U.S. attorney general shakes up prisons bureau after Epstein death

FILE PHOTO: U.S. Attorney General William Barr is pictured after a farewell ceremony for Deputy Attorney General Rod Rosenstein at the U.S. Department of Justice in Washington, U.S., May 9, 2019. REUTERS/Leah Millis

WASHINGTON (Reuters) – U.S. Attorney General William Barr on Monday announced a new leadership team at the federal Bureau of Prisons in a shake-up of the agency in the wake of financier Jeffrey Epstein’s apparent suicide inside a federal jail in New York City.

Kathleen Hawk Sawyer, a veteran of the Bureau of Prisons, will return to the agency to serve as its director, Barr said. He named another former agency official, Thomas Kane, to serve as her deputy.

The Bureau of Prisons has about 37,000 employees and oversees 122 facilities, which house about 180,000 inmates.

Hugh Hurwitz, who has been serving as the bureau’s acting director – including when Epstein was found unresponsive over a week ago in a Manhattan jail cell – has been reassigned to his prior position within the agency.

Epstein had been arrested on July 6 and pleaded not guilty to federal charges of sex trafficking involving dozens of underage girls as young as 14.

An autopsy report released on Friday concluded he committed suicide by hanging.

His death at the age of 66 at the Metropolitan Correctional Center (MCC) in lower Manhattan triggered multiple investigations and had prompted Barr to criticize “serious irregularities” at the facility.

“During this critical juncture, I am confident Dr. Hawk Sawyer and Dr. Kane will lead BOP with the competence, skill, and resourcefulness they have embodied throughout their government careers,” Barr said in the statement.

Barr had previously ordered the reassignment of the warden at the MCC. Two corrections officers assigned to Epstein’s unit were placed on administrative leave pending investigations.

Lawyers for Epstein did not immediately respond to requests for comment on Monday.

His lawyers had said in a statement last week that they were “not satisfied” with the medical examiner’s conclusions and planned to carry out their own investigation, seeking prison videos taken around the time of his death.

Epstein had been on suicide watch at the jail but was taken off prior to his death, a source who was not authorized to speak on the matter previously told Reuters. Two jail guards are required to make separate checks on all prisoners every 30 minutes, but that procedure was not followed, the source added.

Epstein, a registered sex offender who once socialized with U.S. President Donald Trump and former President Bill Clinton, pleaded guilty in 2008 to Florida state charges of unlawfully paying a teenage girl for sex and was sentenced to 13 months in a county jail, a deal widely criticized as too lenient.

Senator Ben Sasse, the Republican chairman of the Senate Judiciary Oversight Subcommittee, has urged Barr to void the agreement and said “heads must roll” after Epstein’s death.

“This is a good start, but it’s not the end,” Sasse said of Barr’s announcement on Tuesday. “Jeffrey Epstein should still be in a padded cell and under constant surveillance, but the justice system has failed Epstein’s victims at every turn.”

(Reporting by Sarah N. Lynch; Writing by Tim Ahmann; Editing by Dan Grebler and Steve Orlofsky)

Kitchen devices resembling bombs cause havoc for New York commuters

New York City police officers are seen as police said they were investigating two suspicious packages at the Fulton St. subway station in Manhattan, New York, U.S. August 16, 2019. REUTERS/Catherine Koppel

By Peter Szekely

NEW YORK (Reuters) – Kitchen appliances resembling pressure cookers were left in two Manhattan locations on Friday, disrupting automobile and subway travel during the morning rush hour before police deemed them harmless and began investigating the possibility of a hoax.

The discoveries of the devices, which the city’s chief counterterrorism officer called “rice cookers that could be mistaken for pressure cookers,” raised concern because of the latter’s previous use as makeshift bombs in New York and Boston.

Surveillance video shows a dark-haired man in his 20s or 30s with a shopping cart placing the devices at two locations inside the busy downtown Fulton Street subway station, said John Miller, the New York Police Department’s deputy commissioner of intelligence and counterterrorism.

“Because of the timing and the placement and items we’re carrying this right now as a hoax device,” Miller told reporters at the scene. “That’s the investigative category.”

The unidentified man is “not a suspect but certainly someone we’d want to interview,” he said. Police posted two photographs on social media of the cookers at Fulton Street.

Officials said they had not determined whether the discovery about an hour later of a third implement resembling a pressure cooker next to a garbage can on a street corner in the borough’s Chelsea neighborhood was related, Miller said.

