Measles Cases Surge in New York, Officials Believe Numbers Are Underreported

With measles cases increasing according to the New York State Department of Health, officials in Otsego and Seneca counties suspect the actual outbreak is larger than the current count reflects.

County officials shared with Gothamist their concerns that numerous cases remain unreported in their regions, where unvaccinated communities are seeing rapid disease transmission.

As of October 10, the state has confirmed 126 measles cases, which includes eight new cases reported last week, according to the Department of Health website.

This data stems from reports made by local health departments. The rapid spread of the disease in rural areas prompted Governor Kathy Hochul to declare a disaster emergency last week, allowing for expanded testing and vaccination efforts.

Scott King, public health director in Seneca County, pointed out that “looking at case counts can be a little deceiving.” His county’s dashboard shows 22 reported cases of measles this year.

King noted that “cases can jump at a moment’s notice,” explaining that when interviewing an infected individual, they might reveal that their family members also had symptoms. He believes it’s common to find entire families affected in communities where vaccination rates are low. While county health workers are attempting to verify additional cases by interviewing those who test positive, cooperation from all households isn’t guaranteed.

“We’re facing some situations right now involving potential cases and numerous people exposed, and the spread continues,” King added.

Measles, categorized as highly contagious, often presents with a rash along with cold-like symptoms such as fever, watery eyes, and a runny nose. In severe instances, it can lead to serious complications like encephalitis, hospitalization, or even death.

The Department of Health has not released demographic details regarding the outbreak. However, state Health Commissioner James McDonald mentioned at a recent public health meeting that around two-thirds of confirmed cases at that time involved unvaccinated adults.

Heidi Bond, public health director for Otsego County, mentioned that their dashboard shows 21 confirmed measles cases, all among unvaccinated individuals, primarily adults. She stated that the county’s assistant public health director has been going door-to-door to offer the measles, mumps, and rubella vaccine in affected areas.

Yet, she remarked that “most people we’ve spoken to have already been affected by measles themselves or within their families, leading them to think, ‘We don’t need the vaccine since we’ve already been sick.’”

Bond noted that the focus has shifted to finding individuals who are unvaccinated and haven’t been exposed to measles, as well as convincing those who have already fallen ill that it’s still important to receive the MMR vaccine for protection against mumps and rubella. Since July, the state health department has administered over 1,200 MMR shots in rural communities.

Outreach to Under-Vaccinated Communities, Including the Amish

Torah Bontrager, executive director of the Amish Heritage Foundation, indicated that Amish residents in upstate New York have been getting sick. Upstate Mennonites and other Anabaptist communities who may be reluctant about vaccines are also at significant risk. Measles outbreaks have previously occurred in under-vaccinated Amish communities in Pennsylvania and Ohio. Some New York counties experiencing cases also have substantial Amish populations, including Seneca and Otsego.

Bontrager shared her experience of growing up in a strict Amish community where she did receive vaccinations, unlike some Amish New Yorkers today who resist vaccines, facing fines from health authorities for not complying with school vaccine mandates.

However, state and local health officials in New York have refrained from confirming whether Amish communities are significantly impacted by the current measles outbreak. “We’re not naming the community, just really saying it is an under-immunized community,” Bond noted.

King echoed similar sentiments, stating, “We don’t want to marginalize or stigmatize any particular community, whether Amish or otherwise. But there is a group within our county that is getting sick, and we are targeting that community with information about the disease as best we can.”

His office initiated an at-home vaccination program last year in Seneca County, which scaled up when initial reports of measles emerged over the summer. King mentioned they’ve distributed 139 doses of the MMR vaccine this year, with most given after June—five to six times more than the previous year.

He also noted that some individuals from the affected communities approached the county seeking vaccinations as illness began spreading. In their outreach, health officials are providing vaccines on porches and sharing safety information, like the importance of isolating if feeling unwell, through flyers in local businesses and during community events. Midwives working with these communities are also sharing disease information.

While he didn’t explicitly link Amish residents to the outbreak, King remarked on their integral role in Seneca County. “They’re our friends and neighbors,” he said. “We want them to be healthy. They want to be healthy. We all have the same goals.”

Bontrager expressed her mixed feelings regarding health officials’ reluctance to acknowledge the spread of measles in Amish communities. “If you’re going to an Amish farm or business, you should know that the risk is higher there,” she added, suggesting that information would be crucial for parents with unvaccinated infants.

Ellen Hey, chief clinical officer for Finger Lakes Community Health, stated that the high-risk population in upstate includes both Amish and Mennonite residents, along with unvaccinated individuals beyond these communities. She indicated that there’s significant interaction among these groups, which facilitates virus transmission.

The measles outbreak coincides with some Amish New Yorkers’ efforts to challenge New York’s strict school vaccine regulations.

Data shows that while vaccination rates among 2-year-olds vary widely across counties, it rises above 97% for kindergarteners once school mandates are enforced, according to federal sources.

Just before Hochul announced the measles outbreak as a state disaster emergency, a group of Amish New Yorkers filed a second petition to the Supreme Court challenging the state’s vaccine requirements, which do not permit religious exemptions.

In a handwritten letter signed by several representatives, a plaintiff stated, “Our Almighty God wants us to fully put our faith and trust in Him. Which is in conflict to put our trust in vaccines.” They expressed regret for the issues caused to the state, stating, “We, as a peace-loving religious group, are sincerely sorry that we are causing the state a prob [sic].”

Previously, lower courts upheld the elimination of religious exemptions in New York.