How one county scrambled to keep America measles-free

What follows is the previously unreported story of how a suburban health department at the epicenter of a national health crisis brought the outbreak under control, in the face of campaigning by people who oppose vaccination. It is based on interviews with more than a dozen health officials, medical experts and local residents.

Measles, which causes a rash, fever and coughing, can be fatal and lands up to 20% of Americans who catch it in the hospital. It afflicted millions of Americans every year before a vaccine became available in 1963. The vaccine is 97% effective with two doses and helped the United States eliminate the disease in 2000, according to the World Health Organization (WHO), which says measles is wiped out if there is no continuous, endemic transmission for 12 months.

The Rockland County case was one of two major U.S. outbreaks last year – the other, in Brooklyn, started a day earlier. Both put the United States on the clock. If they weren’t halted within 365 days, either could have cost America its WHO-certified measles-free status – damaging its reputation as a developed country with an effective public healthcare system.

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