Miller noted that in September 2016 the so-called “Chelsea Bomber,” Ahmad Khan Rahimi, wounded 30 people using a device made from a pressure cooker and a cellphone timer that exploded on Manhattan’s West 23rd Street. Another pressure cooker bomb was left nearby but did not explode.

Rahimi was sentenced last year to life in prison.

There was also an explosion in Midtown Manhattan in December 2017 when a Bangladeshi man, Akayed Ullah, detonated a homemade bomb in a pedestrian tunnel connecting two subway lines and a bus terminal. Three people were wounded.

Pressure cookers were turned into bombs by a pair of ethnic Chechen brothers when they killed three people and injured more than 200 at the 2013 Boston Marathon.

The discoveries, which were first reported at about 7 a.m. EDT (1100 GMT) created havoc for thousands of motorists and commuters on the numerous subway lines that converge at Fulton Street as police and bomb squad vehicles swarmed to the scene.

Even after police deemed the devices harmless at the Fulton Street station complex, which is close to the World Trade Center, officials warned of residual delays for commuters.

(Reporting by Peter Szekely; Editing by Daniel Wallis and Steve Orlofsky)

New York coroner ‘confident’ Epstein’s death was suicide: New York Times

An exterior view of the Metropolitan Correctional Center jail where financier Jeffrey Epstein, who was found dead in the Manhattan borough of New York City, New York, U.S., August 10, 2019. REUTERS/Jeenah Moon

(Reuters) – New York City’s chief medical examiner is confident Jeffrey Epstein died by hanging himself in the jail cell where he was being held without bail on sex-trafficking charges, but is awaiting more information before releasing her determination, the New York Times reported on Sunday, citing a city official.

An autopsy was performed earlier in the day on the disgraced financier found unresponsive on Saturday in a New York City jail, chief medical examiner Dr. Barbara Sampson said. A private pathologist observed the autopsy on behalf of Epstein’s representatives, which she called “routine practice.”

A determination on the cause of death “is pending further information at this time,” Sampson said in a statement.

The suspicion in Epstein’s death was hanging, said a city official not authorized to speak on the record.

The Times did not say why it could not identify the source of information on the medical examiner’s likely determination of the cause of death.

Epstein, 66, was not on suicide watch at the time in his cell in the Special Housing Unit of the Metropolitan Correctional Center (MCC), a source said.

Epstein, a well-connected money manager, was found hanging by his neck, according to the source, who was not authorized to speak on the record.

The wealthy financier, who once counted Republican President Donald Trump and Democratic former President Bill Clinton as friends, was arrested on July 6 and pleaded not guilty to charges of sex trafficking involving dozens of underage girls as young as 14, from at least 2002 to 2005.

The FBI and the Department of Justice’s Inspector General opened investigations into his suicide while he was in federal custody.

Last month, Epstein was found unconscious on the floor of his jail cell with marks on his neck, and officials were investigating that incident as a possible suicide or assault.

Despite that incident, Epstein was not on suicide watch at the time of his death, and he was alone in a cell in the unit of the correctional center used to isolate vulnerable prisoners when his body was found.

It was not immediately clear why Epstein was taken off suicide watch, a special set of procedures for inmates who are deemed to be at risk of taking their own lives.

The Federal Bureau of Prisons, which operates the MCC, provided no explanation beyond its terse statement that Epstein was found dead in an apparent suicide.

His death touched off outrage from Attorney General William Barr, politicians and many of Epstein’s alleged victims, who fear that they may lose their day in court now that Epstein is dead.

That investigation into conduct described in the indictment, including the conspiracy count, will continue despite Epstein’s death, Geoffrey Berman, the U.S. Attorney in Manhattan, said on Saturday.

The indictment – which accused Epstein of knowingly recruiting underage women to engage in sex acts, sometimes over a period of years – came more than a decade after he pleaded guilty in Florida to state charges of solicitation of prostitution from a minor in a deal with prosecutors that has been widely criticized as too lenient.

(Reporting by Letitia Stein in Tampa, Florida; Editing by Frank McGurty and Bill Rigby)

New York man arrested in alleged plot to attack Times Square

New York City Police Department (NYPD) officers patrol in Time Square after a man was arrested in an alleged plot to buy grenades for an attack on Times Square in New York, U.S., June 7, 2019. REUTERS/Mike Segar

By Brendan Pierson

NEW YORK (Reuters) – A New York man was arrested after allegedly discussing acquiring grenades and detonating them in Times Square, one of midtown Manhattan’s most crowded crossroads, a person familiar with the matter told Reuters on Friday.

