NEW YORK - (AP) -- Officials trying to contain a measles outbreak in a county north of New York City on Tuesday ordered all unvaccinated people exposed to the disease barred from public gathering places, including houses of worship, for up to three weeks.
The order, issued by Rockland County, comes one day after New York City closed a preschool over non-compliance with measles vaccine requirements.
Both the county and city are struggling to contain a swelling number of measles cases centered in ultra-Orthodox Jewish neighborhoods while battling lawsuits over their efforts to require vaccinations.
Rockland County issued its order three days ahead of the start of Passover, when many families travel to be together and gather in synagogues.
"Need we wait for someone to die?" Rockland County Executive Ed Day said in announcing the measure.
New York City's Board of Health will vote Wednesday on whether to extend an emergency declaration last week ordering mandatory vaccinations in four Brooklyn ZIP codes.
Health officials have confirmed 329 cases of measles in the city and 184 cases in Rockland since the outbreak of the highly contagious disease began in October.
After announcing the vaccination order on April 9, the city took the step Monday of closing the preschool portion of a private Jewish school because the school had failed to turn over vaccination and attendance records.
"This is about protecting kids and it's also about protecting some adults, including pregnant women, folks who are going through medical treatment like chemotherapy, some senior with compromised health conditions," Mayor Bill de Blasio said in a TV interview . "Measles is very, very serious."
Also on Monday, a group of parents filed a lawsuit against the vaccination order, arguing it was "arbitrary, capricious, contrary to law and in violation of petitioners' rights under the United States Constitution and New York State law."
A judge in Brooklyn state Supreme Court declined to issue an injunction barring the city from enforcing the order, and the parties will appear in court Thursday.
The plaintiffs in the lawsuit are identified by their initials. Their attorney, Robert Krakow, claimed the measles-mumps-rubella vaccine "can cause many vaccine injuries, including encephalitis and death."
Medical experts have debunked those claims and proven that the vaccine is safe, but opposition to vaccines persists.
"In 2017, measles killed 110,000 people worldwide, mostly children under the age of 5," Day said in announcing the new anti-measles rules in Rockland.
Under the county's Communicable Disease and Exposure Exclusion Order, anyone either diagnosed with measles or exposed to a person who has been diagnosed with measles must stay away from indoor and outdoor places of assembly for up to 21 days. Violators could be fined $2,000 per day.
While no one in the county has died of measles, the disease has caused several hospitalizations and a premature birth.
Rockland County announced the new tactics to fight measles after an earlier order banning all unvaccinated children from indoor public places was halted by a judge. The county is appealing that ruling.
The measles cases in Rockland and in Brooklyn have been traced to unvaccinated members of the ultra-Orthodox Jewish community who traveled to Israel, where a measles outbreak is occurring.
Orthodox Jewish leaders say a small faction of vaccine opponents in the community has allowed the disease to spread.
A Yiddish-language newspaper that serves the ultra-Orthodox community in Brooklyn's Williamsburg section took the rare step last week of publishing an editorial in English excoriating those who refuse to vaccinate.
"When it's time to decide if to have a serious surgery, you don't turn to a hotlines, but you go to a conventional doctor," the editorial in Der Yid read. "When you need a referral to a good doctor for a serious health problem you don't stand at the bus stop to and take a poll of friends for the right address, but you call those devoted rabbis who understand medical matters or the recognized medical referral agencies who are familiar with the best doctors. All of them say that one must vaccinate."