Some 285 measles cases have been confirmed in the city since the beginning of an outbreak last September.

New York City Mayor Bill de Blasio has declared a public health emergency in parts of Brooklyn in response to a measles outbreak, requiring unvaccinated people living in the affected areas to get the vaccine or face fines.

The city’s largest measles outbreak since 1991 has mainly been confined to the Orthodox Jewish community in the borough of Brooklyn’s Williamsburg neighbourhood, with 285 cases confirmed since October, de Blasio said at a news conference on Tuesday. There were only two reported cases in 2017.

The disease spreads easily and can be fatal. While there have been no confirmed deaths so far, 21 people have been taken to hospital, with five admitted to intensive care, officials said. All but 39 of the confirmed cases are in children.

“This is the epicentre of a measles outbreak that is very, very troubling and must be dealt with immediately,” de Blasio said.

He was joined by health officials who decried what they called “misinformation” spread by opponents of vaccination.

The order applies to anyone living, working or going to school in areas under four postcodes in the neighbourhood and requires all unvaccinated people at risk of exposure to the virus to get the vaccine, including children over six months old.

The city can’t legally physically force someone to get a vaccination, but officials said people who ignore the order could be fined $1,000.

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The city said it would help everyone covered by the order get the vaccine if they can’t get it quickly through their regular medical provider.

“If people will simply cooperate quickly, nobody will have to pay a fine,” de Blasio said.

New York accounted for about two-thirds of all measles cases reported last week in the United States.

The Brooklyn outbreak is part of a broader resurgence in the US, with 465 cases reported in 19 states so far this year, according to the Centers for Disease Control and Prevention (CDC).

Tuesday’s announcement was the first time New York has ordered mandatory vaccinations in recent history, according to health officials.

‘Measles parties’

The city’s health commissioner, Dr Oxiris Barbot, said that the majority of religious leaders in Brooklyn’s large Orthodox communities support vaccination efforts, but that rates have remained low in some areas because of resistance from some groups that believe the inoculations are dangerous.

“This outbreak is being fuelled by a small group of anti-vaxxers in these neighbourhoods. They have been spreading dangerous misinformation based on fake science,” Barbot said. “We stand with the majority of people in this community who have worked hard to protect their children and those at risk. We’ve seen a large increase in the number of people vaccinated in these neighbourhoods, but as Passover approaches, we need to do all we can to ensure more people get the vaccine.”

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

“There is a campaign with very intentional efforts to give misinformation,” Herminia Palacio, the city’s deputy mayor for public health, said at the news conference.

Health officials also expressed alarm at reports of parents in the city holding so-called “measles parties” where they intentionally expose their unvaccinated children to an infected child in the mistaken belief doing so is a safe means to create immunity.

“I understand that parents may be afraid of getting their children vaccinated,” health commissioner Barbot said. “I know that getting vaccinated is far safer than getting measles.”

The commissioner is empowered by law to issue such orders in cases when they might be necessary to protect against a serious public health threat.

Earlier this week, the city ordered religious schools and daycare programmes serving that community to exclude unvaccinated students or risk being closed down.

Another Jewish religious community, north of the city but with close ties to Brooklyn, has also seen a surge, with at least 166 cases since October.

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Last week, a state judge blocked an attempt by Rockland County officials to halt the spread of measles by banning unvaccinated children from public places.

The CDC recommends that all children get two doses of measles vaccine. It says the vaccine is 97 percent effective.