Photo Credit: CDC/NIP/Barbara Rice via Wikimedia
This child shows a classic day-4 rash with measles.

The Israeli Ministry of Health has warned residents of the community of Itamar in Samaria to get immunized against the measles, or the government would be forced to apply the exceptional clause—Article 19—of the Public Health Ordinance, which permits it to fine and even imprison anyone who refuses to be vaccinated in an area where there has been an outbreak of a contagious disease, Israel Hayom reported on Monday.

Since the beginning of 2018, 54 cases of measles have been reported to the Epidemiology Division, and the Health Ministry has instructed all hospitals and clinics to be alert to the signs of the disease for fear of outbreaks.


In the past few weeks, four residents of Itamar, a predominantly Orthodox Jewish community some 3 miles from Shechem, have been diagnosed with the measles, and dozens of people who came into contact with them have been called on to be vaccinated. A fifth case was identified outside Itamar.

The Health Ministry warns that Itamar is a community of “vaccine refusers” and demands that residents under age 18 be vaccinated as soon as possible.

The Measles is a highly contagious infectious disease caused by the measles virus. Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days. Initial symptoms typically include fever, often greater than 104.0 °F, cough, runny nose, and inflamed eyes. Small white spots known as Koplik’s spots may form inside the mouth two or three days after the start of symptoms. A red, flat rash which usually starts on the face and then spreads to the rest of the body typically begins three to five days after the start of symptoms. Complications occur in about 30% of cases and may include diarrhea, blindness, inflammation of the brain, and pneumonia, among others. Rubella, which is sometimes called German measles, and roseola are different diseases caused by unrelated viruses.

A vaccines to prevent the disease became available in 1963. An improved measles vaccine became available in 1968. Measles as an endemic disease was eliminated from the United States in 2000, but continues to be reintroduced. According to the US National Institute of Health, “a substantial proportion of the US measles cases in the era after elimination were intentionally unvaccinated. The phenomenon of vaccine refusal was associated with an increased risk for measles among people who refuse vaccines and among fully vaccinated individuals.”

“I intend to recommend to my superiors to apply Article 19 of the Public Health Ordinance against every resident of the community who persists in his opposition to vaccinating his children against measles and who will continue to endanger them and endanger the health of the entire public,” Dr. Eran Kopel, the ministry’s Petah Tikva district physician, wrote to Yossi Dagan, chairman of the Samaria Regional Council.

Dagan distributed the letter to residents of Itamar and asked them to be vaccinated.

According to Dr. Kopel, “Of the five cases diagnosed in recent days, four were from the settlement of Itamar. The residents of the community constitute about a third of the overall current outbreaks, and the morbidity rate among them continues to rise at an increasing pace.”

Dr. Kopel notes that a significant portion of Itamar’s residents are “absolute vaccine objectors. This phenomenon of resistance to a vaccine of any kind is common among whole families through several generations in the community.”

According to Dr. Kopel’s letter, in the settlement of Itamar Health Ministry officials have encountered resistance even when the vaccine was intended to prevent the infection of neighbors. The letter notes that in other communities, where the majority of the population has been immunized, the disease has been halted – but in Itamar it continues.