U.S. measles cases have surged again, and are on pace to set a record for most illnesses in 25 years.
Health officials on Monday said 555 measles cases have been confirmed so far this year, up from 465 as of a week ago.
While 20 states have reported cases, New York has been the epicenter. Nearly two-thirds of all cases have been in New York, and 85% of the latest week's cases came from the state. Most of the New York cases have been unvaccinated people in Orthodox Jewish communities.
The 2019 tally is already the most since 2014, when 667 were reported. The most before that was 963 cases in 1994.
The Centers for Disease Control and Prevention recommends that all children get two doses of measles vaccine.
New York City Mayor Bill de Blasio declared a public health emergency last Tuesday amid the worst outbreak in New York City since 1991.
The declaration came the day after the New York City Health Department ordered all ultra-Orthodox Jewish schools in a neighborhood of Brooklyn to exclude unvaccinated students from classes during the current measles outbreak.
The health department previously said that any yeshiva in Williamsburg that does not comply will face fines and possible closure.
The emergency order, which will take effect immediately, states that people living in four zip codes in Williamsburg — 11205, 11206, 11211 and 11237 — must get vaccinated or face fines up to $1,000.
New York City was not the only location that implemented an emergency order.
Rockland County Executive Ed Day enacted a 30-day order on March 26 that banned unvaccinated people under 18 from gathering places including schools, stores and churches.
A state judge issued a preliminary injunction against the county's emergency order April 5.
Supreme Court Justice Rolf Thorsen ruled in favor of several dozen parents challenging Day's order, part of efforts to stop a measles outbreak that has infected more than 165 people people since October.
Civil rights lawyer Michael Sussman called Day's action "arbitrary and capricious."
Officials in Rockland County plan to appeal a judge's order that lifted the ban on unvaccinated children in public places.
New York Gov. Andrew Cuomo has since weighed in on the measles outbreak saying legislation that would end the ability of parents to object to vaccinations for their children on religious grounds is "legally questionable."