Ashiqul Alam, 22, from Jackson Heights in the city’s Queens borough, was arrested on Thursday afternoon, the person said. He is expected to appear in U.S. District Court in Brooklyn later on Friday, but it was unclear what charges he would face.

The New York Police Department declined to comment on the matter and referred inquires to the Federal Bureau of Investigation, which also declined to comment.

The alleged plot was uncovered after police and federal authorities learned the man had been inquiring about buying grenades and using them in Times Square, one of the most visited destinations in the United States, the New York Daily News reported.

Authorities do not believe the man had links to a wider plot involving other people, the Daily News said, citing unidentified law enforcement sources.

The man had been under surveillance for some time and authorities had been closely monitoring him, NBC News reported, citing unnamed officials.

He talked about wanting to make a suicide bomb vest as well as using explosives, and eventually settled on a shooting attack in Times Square, NBC reported.

The man had discussed potential attacks on politicians in New York and Washington before settling on a plot to attack Times Square, NBC said.

Members of the New York Joint Terrorism Task Force, which is made up of FBI agents and New York police detectives, made the arrest. The task force began tracking him and eventually took him into custody, according to media reports said.

With its millions of visitors each year, Times Square, often called the crossroads of the world, has been targeted by at least two bombers in recent years, despite its heavily-fortified police presence.

On May 1, 2010, police thwarted an attempted car bomb in Times Square, defusing a crude device made out of firecrackers and propane gas tanks.

A Pakistani-born U.S. citizen pleaded guilty to the plot, admitting that he had received bomb-making training from the Pakistani Taliban and that the group, known as Tehrik-e-Taliban Pakistan had funded the plot. He was sentenced to life in prison.

In December 2017, a Bangladeshi man set off a homemade pipe bomb strapped to his body in a crowded underground pedestrian tunnel near Times Square. The man, Akayed Ullah, was convicted of six criminal counts, including use of a weapon of mass destruction and support of a terrorist organization.

On Friday morning, it was business as usual in Times Square, with a bustle of people on their way to work and tourists beginning to stream into the area.

Kate Fan, a 28-year-old charity worker visiting from her home in Guangzhou, China, said that she heard about the incident but still felt safe.

“We hear a lot of stories about New York being unsafe, but we feel like people sometimes exaggerate safety issues,” she said.

(Writing and additional reporting by Meredith Mazzilli, Peter Szekely and Ayenat Mersie; Editing by Frank McGurty and Nick Zieminski)

Measles outbreak spreads to Oklahoma as U.S. reports 41 new cases

FILE PHOTO: FILE PHOTO: FILE PHOTO: A vial of the measles, mumps, and rubella virus (MMR) vaccine is pictured at the International Community Health Services clinic in Seattle, Washington, U.S., March 20, 2019. REUTERS/Lindsey Wasson/File Photo/File Photo/File Photo

(Reuters) – The worst measles outbreak in the United States in 25 years has spread to Oklahoma, federal health officials said on Monday as they reported 41 new cases nationwide, raising the total number sickened this year to 880 people.

The U.S. Centers for Disease Control and Prevention reported a 4.9% increase in the number of measles cases from May 10 to May 17 in an outbreak that has now reached 24 states. The agency has been providing weekly updates every Monday.

The CDC said there had been one confirmed case in Oklahoma.

Most of the new cases were in New York, CDC spokesman Jason McDonald said, with 21 cases recorded in New York City and nine in Rockland County.

Health experts say the virus has spread among school-age children whose parents declined to give them the vaccine, which confers immunity to the disease. A vocal fringe of U.S. parents, some in New York’s ultra-Orthodox Jewish communities, cite concerns that the vaccine may cause autism, despite scientific studies that have debunked such claims.

Although the virus was eliminated from the country in 2000, meaning the disease was no longer a constant presence, outbreaks still happen via travelers coming from countries where measles is still common, according to the CDC.

Experts warn that the outbreak is not over as the number of cases approaches the 1994 total of 958. That was the highest number since 1992, when the CDC recorded 2,126 cases.

More than 40 people in 2019 brought measles to the United States from other countries, most frequently Ukraine, Israel and the Philippines, federal officials said.

