From Ukraine and Israel to the United States, the global measles journey



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The origin of the measles epidemic in the United States is not mysterious: the virus arrived by plane, transported by some travelers who captured it in Israel and Ukraine and transmitted in their communities where many did not or sub-vaccinated.

Of the 555 US cases registered since January 1, most come from two areas: New York and a small township near Portland, in the northwestern corner of the United States, in Washington state.

In New York, the Brooklyn Orthodox Jewish community was the first to be hit, via Israel.

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Travelers returned from Israel throughout the fall with the virus and spread it to schools, synagogues and the community, for unvaccinated children or for those who did not receive booster, recommended between 4 and 6 years of age. The reasons are diverse, from the difficulty of following the schedule of vaccination to anti-vaccine distrust.

In addition to Brooklyn, the Orthodox community of Rockland County, upstream of the Hudson, was also affected: nearly 200 patients again contaminated by travelers returning from Israel.

Only one man is responsible for transferring the epidemic to 1,000 km away. Returning from Israel in November, he drove from Brooklyn to Detroit, unknowingly ill, creating a new home for 39 patients while visiting homes, synagogues and kosher businesses in this Michigan city. , a route drawn in the Washington Post on Tuesday.

For Clark County in Washington, the origin is Ukrainian and targets the Russian-Ukrainian and Ukrainian communities.

A first child brought measles from Ukraine in December, and like a spark in a haystack, the virus spread rapidly, affecting 74 people, mostly children, via schools, supermarkets or a bowling alley.

"This child lived in a pocket of children who were not vaccinated by choice, that's how it started," says Scott Lindquist, a state epidemiologist. "We analyzed the DNA" of viruses, he says. "They all come from the Ukrainian stock."

One theory links even the two tensions: the virulent Ukrainian epidemic would have fueled Israel's most moderate, starting in September 2018, Patrick O & # 39; Connor of the World New York Times.

Ultra-Orthodox Jews travel to Uman, Ukraine, on Rosh HaShana, from Ben Gurion Airport on September 5, 2018. (Avi Dishi / Flash90)

One theory even attributes an accelerator role to Rosh Hashanah's great Hasidic pilgrimage in September in Uman, Ukraine, which would have exploded the number of cases in Israel … and indirectly contributed to the American epidemic.

Sub-vaccinated pouches

"All cases of measles in the United States come from other countries," says AFP Nancy Messonnier, who is responsible for the epidemic response at the Centers for Disease Control and Prevention (CDC), the government's armed health arm. federal.

The number of American cases is low compared to other countries in Africa and Europe, which are experiencing a real outbreak with tens of thousands of patients. Ukraine has already had more than 30,000 patients and 11 deaths since January.

If no American has recently died of measles, authorities are alarmed by the trend: at this rate, 2019 will be the worst year since 2000 when measles was declared eliminated in the United States.

A nurse is preparing the measles, mumps, and rubella vaccine at the Rockland County Health Department in Haverstraw, Rockland County, New York. Illustration. (Credit: Johannes Eisele / AFP)

In recent years, the highly contagious disease has spread to relatively closed communities, "pockets" where the vaccination rate was below the very good national average of more than 90%: the Ohio Amish in 2014, the Somalis of Minnesota in 2017, the Russian speakers from Washington and the Orthodox Jews of New York.

Nancy Messonnier estimates that three quarters of the patients for five years belonged to communities with close ties. According to her, the challenge is to find the "good messenger" to encourage parents to vaccinate their children.

In Clark County, local authorities excluded 849 unvaccinated students from 15 schools where children had measles. "We have had no more cases for nearly 42 days," said Scott Lindquist, who will shortly announce the end of the epidemic and noted an unexpected effect of the uproar: the number of vaccinations has more than doubled so far. year by year.

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