20 March 28 • 2019 jn ROCHEL BURSTYN CONTRIBUTING WRITER A vi Cohen, 23, of Oak Park has the measles, confirmed Monday evening. He is among the 10 additional cases confirmed after March 22, bringing the total to 18 at press time, according to the Oakland County Health Division (OCHD). He’ s also one of the three of 100 peo- ple who get the required two doses of measles vaccine who will still get measles if exposed to the virus, according to the Centers for Disease Control. Avi received both his MMR shots on schedule when he was a child. He gave the JN his vacci- nation records as proof. Avi and his wife, Debbie, first became concerned when they realized their son, Reuven, 2, had been in a synagogue with his grandfather the same time as some- one wth the measles. And Reuven had been running a fever that week although he was diagnosed with an ear infection and began a round of antibiotics. Avi and Debbie were extra cautious after his exposure, so they had Reuven swabbed for measles and split their fam- ily last week for Shabbat, each taking a child to their respective parents’ home. By March 18, however, Avi had devel- oped a cough and fever and felt pro- gressively worse. Meanwhile, Reuven’ s measles test came back negative. “ Avi had both his immunizations so they weren’ t even so worried about him getting the measles. They believed he was immune, ” said his mother, Ita Leah Cohen of Birmingham. “We were just worried about my grandsons, especially the new baby [5-week-old Uriel]. ” On March 20, Debbie took Reuven back to the doctor, and he was diagnosed with a double ear infection. On Purim day, Avi woke in so much pain he couldn’ t even open his eyes. Debbie rushed him to the Emergency Room at Beaumont Royal Oak. If they had suspected the measles, they would have avoided going anywhere, she says. They told doctors Avi had been exposed to measles, but he was fully vaccinated. The Beaumont doctors did not sus- pect measles either. They checked Avi’ s medical records, saw he’ d been immu- nized appropriately, yet did a swab test anyway. They also did lung and chest X-rays, found nothing and said he must have “an upper-respiratory virus, ” Debbie says. They sent him home. On March 22, Reuven’ s fever reap- peared so Debbie took him to the doctor. As she was leaving, Avi called and told her he’ d broken out with a suspicious rash over his entire body. In a panic, Debbie told the doctor, who advised her to contact OCHD immediately. On Saturday, March 23, OCHD came to their house, swabbed the entire family and gave out extra vaccinations to extended family members. Debbie, Avi and Reuven were all up to date on their immunizations. They also gave Uriel immune-globulin (Ig) to boost his immune system because he is too young to get a live vaccine. Uriel moved to Debbie’ s parent’ s home temporarily while she cared for Avi and Reuven at home. In the meantime, the entire family and extended family (who had been in contact with Avi and Reuven) tested negative. Avi, however, was quarantined until Wednesday. Debbie has no symp- toms, but she remained home, too, just in case. “I see my husband is in so much pain, and I don’ t want to pass that on to anybody. ” Avi teaches at Farber Hebrew Day School, where Reuven also attends, which is why Farber appeared on OCHD’ s official list of places that had possible measles exposure. Yet Avi was not in school while contagious, accord- ing to an email sent by Head of School Rabbi Scot Berman. CAUTION AND NO BLAME It is likely most people at ground zero — the Orthodox communities in Oak Park and Southfield — have been exposed because of the widespread locations OCHD cited as possible exposure spots. An update from the OCHD Monday listed more sites, including a few locations in West Bloomfield and Farmington Hills. (Go to oakgov.com/ health for updates). The OCHD says vaccination is effective within 72 hours of exposure. High-risk individuals can receive immune-globulin (Ig) treatment with- in six days of exposure. The measles are being traced to a visitor from Israel, by way of New York, who came to soliticit donations throughout the Orthodox community. He was diagnosed March 13. Ita Leah Cohen said Avi’ s case proves immunizations are not 100 percent effective all the time. So, she plans to keep her younger kids home from school until the outbreak is over, even though they’ re immunized. “People who have had only one dose of MMR (particularly those vaccinated from 1957-1985) need to verify if they received a second dose, ” said Phyllis Meer, RN, BSN, CPNP . “If they don’ t have proof of two doses or a blood titer proving immunity, they must get another dose to boost their immunity. ” Ita Leah went to get the booster shot offered free at Young Israel of Oak Park (YIOP) on March 22, but the OCHD had run out already. She arrived early Sunday morning at YIOP for a second clinic and found a long line had formed at 9:30, a half-hour before doors opened. From March 22-24, OCHD gave 970 vaccinations. She says everyone has been very kind and understanding. “Nobody’ s pointing fingers; blaming won’ t solve anything, ” she said. “We all have to be responsible, do what we can; but, ultimately, the rest is up to God. ” Debbie says she received mixed reac- tions. Mostly, people are offering support and bringing food. “People who know us know we’ re super careful when it comes to health issues, ” Debbie said. “No one has yelled, nothing like that, but I know they’ re ner- vous and upset. “No one’ s upset with me; they’ re just scared, ” she said. “Parents want to protect their families. ” Word has spread quickly and rumors are flying. Debbie was eager to set the record straight after being told about some of the stories going around. The OCHD has said everyone who can get immunized absolutely should, but there should also be awareness there is that tiny 3 out of 100 chance that even that won’ t be protection enough. ■ Unlikely Case Immunized young father comes down with measles. jews d in the FAR LEFT: Avi Cohen with Uriel, 5 weeks, and Reuven, 2. LEFT: Avi Cohen’ s immunization records.