As health officials in Ocean County are keeping an eye on a second measles outbreak to hit Lakewood, officials in Rockland County, New York, where an outbreak with 153 cases has continued since the fall, declared a state of emergency barring unvaccinated children from public places.

The declaration took effect at midnight on Wednesday and bars anyone 18 and under who is unvaccinated against measles from public places and public transit until this declaration expires in 30 days or until they receive the MMR vaccination. Children with medical exemptions are not part of the ban.

The outbreak was one of three in the region including Brooklyn, which has had 181 confirmed cases as of March 19, and Ocean County — mostly in Lakewood — with 33 cases last fall. The outbreak locations in both states are in tight-knit Orthodox Jewish neighborhoods where people were exposed to travelers who visited public places. Religious leaders in these communities have been urging families to get vaccinated and dispelling anti-vaccination concerns.

The Ocean County outbreak was considered to be over on Jan. 15 but a second outbreak was declared by the New Jersey Department of Health on March 19 with four new cases. An additional two confirmed cases brought the total to six, all in Lakewood. A possible exposure was reported in Monmouth County after a child from Lakewood was treated at Monmouth Medical Center in Long Branch.

The Rockland County declaration defined a public places as "a place where more than 10 persons are intended to congregate for purposes such as civic, governmental, social, or religious functions, or for recreation or shopping, or for food or drink consumption, or awaiting transportation, or for daycare or educational purposes, or for medical treatment. A place of public assembly shall also include public transportation vehicles, including but not limited to, publicly or privately owned buses or trains, but does not include taxi or livery vehicles."

Rockland County Executive Ed Day said the declaration was an effort to end the outbreak by protecting the health of those who cannot be vaccinated for medical reasons and children who are too young to be vaccinated. Violation of the ban is subject to a $500 fine or six months in jail although law enforcement will not be asking residents for proof of vaccination.

About 73 percent of children between the ages of 1 and 18 in Rockland County are fully vaccinated against measles, according to Day. 128 Of the Rockland County measles cases, 128 were children.

During the first Ocean County outbreak, Public Health Coordinator Daniel Regenye said the Orthodox Jewish population in Lakewood has a high vaccination rate and most of the residents are not against vaccines.

"With any population, this goes across all religions and ethnic and cultural backgrounds, whether its a Jewish, Catholic or Protestant or Caucasian or African American or Hispanic. I think there's always going to be those pockets of folks that are anti-vaccine and they believe there's natural immunity and think vaccines are unsafe," Regenye said.

A gym and a restaurant in Lakewood barred unvaccinated customers during last fall's outbreak. The gym went so far as to require proof of vaccination.

The origins of the outbreaks were traced back to people who traveled to Israel, Great Britain and Ukraine.

Contact reporter Dan Alexander at Dan.Alexander@townsquaremedia.com or via Twitter @DanAlexanderNJ

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