(Reporting by Gabriella Borter in New York, Ankur Banerjee in Bengaluru; Editing by Scott Malone and Bill Berkrot)

Accused sex cult founder could face former ‘slaves’ at New York trial

Actress Allison Mack departs the Brooklyn Federal Courthouse after facing charges regarding sex trafficking and racketeering related to the Nxivm cult case in New York, U.S., April 8, 2019. REUTERS/Shannon Stapleton

By Joseph Ax and Brendan Pierson

NEW YORK (Reuters) – Former self-help guru Keith Raniere goes on trial on Tuesday on charges of running a secretive New York sex cult that recruited female “slaves” who were then starved, branded with his initials and blackmailed into having sex with him.

Federal prosecutors have charged Raniere, 58, with using his cultlike Nxivm group, which claimed to offer members unique insights into life, as a front for crimes including sex trafficking, child pornography and sexual exploitation of a minor.

Several of his alleged “slaves” are expected to testify at U.S. District Court in Brooklyn. While prosecutors have not said who will take the stand, former “Smallville” star Allison Mack and Seagram liquor heiress Clare Bronfman have already pleaded guilty to playing supporting roles in the scheme.

Jurors have been warned to expect disturbing testimony and evidence during a trial that could run six weeks. Prosecutors intend to introduce explicit photographs of a 15-year-old girl alleged to have been one of Raniere’s victims, seized from his computer hard drive.

Mack and Bronfman are among five co-defendants, all women accused of involvement in Nxivm, who pleaded guilty to various charges in March and April, leaving Raniere as the sole person to face trial. The television actress tearfully acknowledged in court that she had blackmailed two women into providing services for her and other Nxivm members.

Bronfman, who provided key financial support for Nxivm, pleaded guilty in April and agreed to forfeit $6 million.

Raniere has pleaded not guilty to all charges. Marc Agnifilo, one of Raniere’s lawyers, has said that his client’s sexual encounters with women in the organization were consensual and denied the child pornography and exploitation charges.

The trial caps a bizarre saga for Raniere, who was arrested in March 2018 after fleeing to Mexico with Bronfman.

Nxivm, which started under another name in 1998 and is pronounced “Nexium,” was based in Albany, New York, and at one time operated numerous centers across the United States, Canada, Central America and Mexico.

The organization marketed itself as a business “providing educational tools, coaching and trainings” that would allow “humanity to rise to its noble possibility,” according to court filings.

In 2015, prosecutors say, Raniere established a sorority within Nxivm known as DOS, an acronym for a Latin phrase that roughly translates to “master of the obedient female companions.”

The subgroup included “slaves” who were expected to bend their wills to “masters” in a pyramid-like structure, with slaves expected in turn to recruit their own subordinates and Raniere standing alone at the top.

The slaves were required to submit “collateral” to win acceptance that could then be used as blackmail material: Nude photos, rights to their financial assets or damaging information about friends and relatives, prosecutors said.

Several women were branded with Raniere’s initials, prosecutors said, and they were required to engage in sexual acts with him. He is also accused of having forced some women to maintain slim figures by following a dangerously restrictive diet.

If convicted, Raniere faces up to life in prison.

(Reporting by Joseph Ax and Brendan Pierson; editing by Scott Malone and Jonathan Oatis)

U.S. records 71 new measles cases in week as outbreak spreads

FILE PHOTO: A general view of the Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Georgia September 30, 2014. REUTERS/Tami Chappell

(Reuters) – The United States recorded 71 new measles cases last week, a 13 percent increase as the country faces its second-worst outbreak of the disease in almost two decades, federal health officials said on Monday.

The U.S. Centers for Disease Control and Prevention said it had recorded 626 cases of the highly contagious and sometimes deadly disease in 22 states as of April 19, the highest rate of infection in five years.

The CDC had previously reported 555 cases in 20 states between Jan. 1 and April 11. The current outbreak will likely surpass the 2014 outbreak in number of cases, the CDC said on Monday.

Iowa and Tennessee were the two states that joined the CDC list with new measles cases.

More than half the cases recorded this year occurred in New York City, primarily in the Williamsburg neighborhood of Brooklyn.

The U.S. outbreak is part of a worldwide rise in the once nearly eradicated disease. The World Health Organization reported last week that global cases had risen nearly four-fold in the first quarter of 2019 to 112,163 compared with the same period last year.

A vocal fringe of parents in the United States oppose vaccines believing, contrary to scientific evidence, that ingredients in them can cause autism or other disorders.

