Plague

Keritot 5b ~ Hemorrhoids, Plague, and the Ark of the Covenant

כריתות ה,ב

משנגנז ארון נגנז צנצנת המן וצלוחית שמן המשחה ומקלו של אהרן שקדים ופרחים וארגז ששגרו פלשתים דורון לאלהי ישראל

When the Ark was hidden, along with it was sequestered the jar of manna, and the flask of the anointing oil, and Aaron’s staff with its almonds and blossoms. And also hidden with the Ark was the chest that the Philistines sent as a gift to the God of Israel [after they captured the Ark and were stricken by several plagues].

The Talmud relates that when King Josiah hid the Ark of the Covenant, he also hid, among other things “the gifts to the God of Israel.” And what were these gifts? Golden Hemorrhoids. To understand why, you need some some background.

How Israel lost their Ark

In one of the many battles between the Philistines and the People of Israel, the latter were routed, losing “four thousand men on the field of battle” (I Sam 4:2). The Israelites then came up with a plan: “Let us fetch the Ark of the Covenant of the Lord from Shiloh, so that He will be present among us and will deliver us from the hands of our enemies.” This turned out to be a terrible idea. The Ark was quickly captured, taken to Ashdod and “ put into the temple of Dagon where they set it up beside Dagon.”

But watching the Ark of the Covenant comes with a lot of responsibility, which the Philistines had not really factored in. The very next day “they woke to find Dagon lying face down on the ground in front of the Ark of the Lord. They picked Dagon up and put him back in his place.” Next day, same thing, except this time “the head and both hands of Dagon were cut off, lying on the threshold; only Dagon’s trunk was left intact.”

The priests in Ashdod got the message and decided to move the Ark to Gath. And what happens next is critical to our story:

וַיְהִי אַחֲרֵי הֵסַבּוּ אֹתוֹ וַתְּהִי יַד־יְהוָה בָּעִיר מְהוּמָה גְּדוֹלָה מְאֹד וַיַּךְ אֶת־אַנְשֵׁי הָעִיר מִקָּטֹן וְעַד־גָּדוֹל וַיִּשָּׂתְרוּ לָהֶם עפלים [טְחֹרִים]׃

And after they had moved it, the hand of the Lord came against the city, causing great panic; He struck the people of the city, young and old, so that hemorrhoids broke out among them.

The Philistines had enough of the Ark, and decided to send it back to Israel, but they were warned by their priests, “If you are going to send the Ark of the God of Israel away, do not send it away without anything; you must also pay an indemnity to Him.”

וַיֹּאמְרוּ מָה הָאָשָׁם אֲשֶׁר נָשִׁיב לוֹ וַיֹּאמְרוּ מִסְפַּר סַרְנֵי פְלִשְׁתִּים חֲמִשָּׁה עפלי [טְחֹרֵי] זָהָב וַחֲמִשָּׁה עַכְבְּרֵי זָהָב כִּי־מַגֵּפָה אַחַת לְכֻלָּם וּלְסַרְנֵיכֶם׃

They asked, “What is the indemnity that we should pay to Him?” They answered, “Five golden hemorrhoids and five golden mice, [corresponding to the number of lords of the Philistines;] for the same plague struck all of you and your lords.

The Plague of Ashdod  1630 by Nicolas Poussin (1594–1665). Louvre, Paris. The picture was on the front cover of the January 2018 edition of the journal   Emerging Infectious Diseases   .

The Plague of Ashdod 1630 by Nicolas Poussin (1594–1665). Louvre, Paris. The picture was on the front cover of the January 2018 edition of the journal Emerging Infectious Diseases.

So “they placed the Ark of the Lord on the cart together with the chest, the golden mice, and the figures of their hemorrhoids” and sent them on their merry way. The Ark was taken briefly to Bet Shemesh, where the Bible tells us more than 50,000 people were killed “because they looked into the Ark” before it finally found a resting place in Kiryat Ya’arim, where, for the first time, no-one who came into contact with the Ark died.

Those “Five Golden Hemorrhoids” were the gifts that were kept with the Ark, and which were later hidden by King Josiah. And I hear you ask “what on earth is going on in this story?” That’s where science, and a bit of Latin come in.

It wasn’t hemorrhoids. it was plague.

The story about the “hemorrhoids” seems to be somehow related to mice - for why did else did the Philistines send back golden mice? And what’s with hemorrhoids as a divine reaction to removing the Ark? The author of a Letter to the Editor that appeared in the Journal of the Royal Society of Medicine, noted something important.

