Image by Thinkstock Just a Prick: What happens when communities stop vaccinating?

The largest outbreak of measles in New York City in decades occurred in 2013 entirely within the Orthodox Jewish communities of Williamsburg and Borough Park, Brooklyn, according to an analysis published Monday in the academic journal JAMA Pediatrics.

Fifty-eight people were infected with the disease, with a median age of three, according to the report; 45 of them were unvaccinated because of “parental refusal or intentional delay,” and 12 were under age one and therefore too young to be vaccinated. The last infected person was an adult who said he had been vaccinated but did not have documentation. “Orthodox Jewish persons accounted for 100% of the case patients,” the report noted.

The outbreak began when an infected adolescent returned to New York from a visit to London, according to the report, which was filed by six officials from the New York City Department of Health and Mental Hygiene. Although the outbreak was eventually contained after three months, it did lead to further complications, including a miscarriage. The report also said that combatting the outbreak cost the city nearly $400,000.

All told, more than 3,00 people were exposed to the disease due to geographic clustering of people who refused or declined vaccination.

Measles had been officially declared eliminated in 2000, but has made a comeback due to parents choosing not to vaccinate their children.

Contact Aisha Tahir at tahir@forward.com or on Twitter, @aishatahir