The first major measles outbreak in New York State this year may have started in upstate New York, but it’s officially reached the epicenter — New York City.

For several months, officials in New York City have been encouraging members of ultra-Orthodox Jewish communities in the Brooklyn area of New York City to vaccinate their children in an attempt to squash the rapidly growing number of measles cases in the region. In addition to providing education about the vaccine and talking to local rabbis, they have also tried keeping unvaccinated children from attending school.

Despite those efforts, there have been 285 confirmed cases of the infection since September with 21 of them leading to hospitalization. It’s the largest measles outbreak the city has seen in over three decades. So this week, officials took a more staunch approach — Mayor Bill de Blasio declared a public health emergency.

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