The New International Version (NIV) in its footnotes records that the Septuagint (a translation from the Hebrew to Greek done in Alexandria for Ptolemy Philadelphus) and Vulgate (a translation by St Jerome into Latin from the Septuagint) texts elaborate on the fact that Philistines were smitten with tumours as follows. In 1 Samuel 5 v6 the NIV states the Philistines were afflicted with tumours and the Septuagint and Vulgate expand this point with the words `and rats appeared in their land, and death and destruction were throughout the city' and in v 9 of the same chapter the Septuagint versions expand `He afflicted the people, both young and old with an outbreak of tumours' by specifying the site of the tumours as being `in the groin.’

A bubo, a swelling of the lymph nodes of the groin.

A bubo, a swelling of the lymph nodes of the groin.

As a result, the letter suggests it was bubonic plague that struck the Philistines, and it was the associated swelling of the lymph nodes - called buboes- that the Book of Samuel was describing. It wasn’t hemorrhoids at all.

Bubonic plague is caused by a nasty bacteria called Yersinia Pestis. It first causes a flu-like illness with fevers and muscle cramps, followed by severe swelling of the lymph nodes (but not hemorrhoids). Then things get really bad: there is secondary pneumonia, sepsis, gangrene of the fingers and toes, bleeding and death. Lots of death. The Black Death of 1347 killed one-third of the population of Europe. And it still kills; the World Health Organization reports a couple of thousand cases each year, and the actual number of cases is far higher. Fortunately it can usually be treated with antibiotics if they are started early enough.

The Role of the Mice and the rats

The bacteria that causes plague is carried inside fleas that feed primarily on rats. While the Hebrew Bible doesn’t mention the role of rats, the Septuagint does. Here is the verse in the Hebrew Book of Samuel (I Sam 6:1)

וַיְהִי אֲרוֹן־ה’ בִּשְׂדֵה פְלִשְׁתִּים שִׁבְעָה חֳדָשִׁים׃ - The Ark of the Lord remained in the territory of the Philistines seven months.

And here is the Greek Septuagint: “And the ark was seven months in the country of the Philistines, and their land brought forth swarms of mice.”It was theses swarms of mice (or really rats, which are the primary host for the rat flea that carries the plague bacteria Yersinia) that were responsible for the spreading the plague among the Philistines, causing the lymphatic swellings, the buboes, that were later (mis)translated as hemorrhoids.

So which is it, hemorrhoids or swellings?

It was with this same Septuagint translation that the hemorrhoids thing began: “According to the number of the lords of the Philistines, πέντε έδρας χρυσάς five buttocks of gold, for the plague was on you, and on your rulers" (I Sam 6:5). From this Greek version of the Hebrew we move to the Latin. In the late fourth century Jerome produced a Latin translation of the Hebrew Bible known as the Vulgate, which is still used by the Catholic Church. This translation gave us the quinque anos aureos, “five golden behinds,” which was then translated by the King James Bible as “five golden emerods.”

The Koren Jerusalem Bible translates the phrase as “five golden swellings,” but there is ambiguity as to the meaning in the very text of the Hebrew Bible itself. The text has the word ophalim, עפלים, but the traditional way of pronouncing this word is techorim טְּחֹרִים, which in both the Talmud and modern Hebrew means hemorrhoids. So the different ways of translating the text is embedded in the Hebrew text itself. But one thing is certain: although they may be painful, hemorrhoids won’t kill you, but bubonic plague certainly will. And that should certainly enter into any consideration of an appropriate translation.

From Panagiotakopulu E. Pharaonic Egypt and the origins of plague.  Journal of Biogeography  2004:31; 269–275.

From Panagiotakopulu E. Pharaonic Egypt and the origins of plague. Journal of Biogeography 2004:31; 269–275.

The Vulgate says that they offered five golden images of mice and ‘quinque aureos anos’. It would seem, therefore,that the compilers of the Vulgate were satisfied that the word opalim meant haemorrhoids ,and that the Philistines made golden replicas of the anal ring with a haemorrhoid,or a cluster of piles, protruding from it, not a difficult matter for a reasonably expert goldsmith.
— Shrewsbury, J.F.D. The Plague of the Philistines.The Journal of Hygiene Vol. 47, No. 3 (Nov., 1949), pp. 244-252.

One last candidate: Tularemia

There is another possible etiology of the disease that plagued the Philistines. It is a bacterial disease called tularemia, which most commonly kills rabbits and rodents, but may rarely pass into humans. It causes fever and pneumonia as well as swelling of the lymph nodes in the neck and groin. In a 2007 paper published in the journal Medical Hypotheses, Siro Igino Trevisanato suggested that bubonic plague was not known in the area, tularemia was a better candidate for the outbreak described in the Book of Samuel:

The biblical data appear to center around the box as a vehicle for the disease, as well as the rodents that appear shortly thereafter, and are depicted in the ‘‘settlement’’ paid in gold. The Hebrew word akhbar for the rodents fails to distinguish between mice and rats. Rats would have carried Y. pestis, but bubonic plague fails to adequately explain the epidemic. Mice are a better option: they can carry diseases, and fit the other data relative to the historical text, i.e., box, idol, and settlement payment.

