Friday, December 18, 2009


According to the Center for Disease Control and local sources, a mumps epidemic is quickly gaining ground in Hasidic communities in Brooklyn and upstate NY. Despite the fact that most non-hasidic Americans are vaccinated a very real danger exists that the disease will soon spread to non-hasidic and non-Jewish communities as well. The cause? Ignorance, apathy, and rabbinic malpractice.

Full story with information from the CDC after the jump. Update to the post here

How the epidemic started:
An infected Hasidic boy from Britain attended summer camp in NY.  He was what's called the "index" case. According to the CDC, 25 cases were reported at the camp.

How it spread: The majority of the campers returned to Borough Park. As of October 2009, there were 79 new cases. My physician source on the ground say there are well over 500 cases now. Four campers returned to Monsey, where a second MD source tells me over 100 cases have already been reported. According to the CDC, the disease has also been spread from contact with secondary and tertiary infections in shuls and schools to Montreal, NJ, and Kiryas Joel.

Why it will keep spreading: Mumps is an infectious disease that is "spread from person-to-person by respiratory droplets (for example, when you sneeze) or by direct contact with items that have been contaminated with infected saliva." Shuls and schools - especially boarding schools - are perfect places for the disease to spread, and because the incubation period can be as long as 21 days, there's plenty of time for one person to infect hundreds of others before he even realizes he's infected. Though there is a vaccination, my Brooklyn source estimates that 30-40 percent of the Hasidim in his community are not vaccinated. My Monsey sources says that in his neighborhood its at least 40 percent. According to both sources, many Hasidim refuse vaccinations out of apathy or ignorance: Some simply don't bother; others worry about side effects, or put stock in fully debunked theories such as "vaccines cause autism"; still others hold that its forbidden to admit a dangerous substance into their bodies (i.e. the weakened virus the is contained in the vaccine, and in some rare cases, causes an outbreak.) As a result, the Hasidic communities are especially vulnerable

Why we're all in danger: The mumps vaccine only works about 90 percent of the time, which means that for every 100 people who have received the inoculation, ten remain susceptible to the disease. Under normal circumstances, the susceptible 10 percent can rely on community immunity, which Wikipedia accurately defines as follows: "Community immunity theory proposes that, in diseases passed from person to person, it is more difficult to maintain a chain of infection when large numbers of a population are immune. The higher the proportion of individuals who are immune, the lower the likelihood that a susceptible person will come into contact with an infected individual." Those protections go out the window when your community overlaps with a community where as many as 40 percent of the people aren't vaccinated. In places like Borough Park and Monsey your odds of encountering an infected person are now greatly increased which means that, in time, the epidemic will snowball. Britain, home of the index case, has over 4000 cases of mumps. As the infected Hasidim in Brooklyn and elsewhere come into contact with non-Hasidim and non Jews more and more cases will be reported.

Why the Rabbis are responsible: Ponder this irony: You can't be admitted to a Hasidic school if your father wears a blue shirt because the administration worries that this "corruption" might spread to the other students -- yet these same schools will admit students who have not been vaccinated. Enter any charedi or hasidic shul in Brooklyn or Monsey and you're likely to see a sign, or hear a sermon, warning of the dangers of gazing at an immodestly dressed women -- yet you won't ever encounter a similar sign or sermon about health risks. Instead of worrying about what is tangible and evidence-based  (ie infectious diseases) the rabbi's prefer to inveigh about the invisible and unprovable effects of short hem lines. We hear about the dangers of  immodestly dressed women, the internet, and malls but not one word about vaccinations and other basic disease prevention steps.

In Hasidic communities, where the people generally know little about germ theory, the Rabbis are relied upon to lead and to keep their flock safe. Their word is law, and people who take it for granted that listening to the Rabbi is a recipe for health and success rely exclusively on their Rabbis when it comes to any important matter. By neglecting to demand vaccinations these all powerful Rabbis have put their communities at risk --and if you live in Brooklyn or Monsey, their lapse has put your family in danger, too.

UPDATE: Its worse than I thought. This story was in the Daily News in October, but have the Rabbis called on everyone to run and get vaccinated? No. Why the hell not?

From the Center for Disease Control:

Sullivan County, New York. On August 18, 2009, the New York State Department of Health was notified of mumps cases in a summer camp serving approximately 400 boys from the tradition-observant religious community. The index patient was a boy aged 11 years who had returned on June 17 from the United Kingdom, where a mumps outbreak is ongoing with approximately 4,000 cases, primarily in unvaccinated young adults in the general population.§ The boy became symptomatic at camp on June 28. A total of 25 cases were reported among camp attendees and staff members. The median age of patients was 12 years (range: 9--30 years), and all were male. Of the 24 patients for whom vaccination status was reported, 20 (83%) had received age-appropriate vaccination with 2 doses, one (4%) had received partial age-appropriate vaccination with 1 dose, and three (13%) were unvaccinated. The attack rate in this camp was approximately 6% (25 of 400).
Brooklyn, New York. The majority of campers were residents of the Borough Park neighborhood of Brooklyn, where mumps transmission began after their return home from camp. Although returning campers were implicated in most of the initial exposures, no predominant focus of spread was identified. By October 30, 79 additional persons from Brooklyn or other boroughs who were linked to the outbreak had been reported, exclusive of returning campers. The median age of these patients was 14 years (range: 8 months--84 years), and 81% were male. Of the 61 patients (77%) for whom vaccine is recommended and vaccination status and age were reported, 47 (77%) had received age-appropriate vaccination, six (10%) had received partial age-appropriate vaccination, and eight (13%) were unvaccinated.
Ocean County, New Jersey. On September 26, the New Jersey Department of Health and Senior Services was informed of eight suspected mumps cases in two Ocean County private schools for boys with both boarder and commuter students from the same religious community. The index patient, who became symptomatic at one of the boarding schools on September 6, was aged 20 years and a resident of the Borough Park neighborhood of Brooklyn, New York. Transmission was initially limited to the schools but subsequently was observed in households and the community. By October 30, a total of 40 cases had been reported. The median age of patients was 19.5 years (range: 1--65 years), and 83% were male. Mumps vaccination status was reported for 29 (73%) patients, of whom 28 (97%) had received age-appropriate vaccination.
Rockland County, New York. Four of the patients who had attended the Sullivan County summer camp resided in Rockland County, New York. By October 30, an additional 27 cases (exclusive of returning campers) had been reported among members of the same religious community, with transmission occurring in a variety of settings, including a school for boys. The median age of patients was 12 years (range: 1--62 years), and 23 (85%) were male. Mumps vaccination status was reported for 19 (70%), of whom 11 had received age-appropriate vaccination, and two had received partial age-appropriate vaccination.
Orange County, New York. In September, members of the same religious community in Orange County visited a synagogue in Brooklyn. During October 8--14, eight cases occurred among the travelers. The median age of patients was 18 years (range: 11--23 years), and five were male. Seven patients had received age-appropriate vaccination with 2 doses, and one was unvaccinated.
Quebec, Canada. Members of affected New York and New Jersey communities traveled to the province of Quebec to attend religious gatherings during September 19--October 11. By October 30, 15 cases (patient age range: 8--47 years) from Montreal and the Laurentian region of the province had been reported to the Public Health Agency of Canada. All patients were male, and 11 had documented vaccination with at least 1 dose of mumps-containing vaccine.

Update to the post here

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