At A Glance

NEW CITY, N.Y. (CBSNewYork) – A man on a trip from New York, who was unknowingly infected with the measles, traveled to Michigan and spread the virus to 38 other people, authorities said.

Meanwhile, Rockland County officials announced their next steps Tuesday in combating the measles outbreak. Threatening letters and hefty fines are part of the new tactics.

Rockland county is currently dealing with 186 confirmed measles cases. New York City has had 329 cases since October. In just the last two weeks, Westchester has confirmed ten cases.

Rockland residents are already getting knocks on the door and delivery of notices that say unvaccinated people exposed to measles must stay away from indoor and outdoor public places for 21 days or face $2,000 fines.

“We will restrategize at every opportunity regardless of what’s thrown in front of us. That’s just what we’re going to do,” Nassau County Executive Ed Day said.

County leaders believe a new order that’s more focused will stand up to legal challenges. It goes one step further in keeping people who are unvaccinated away from everyone else.

Watch: Rockland County Officials Update On Measles Outbreak 

The Rockland County executive and health officials are taking another shot at curbing the measles outbreak. The new order would keep unvaccinated students who don’t have medical or religious exemptions in the most affected areas from going to school, and those who have measles or have been exposed to it and are not vaccinated from going to public places, both indoor and outdoor.

They believe this order, unlike the first attempt, will stand up to lawsuits, CBS2’s Aundrea Cline-Thomas reported. The new mandate requires cooperation with investigators from the Department of Health. Failure to comply will result in fines up to $2,000 per violation per day. The Health Department will notify those affected.

“We’re not out there searching the people, arresting people, having the cops go out. That’s not what it’s about. What it’s about is reemphasizing to the people of Rockland that this is serious,” Day said.

The county also has completed an audit of school age children, has their names and addresses, and is ordering parents to keep unvaccinated children home unless they have a religious or medical exemption.

“I didn’t have that information weeks ago. Now that I have it, I’m going to look at those students and say ‘You need to be out until you get it,'” said Rockland County Health Commissioner Dr. Patricia Ruppert.

Five of the Rockland children with measles needed time in intensive care, CBS2’s Tony Aiello reported.

But some parents are suspicious of vaccine safety, including one who spoke to Aiello off camera.

“I’m deciding. I’m not sure,” one parent told Aiello.

“What’s holding you back?” he asked.

“They’re not being honest. They’re lying.”

The measles outbreak is centered in the ultra-Orthodox community, but health officials say unvaccinated people in the general population are definitely at risk. The communities mingle at shopping centers and other pubic places, where the measles virus can survive for hours in the air and on surfaces.

MEASLES HEALTH EMERGENCY RESOURCES

More than 18,000 vaccines have been given as many residents comply with the growing concern. Still, health officials say more needs to be done.

County leaders estimate the impact of this outbreak to be at least $2 million.

Vaccines are available for free, and officials stress that it’s safe. Health experts say concerns about the vaccines are “junk science.”

In New York City Monday, the health department shut down a Brooklyn preschool after it allegedly refused to provide vaccination records.

Williamsburg is home to the most cases in the city. According to the Centers for Disease Control and Prevention, the neighborhood has seen 39 new cases in the last week alone.

The number of confirmed measles cases tops 500 between Rockland County and New York City since the outbreak started last October.

Click here for more information on the Rockland County outbreak.