Mice nesting in the [gold plated wooden] box would have explored their new habitat upon each the transfer of the box, thus offering an explanation for the box transmitting the disease.

Mice also explain the otherwise odd detail of a small Philistine idol falling on the floor. Once the box was hosted in the Philistine temple, the animals exiting the box from the same aperture, would have tipped over the statuette, eventually breaking the extremities after repeated falls (1Sa.5.2-5)…

Linking mice to the box and to the disease singles out tularemia as the disease portrayed by the biblical text: mice are known to carry Francisella tularensis, the etiological agent for tularemia. Moreover, the text calls for a disease which originated from animals, can be communicated, can form tumors, and is deadly. Tularemia is a zoonotic disease that can be transferred to humans, manifests ulceroglandular formations, which tend to be misdiagnosed for signs of bubonic plague, and carries a 15% fatality rate when untreated, thus fitting all the criteria in the text.

Nicolas Poussin’s Plague at Ashdod

The French Baroque painter Nicolas Poussin (1594–1665) depicted the Plague at Ashdod in a painting that now hangs in the Louvre. He drew the Philistines dying from what appears to be bubonic plague, a disease with which he was well acquainted, since there was an outbreak of bubonic plague in Italy in 1630, where Poussin painted the work. “By including recognizable signs in his picture of the disease that was at that time a grave concern or all of Italy” wrote Sheila Barker, a specialist in southern Baroque painting, “Poussin coaxed his contemporary audience to identify their own friends’ and relatives’ suffering with the plight of the ancient Philistines.” She continues:

Ostensibly, Poussin's depiction accords with the biblical reference to a plague of "tumors in secret parts," since no tumors can be seen on the victims' bodies. In other respects however, he took great liberty with his laconic source, supplementing one "secret" attribute with a veritable catalogue of the bubonic plague's recognized symptoms. One of these, the telltale darkening of the victim's skin, is detectable in the old woman collapsed against a fallen column, the deceased mother and infant in the foreground, and the make cadaver being carried away by two men in the middle ground at right….Though the bubonic plague's namesake buboes are not visible in the picture, their painful presence can be intuited from the victims' postures. Both the dead mother in the central foreground and the male victim to the far left have raised the right arm away from the body, as if to avoid contact with the inflamed, tumescent, and pus-filled lymph glands in the armpit area….

Beyond the symptoms of bubonic plague, Poussin provides another identifying feature of the disease: its much-disputed means of propagation. Several figures in the painting pinch their noses or cover their faces in proximity to Ashdod's dead and dying. They are protecting themselves from one of the many mechanisms of contagion recognized by seventeenth- century physicians: the breath of the plague victims (rightly so, as today it is recognized that Yersinia pestis occasionally develops into a pulmonary plague transmitted through human sputum). More widely recognized by laymen and physicians alike, however, was the danger of breathing in the vicinity of putrefying corpses, since the foul odors they released were assumed to be the essence of the disease's poison, and of death itself…

Poussin's picture accommodates advanced plague etiologies in other ways as well-particularly in its depiction of the rats scurrying about the city of Ashdod, a detail that has intrigued modern viewers who recognize them as vectors of the plague-causing bacillus Yersinia pestis, discovered in 1894.

Whatever the true etiology of this curious plague, it was frightening enough for a memorial of it to be displayed at the epicenter of religious worship, as a constant reminder that pain and suffering will follow if the Ark of the Covenant is ever removed from its rightful place in Israel.

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Bava Kamma 60b ~ Quarantine and Social Isolation

בבא קמא ס, ב

ת"ר דבר בעיר כנס רגליך

Our Rabbis taught: When there is an epidemic in the town keep your feet inside your house (Bava Kamma 60b.)

Social Isolation

There is a long history of isolating those with disease, beginning with our own Hebrew Bible:

 (כל ימי אשר הנגע בו יטמא טמא הוא בדד ישב מחוץ למחנה  מושבו.  (ויקרא פרק יג, מו

As long as they have the disease they remain unclean. They must live alone; they must live outside the camp (Lev. 13:46).

(צו את בני ישראל וישלחו מן המחנה כל צרוע וכל זב וכל טמא לנפש. (במדבר ה, ב

Command the people of Israel to remove from the camp anyone who has a skin disease or a discharge, or who has become ceremonially unclean by touching a dead person (Num. 5:2).