(Reporting by Manojna Maddipatla in Bengaluru and Gabriella Borter in New York; Editing by Maju Samuel and Bill Berkrot)

Judge upholds New York City’s mandatory measles vaccination order

FILE PHOTO: Materials are seen left at demonstration by people opposed to childhood vaccination after officials in Rockland County, a New York City suburb, banned children not vaccinated against measles from public spaces, in West Nyack, New York, U.S. March 28, 2019. REUTERS/Mike Segar/File Photo

By Jonathan Allen

NEW YORK (Reuters) – A Brooklyn judge on Thursday ruled against a group of parents who challenged New York City’s recently imposed mandatory measles vaccination order, rejecting their arguments that the city’s public health authority exceeded its authority.

In a six-page decision rendered hours after a hearing on the matter, Judge Lawrence Knipel denied the parents’ petition seeking to lift the vaccination order, imposed last week to stem the worst measles outbreak to hit the city since 1991.

The judge sided with municipal health officials who defended the order as a rare but necessary step to contain a surge in the highly contagious disease that has infected at least 329 people so far, most of them children from Orthodox Jewish communities in the borough of Brooklyn.

Another 222 cases have been diagnosed elsewhere in New York state, mostly in a predominantly ultra-Orthodox Jewish neighborhood of Rockland County, northwest of Manhattan.

The New York outbreaks are part of a larger resurgence of measles across the country, with at least 555 cases confirmed in 20 states, according to the U.S. Centers for Disease Control and Prevention.

Health experts say the virus, which can cause severe complications and even death, has spread mostly among school-age children whose parents declined to get them vaccinated. Most profess philosophical or religious reasons or cite concerns – debunked by medical science – that the three-way measles-mumps-rubella (MMR) vaccine may cause autism.

The judge rejected the parents’ contention that the vaccination order was excessive or coercive, noting that it does not call for forcibly administering the vaccine to those who refuse it.

Under the public health emergency declared last Tuesday by Mayor Bill de Blasio, residents of certain affected Brooklyn neighborhoods who refuse orders to obtain an MMR vaccine face fines unless they can otherwise demonstrate immunity to measles or provide a valid medical exemption.

The court challenge was filed in Brooklyn’s Supreme Court on behalf of five mothers and their children in the affected neighborhoods. Their identities were kept confidential to protect the children’s privacy, their lawyers said.

They told Knipel in court on Thursday the city had overstepped its authority and that quarantining the infected would be a preferable approach.

Robert Krakow, an attorney for the parents, estimated that just 0.0006 percent of the population of Brooklyn and Queens had measles. “That’s not an epidemic,” he said. “It’s not Ebola. It’s not smallpox.”

The health department’s lawyers argued that quarantining was ineffective because people carrying the virus can be contagious before symptoms appear.

The judge cited 39 cases diagnosed in Michigan that have been traced to an individual traveling from the Williamsburg community at the epicenter of Brooklyn’s outbreak. The surge in measles there originated with an unvaccinated child who became infected on a visit to Israel, where the highly contagious virus is also running rampant.

Krakow later told Reuters he was reviewing the judge’s dismissal of the case – brought under special proceedings for the appeal of administrative actions – to determine how his clients might respond.

The number of measles cases worldwide nearly quadrupled in the first quarter of 2019 to 112,163 compared with the same period last year, the World Health Organization said this week.

(Reporting by Jonathan Allen in New York; Additional reporting by Steve Gorman in Los Angeles; Editing by Bill Berkrot and G Crosse)

New York City defends measles vaccination order in court

FILE PHOTO: A sign warning people of measles in the ultra-Orthodox Jewish community of Williamsburg, two days after New York City Mayor Bill de Blasio declared a public health emergency in parts of Brooklyn in response to a measles outbreak, is seen in New York, U.S., April 11, 2019. REUTERS/Shannon Stapleton/File Photo

By Jonathan Allen

NEW YORK (Reuters) – New York City’s Department of Health defended its mandatory measles vaccination order in a state court on Thursday after a group of anonymous Brooklyn parents sued, arguing that the order was unconstitutional.

The department issued the order last week, saying it was an unusual but necessary step to contain the worst outbreak of the highly contagious virus seen in the city since 1991. The outbreak has infected 329 people so far, most of them children from Orthodox Jewish communities in Brooklyn.

The order, which was extended this week, requires unvaccinated people living in certain affected Brooklyn neighborhoods to get the measles-mumps-rubella vaccine if they cannot otherwise demonstrate immunity to measles, or face a $1,000 fine.

