The worst measles outbreak in New York since the disease was considered eradicated is still growing—with nearly a dozen more cases reported in Orthodox Jewish communities in the last week, officials said Wednesday.

Health authorities in Brooklyn and Rockland County are fighting to contain the disease 3,000 miles from the nation’s other major outbreak in the Pacific Northwest, where opposition to vaccinations has fueled a crisis.

As of Wednesday the number of measles infections in Rockland, north of New York City, was up to 135, with five new cases this week. In Brooklyn, 73 cases have been reported, six of them in the last week.

“By the numbers, Rockland County has experienced the longest measles outbreak since the disease was declared ‘eradicated’ nearly 20 years ago AND the most amount of infections,” Rockland County Executive Ed Day wrote in a Facebook post.

“And this is a totally preventable disease! We must ensure that this type of outbreak never, ever happens again,” he added.

New York City officials told the Daily Beast there are several factors causing the outbreaks: children being vaccinated later than average; anti-vaccine propagandists targeting the community; and frequent travel to and from Israel, where a measles outbreak is underway.

The Rockland County Health Department said that an international traveler who arrived there in September sparked the current flare-up. Measles is so contagious that someone can contract it just by being in the same room with an infected person, and 90 percent of unvaccinated people who are exposed to it will fall ill, the agency said.

Other insular communities, including the Amish in Ohio and Somali-Americans in Minnesota, have experienced outbreaks in recent years due to low vaccination rates, sometimes fostered by propaganda from anti-vaxxers.

The outbreak in Oregon and Washington, with a combined 56 cases, isn’t within a closed community. Health officials there say it’s been stoked by philosophical opposition to vaccines and the repeatedly debunked belief that the shots can cause autism or other health problems.

A hearing on legislation that would bar unvaccinated children from Washington daycares and public schools brought out crowds of protesters against the measure—even as parents of very young children in the region are stranded at home, afraid to go out in public with babies too young to be immunized.

Measles is a highly preventable disease; the vaccine, which has been proven to be safe again and again by the CDC, the WHO and dozens of scientific studies, can prevent 97 percent of cases, and can even stop a case of measles in its tracks if administered within three days of exposure.

That is the message public health officials have been trying to spread in the affected areas.

Since the New York outbreak took root back in October, state and city officials have been waging a coordinated campaign to educate and vaccinate the Orthodox community against measles.

They’ve been papering nearby airports with signs in both English and Hebrew alerting travelers to the measles outbreak in Israel and imploring people to get vaccinated. They’ve also suspended a religious exemption and are banning unvaccinated children from schools.

“School and daycare exclusions have been very effective at motivating parents to agree to get their children vaccinated with MMR,” Jill Montag, a spokesperson for the New York State Department of Health, told the Daily Beast in an email. “Since the outbreak began, approximately 6,000 unvaccinated students in more than 60 schools or daycares have been excluded. Many of them have subsequently been able to return to school due to having been vaccinated.”