April 9, 2019/אור לה' ניסן תשע"ט

Dear Community Members:

As indicated in our communication of April 7, there has been one confirmed case of measles in our community.  Since then, representatives of the Vaad HaRabbonim, Hatzalah, our community’s schools, physicians, the leadership and infectious disease team at Sinai/Lifebridge, and State, City and County Health Departments have been working diligently to develop community guidance and a strategy to avoid spread of the disease.  We note again that the medical professionals and governmental officials emphasized that while our community should exercise caution, at this time we have one documented case, not an outbreak – much less an epidemic - of any kind in our community.

Today, the Maryland Department of Health released an information sheet regarding measles and the current situation.  We would like to highlight the following specific action points for the focused attention of all the members of our community.

• If you think you have been exposed to measles, immediately call your doctor - before showing up in the waiting room - and let him or her know that you have been exposed to someone who has measles. Your doctor can determine if you are immune to measles based on your vaccination record, age, or laboratory evidence, and make special arrangements to evaluate you, if needed, without putting other patients and medical office staff at risk.

If you are not immune to measles, MMR vaccine or an antibody preparation called immune globulin, given during the first days following exposure, will help reduce your risk of developing measles. Your doctor can help to advise you, and monitor you for signs and symptoms of measles.

• No preventive treatment is needed for exposed healthy persons who have documentation of two doses of MMR vaccine administered on or after the first birthday and given at least 28 days apart.

The Health Department has made specific recommendations for people who might be at increased risk of measles exposure, including people planning to travel to areas with measles outbreaks or who might have contact with visitors from these areas.  Please note that - especially in the light of recent patterns of outbreaks in other Orthodox communities, and because of the extensive travel and close contact between communities – we consider the entire Orthodox community at increased risk and should as such follow these recommendations.

• Children under 6 months old:  At this age, they are too young to be vaccinated.  take every precaution to keep them away from areas with measles outbreaks or from under-vaccinated individuals from those areas.

• Children 6-11 months old: Give an initial MMR vaccine to children 6 months through 11 months of age to help protect them against measles. These children must be revaccinated when they are 12 through 15 months old and again when they are 4 through 6 years of age.  

• Children 1-3 years old: Give a second dose of MMR vaccine to children 1 year through 3 years of age who have already received their first MMR vaccine, as long as 28 days have passed since the first MMR vaccine was given to them.  This will count as the second MMR for school admissions.

Please note that all of these recommendations should be discussed with and implemented by your child's pediatrician.

• Pregnancy:  Most pregnant women have been vaccinated with two doses of MMR prior to pregnancy, and can consider themselves safe.  For those who have not received both vaccinations who are pregnant or approaching pregnancy, please consult your physician and the detailed Department of Health information sheet.

• ADULTS:  Adults born after 1957 and before 1989, who have likely only received 1 dose of MMR vaccine, should receive a second dose of vaccine. To accomplish this, you may contact your physician who can administer the vaccine or write a prescription that you can bring to a pharmacy that administers the vaccine.

Please note that this recommendation is extremely significant, and has been shown to be most important in combating the spread of the disease in the Detroit area.  

As such, we encourage all adults of this age group to get their second MMR.  To facilitate this, we are working closely with the Baltimore City Health Department, with the critical help of Lifebridge Sinai, to conduct a community MMR clinic for adults.  We expect this will be held before the end of the week; details will be forthcoming very shortly.

We will continue to communicate with you as plans for the MMR clinic are clarified, and as we receive guidance from the health professionals.

We pray that HKB”H continue to watch over all of us.

Vaad HaRabbonim of Baltimore

Hatzalah of Baltimore

Bais Yaakov of Baltimore

Bnos Yisroel of Baltimore

Cheder Chabad of Baltimore

Cheder D’Kahal Chassidim

JEWELS School

Ner Israel Rabbinical College

Ohr Chadash Academy of Baltimore (OCA)

Yeshivas Chofetz Chaim/Talmudical Academy of Baltimore

Yeshivas Kochav Yitzchok/Torah Institute of Baltimore

Yeshivas Toras Simcha of Baltimore