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Confirmed case of measles in an individual visiting from Israel area prompts cautionary mode among local families.

By Jennifer Lovy

Just a few hours after David and Erin Stiebel hosted a bris for their fourth son last week, word spread through the Orthodox community that an Israeli visitor who had been to a number of local Jewish establishments and countless homes was diagnosed with measles.

Because their newborn was too young to be vaccinated, the Southfield couple was understandably concerned about this highly contagious disease. Once the Stiebels confirmed the infected individual was not at the bris, held at Yeshiva Beth Yehudah, or in the building before the ceremony, they felt less worried. Still, they had some concerns because earlier in the week David had contact with a stranger who had “a notable cough.”

Conversations with the health department and physicians eased their anxiety. David had been vaccinated for measles. There was no further reason to be concerned.

Health officials confirmed the case on Wednesday, March 13, saying the infected individual came to the area from Israel after spending time in New York. This person visited Ahavas Olam Torah Center, Congregation Ahavas Yisroel, Congregation Yagdil Torah, Dovid ben Nuchim-Aish Kodesh, Jerusalem Pizza, Kollel Institute of Greater Detroit, Mikveh Israel, One Stop Kosher Market and Yeshiva Gedolah of Greater Detroit as well as Lincoln Liquor & Rx.

Responding to the wide exposure, the Oakland County Health Department offered a measles vaccine clinic last Friday at Young Israel of Oak Park. Forty-three people, not all necessarily Jewish, received vaccinations.

Those interviewed didn’t know the identity of the man who contracted measles but said he was in town soliciting donations for a program to help high school drop-outs in Israel. Local Orthodox families often receive door-to-door solicitations, especially from international visitors.

Rabbi Daniel Arm, a coordinator with the Tzedakah Enhancement Project, vets such solicitors to confirm a cause is legitimate. Arm met with the man, researched his organization and issued him a letter stating his cause was worthy.

“This has people really nervous because this man was in almost all the local Jewish establishments, and he went door to door throughout the community. He went to places we all frequent and, truthfully, all of us could have had exposure to him during his time here,” said Michelle Faber, a pediatrician with Southfield Pediatrics and Orthodox.

Safety Issues

Measles is a highly contagious, vaccine-preventable disease spread by direct person-to-person contact and through the air. The virus can live for up to two hours after an infected person leaves, according to Dr. Carl Lauter, a specialist in infectious diseases and allergy and immunology at William Beaumont Hospital. Symptoms typically present within seven to 14 days after exposure but can appear up to 21 days later and include a rash, high fever, cough, runny nose, red, watery eyes and small white lesions in the patient’s mouth.

Those who have been vaccinated for measles or previously had the measles are not at risk for contracting the disease, but approximately 90 percent of those who have not been vaccinated and become exposed will develop it.

Faber’s pediatric office received inquiries from concerned parents, and she heard from family and friends asking for advice. Her office treats a number of Orthodox patients. She said the vast majority of them are vaccinated.

“Not everyone is vaccinated, but I have more non-Jewish, non-religious patients who are unvaccinated than I do religious patients who are unvaccinated,” she said. “Most religious leaders in the Jewish community are in favor of vaccinating.”

Lauter added there is a small percentage of sects from all religions that tell their congregants not to vaccinate, but such advice is based on misinformation. He said there is nothing in the interpretations of the Torah that say not to vaccinate.

Michigan law requires children enrolled in public or private schools, licensed day care centers and preschools to be vaccinated unless there is a medical reason for exemption. Parents who want to opt out based on philosophical or religious objections must get a waiver from their county health department; private schools can choose not to accept waivers.

Recommendations for the MMR (measles, mumps and rubella) vaccination are to administer the first dose between age 12-15 months with the second dose at age 4. Faber tells concerned parents they can vaccinate their infants as early as 6 months but any baby receiving an early first dose must get the shots again at 12 months and at age 4.

Concerned parents can give their child the second dose 28 days after the first shot. She doesn’t recommend early doses unless a child has been exposed or potentially exposed. Immuno-compromised individuals also are unable to receive the vaccination, according to Lauter.

Taking Caution

“Being cautious is important,” said Faber, who suggests unvaccinated children avoid public areas. “Otherwise, there is no reason to avoid going out.”

Still, the case has some individuals concerned. Ben Jacobovitz of Oak Park worries about his 8-month-old son being exposed if others in the community contract the disease. At press time, no secondary cases have been reported, the health department stated.

“All the festivities surrounding Purim (Thursday) such as the Megillah reading, seudahs (special Purim meals) and delivering of mishloach manot, seemed like a perfect place for this to spread,” Jacobovitz said. “I hate having to worry about something I shouldn’t have to worry about, but I am concerned the vaccination rate in our community may be less than optimal.”

He was deciding whether to vaccinate his son before his first birthday; he plans to keep him home on Purim.

Erin Stiebel was also erring on the side of caution last week when she sent her mother to One Stop — without her children — to buy treats for their mishloach manot.

Others in the community are less concerned. A Yeshiva Gedolah rabbi, preferring anonymity, said school officials are not worried the infected individual visited the yeshivah because “we have a very strong vaccination policy and everyone here — teachers and students — are vaccinated.”

A spokesperson from One Stop Kosher Market, also anonymous, said that since the grocery store was identified as one of the places of potential exposure, there has not been a decrease in business.

“People are asking questions, but we really don’t know anything more than what everyone was told. We don’t know who it was. We don’t know what time he was here. We really don’t have any more information.”

Unfortunately, cases of measles are not unknown to the Jewish community. In the fall, members of a local Orthodox family contracted the disease. And, according to the Centers for Disease Control and Prevention website, last year there were 17 measles outbreaks in the United States. Three of those outbreaks occurred in New York and New Jersey and contributed to the majority of the cases.

“Cases in those states occurred primarily among unvaccinated people in Orthodox Jewish communities. These outbreaks were associated with travelers who brought measles back from Israel, where a large outbreak is occurring,” the CDC website reported.

This year, from Jan. 1, 2019, through March 7, 2019, there were 228 confirmed cases of measles in 12 states.

Between March 2018 and January 2019, more than 3,400 people living in Israel were infected with the disease, according to the State of Israel Ministry of Health website.

In November, Erin Stiebel, also an educator at Partners Detroit, canceled a Partners’ Israel trip designed exclusively for young Jewish couples and their babies under age 1.

Six families were scheduled to participate in the 10-day trip when the number of reported measles cases became highly concerning. After monitoring the situation closely and consulting with various medical experts, they decided to cancel the trip a few days before their departure date.

“The risk was just too high for what we felt was a luxury trip to Israel,” Stiebel said.

Whenever there is word that the Orthodox community is impacted by a case of the measles, there are those who feel it puts the community in an unnecessarily negative light.

“This community is very health aware and as likely as any other population to vaccinate. From this particular story, I think we can see a beautiful part of our community and how we open our doors to complete strangers and help with donations,” said Rabbi Simcha Tolwin, executive director of Aish HaTorah Detroit.