Unvaccinated children have been banned from all public spaces in a New York county as the state battles its largest measles outbreak in decades.
Officials in Rockland County, about 65km from Manhattan, have declared a state of emergency to stop the spread of the disease.
Children who have not been vaccinated will not be permitted in public places, such as churches, schools and shopping centres, though outdoors spaces such as playgrounds are not included in the ban.
Hundreds of confirmed cases of measles have been reported across the state, more than 150 of them in Rockland County.
More than 82pc of patients had not received a single dose of the measles, mumps and rubella (MMR) vaccine, health officials said.
The ban will remain in place for 30 days or until the unvaccinated children receive the MMR vaccine, they added.
“We must not allow this outbreak to continue,” Ed Day, the county executive, said. “We will not sit idly by while children in our community are at risk.”
The announcement comes as outbreaks have also hit areas in California, Illinois, Texas and Washington, according to the Centres for Disease Control and Prevention. In New York City, more than 180 cases have been confirmed.
In Rockland County, data shows that the largest number of cases – 46pc – were seen in children aged four to 18. Of those, 39pc were in children younger than three.
Mr Day said the authorities will not be searching for children who are not vaccinated but are expecting parents and legal guardians to step up and get children vaccinated.
Parents and guardians who are found to be in violation will be held accountable and their cases will be referred to the district attorney’s office.
Such a violation will be considered a misdemeanour, punishable by a $500 (€444) fine or up to six months in jail.
Mr Day added that children unable to be vaccinated for documented medical reasons are exempt.
“Rockland will lead the way in service and safety to the people here,” he said.
Amid concerns about the growing incidence of measles, Rockland County tried something similar last year.
Public health officials barred unvaccinated children from attending schools with vaccination rates lower than 95pc.
Months later, the parents of more than 40 banned children at Green Meadow Waldorf School sued the county health department to allow the students to return to class.
This week, a US district court judge denied their request, ruling that it was not in the public interest to allow the children to go back to school.
Measles is highly contagious and the consequences include pneumonia, brain damage, hearing loss and even death.
Before the introduction of the vaccine in 1963, most children contracted measles, with 400 to 500 in the US dying annually. (© The Washington Post)