Five people who said they were parents living in the affected neighborhoods sued the department this week in Brooklyn’s Supreme Court, filing their lawsuit anonymously in order, their lawyers said, to protect their children’s privacy.

Their lawyers told Judge Lawrence Knipel that the city had overstepped its authority, saying 329 confirmed cases so far did not constitute an epidemic. They argued that quarantining people with measles would be a preferable approach.

“It’s excessive, it’s coercive,” Robert Krakow, a lawyer for the parents, said in court. He said he estimated that 0.0006 percent of the population of Brooklyn and Queens had measles. “That’s not an epidemic,” he said. “It’s not Ebola. It’s not smallpox.” He said even vaccinated people could spread the virus and that the vaccination carried a “risk of injury,” which the city disputed.

The department’s lawyers argued that this is a serious outbreak and that quarantining was ineffective because infected people can be contagious before symptoms appear. They said the lawsuit relied on bogus or discredited science.

Lawyers for the Health Department said three or more cases constituted an outbreak, given the United States had declared the disease eliminated in 2000, meaning it is no longer present year round. Measles can lead to serious complications and death.

“The percentage is irrelevant,” Sherrill Kurland, a lawyer from the city’s Law Department, told the court. “The rates of transmission has continued to increase. These areas remain serious for concern.”

The Brooklyn outbreak has been traced to an unvaccinated child who became infected on a visit to Israel, which is also grappling with an outbreak.

The number of measles cases worldwide nearly quadrupled in the first quarter of 2019 to 112,163 compared with the same period last year, the World Health Organization said this week, while the U.S. Centers for Disease Control and Prevention has reported measles cases in at least 20 U.S. states.

Judge Knipel said he would release his decision on whether to temporarily block the city’s order by the end of the week.

(Reporting by Jonathan Allen; Editing by Bill Berkrot)

U.S. sees surge of nearly 20% in confirmed cases of measles, CDC reports

FILE PHOTO: A sign warning people of measles in the ultra-Orthodox Jewish community of Williamsburg, two days after New York City Mayor Bill de Blasio declared a public health emergency in parts of Brooklyn in response to a measles outbreak, is seen in New York, U.S., April 11, 2019. REUTERS/Shannon Stapleton/File Photo

(Reuters) – The number of confirmed cases of measles in the United States this year jumped by nearly 20 percent in the week ended April 11 in the country’s second-worst outbreak in nearly two decades, federal health officials reported on Monday.

As of April 11, the U.S. Centers for Disease Control and Prevention (CDC) recorded 555 cases of the disease since the beginning of the year, up from 465 cases confirmed by April 4. The cases were found in 20 states spanning the country.

FILE PHOTO: A general view of the Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Georgia September 30, 2014. REUTERS/Tami Chappell/File Photo

FILE PHOTO: A general view of the Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Georgia September 30, 2014. REUTERS/Tami Chappell/File Photo

The measles virus is highly contagious and can lead to deadly complications, particularly in children. The CDC report did not say whether there have been any fatalities.

A growing and vocal fringe of parents in the United States oppose measles vaccines believing, contrary to scientific evidence, that ingredients in the vaccines can cause autism or other disorders.

The United States declared that measles had been eliminated from the country in 2000, meaning the virus is no longer present year-round. But outbreaks still happen each year, typically when unvaccinated people travel to the country from parts of the world where the disease is still common.

New York City has recorded at least 285 cases of measles since October, according to local health officials, the large majority among members of the Orthodox Jewish communities in Brooklyn.

Mayor Bill de Blasio declared the outbreak a public health emergency last week and ordered unvaccinated people in the affected parts of Brooklyn to get the vaccine or face a fine. It is the worst outbreak seen in the city since 1991, the mayor said.

Most of the Brooklyn cases are among children. Several people had to be hospitalized but no fatalities had been reported as of last week.

New York health officials said the Brooklyn outbreak was caused by an unvaccinated child returning from a trip to Israel, which is also grappling with an outbreak.

Health officials say they have seen anti-vaccination pamphlets containing misinformation being distributed in the affected parts of Brooklyn.

Another outbreak has hit Orthodox Jewish families in New York’s Rockland County. Officials there banned children not vaccinated against measles from public spaces last month.

That order was overturned by a state judge, a decision being appealed by Rockland officials.

(Reporting by Tamara Mathias in Bengaluru and Jonathan Allen in New York; Editing by Anil D’Silva and Bill Trott)