BP, but are planning on going in for Shabbos to visit family. I will check that the children in the family are immunized, but should I be nervous about going in? I know there's only so much hishtadlus you can do, but this pregnancy is too precious to me to take any risks...


Take a blood test to see if you have immunity.
If you have immunity,there's no reason to worry.

And if you are vaccinated (or have had the disease itself), you "should" be immune. Vaccines work, don't they?


It is people like you that I am scared of. Vaccines are not guaranteed to last forever, there is a principle of herd immunity, and if a mild strain enters my body I will be okay, but my unborn baby who is not vaccinated may not be okay.


I have to add: do you want to take responsibility for injuring or killing my baby?
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amother


 

Post Tue, Jun 04 2013, 11:49 am
Cookies n Cream wrote:
amother wrote:
I just though of something after reading this thread. I am pregnant, B"h, but it was a long and difficult journey of IVF. We don't live in BP, but are planning on going in for Shabbos to visit family. I will check that the children in the family are immunized, but should I be nervous about going in? I know there's only so much hishtadlus you can do, but this pregnancy is too precious to me to take any risks...


Take a blood test to see if you have immunity.
If you have immunity,there's no reason to worry.


Thank you, that's a good idea. I will make an appointment at the doctor.
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amother


 

Post Tue, Jun 04 2013, 11:56 am
amother wrote:
amother wrote:
Cookies n Cream wrote:
amother wrote:
I just though of something after reading this thread. I am pregnant, B"h, but it was a long and difficult journey of IVF. We don't live in BP, but are planning on going in for Shabbos to visit family. I will check that the children in the family are immunized, but should I be nervous about going in? I know there's only so much hishtadlus you can do, but this pregnancy is too precious to me to take any risks...


Take a blood test to see if you have immunity.
If you have immunity,there's no reason to worry.

And if you are vaccinated (or have had the disease itself), you "should" be immune. Vaccines work, don't they?


It is people like you that I am scared of. Vaccines are not guaranteed to last forever, there is a principle of herd immunity, and if a mild strain enters my body I will be okay, but my unborn baby who is not vaccinated may not be okay.

Umm... what? Do you even KNOW what you're talking about? Unless you are in the really early stages of pregnancy, your immunity=your baby's immunity.http://en.wikipedia.org/wiki/Passive_immunity
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seeker




 
 
    
 

Post Tue, Jun 04 2013, 11:58 am
As if there wasn't enough to worry about giving the vaccine at 18 months, now we need to worry about giving it to 6-month-olds. Great.

The cynic in me suspects that people have not been taking isolation seriously enough. Come on, how much of a social life do most under-twos have that it spread to so many babies? As soon as a case comes to light, everyone who they know was in contact with them and does not have immunity should be quarantined immediately, regardless of how inconvenient it is for the parents, until it is clear they were not infected. Even if a baby's whole daycare got exposed before it was realized that they had it, that would only be maybe 10 babies.

I'm OK with individual choices in vaccination BUT it has to come along with that responsibility of going the extra mile to keep your kids isolated. If you don't mind your kid getting measles, then at least keep them away from others once they've been exposed. I think in the broader crunchy/non-vax community this is understood, but I suspect that in the demographic in question there may be more doing it because their sister-in-law/cousin/neighbor/whatever does, without a personal understanding of the mechanics involved.
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