These are examples of social isolation, that is, individual and community measures that reduce the frequency of human contact during an epidemic. Here, for example, are some of the ways that social distancing was enforced during the Spanish flu epidemic of 1918-1918, an outbreak that killed about 40 million people worldwide:

... isolation of the ill; quarantine of suspect cases and families of the ill; closing schools; protective sequestration measures; closing worship services; closing entertainment venues and other public areas; staggered work schedules; face-mask recommendations or laws; reducing or shutting down public transportation services; restrictions on funerals, parties, and weddings; restrictions on door-to-door sales; curfews and business closures; social-distancing strategies for those encountering others during the crisis; public-health education measures; and declarations of public health emergencies. The motive, of course, was to help mitigate community transmission of influenza.

The teaching in tomorrow's page of Talmud emphasizes not the isolation or removal of those who are sick, but rather the reverse - the isolation of those who are well.  Of course the effect is the same: there is no contact between those who are ill and those who are well, but since there are usually many more well than there are sick, the effort and social disruption of isolation of the healthy will be much greater.  

Implementation of social distancing strategies is challenging. They likely must be imposed for the duration of the local epidemic and possibly until a strain-specific vaccine is developed and distributed. If compliance with the strategy is high over this period, an epidemic within a community can be averted. However, if neighboring communities do not also use these interventions, infected neighbors will continue to introduce influenza and prolong the local epidemic, albeit at a depressed level more easily accommodated by healthcare systems.
— Glass, RJ. et al. Targeted Social Distancing Design for Pandemic Influenza. Emerging Infectious Diseases 2006. 12: (11); 1671-1681.

It is not hard to see a relationship between expelling those who are ill and denying entry to those whose health is in doubt.  In the 14th century, when Europe was ravaged by several waves of bubonic plague that killed one-third of the population, many towns enacted measures to control the disease. Around 1347 the Jewish physician Jacob of Padua advised the city to establish a treatment area outside of the city walls for those who were sick.  "The impetus for these recommendations" wrote Paul Sehdev  from the University of Maryland School of Medicine, "was an early contagion theory, which promoted separation of healthy persons from those who were sick. Unfortunately, these measures proved to be only modestly effective and prompted the Great Council of the City to pursue more radical steps to prevent spread of the epidemic." And so the notion of quarantine was born. Here is Sehdev's version of the story:

In 1377, the Great Council passed a law establishing a trentino, or thirty-day isolation period . The 4 tenets of this law were as follows: (1) that citizens or visitors from plague-endemic areas would not be admitted into Ragusa until they had first remained in isolation for 1 month; (2) that no person from Ragusa was permitted go to the isolation area, under penalty of remaining there for 30 days; (3) that persons not assigned by the Great Council to care for those being quarantined were not permitted to bring food to isolated persons, under penalty of remaining with them for 1 month; and (4) that whoever did not observe these regulations would be fined and subjected to isolation for 1 month. During the next 80 years, similar laws were introduced in Marseilles, Venice, Pisa, and Genoa. Moreover, during this time the isolation period was extended from 30 days to 40 days, thus changing the name trentino to quarantino, a term derived from the Italian word quaranta, which means “forty."
The precise rationale for changing the isolation period from 30 days to 40 days is not known. Some authors suggest that it was changed because the shorter period was insufficient to pre- vent disease spread . Others believe that the change was related to the Christian observance of Lent, a 40-day period of spiritual purification. Still others believe that the 40-day period was adopted to reflect the duration of other biblical events, such as the great flood, Moses’ stay on Mt. Sinai, or Jesus’ stay in the wilderness. Perhaps the imposition of 40 days of isolation was derived from the ancient Greek doctrine of “critical days,” which held that contagious disease will develop within 40 days after exposure. Although the underlying rationale for changing the duration of isolation may never be known, the fundamental concept embodied in the quarantino has survived and is the basis for the modern practice of quarantine.

More talmudic health measures during an epidemic

In addition to staying indoors, tomorrow's page of  Talmud recommends two other interventions during a plague:

ת"ר דבר בעיר אל יהלך אדם באמצע הדרך מפני שמלאך המות מהלך באמצע הדרכים

Our Rabbis taught: When there is an epidemic in the town, a person should not walk in the middle of the road, for the Angel of Death walks in the middle of the road...

 ת"ר דבר בעיר אל יכנס אדם יחיד לבית הכנסת שמלאך המות מפקיד שם כליו

Our Rabbis taught: When there is an epidemic in the town, a person should not enter the synagogue alone, because the Angel of Death deposits his tools there...

It probably won't surprise you to learn that neither of these two measures is discussed in the medical literature, and in fact if there's an epidemic in town, you probably shouldn't go to shul at all. Nevertheless, the first suggestion made by the rabbis - to isolate yourself from others during an epidemic - is a basic part of public infection control. You'd be wise to listen.  

שולחן ערוך יורה דעה הלכות מאכלי עובדי כוכבים סימן קטז סעיף ה 

עוד כתבו שיש לברוח מן העיר כשדבר בעיר, ויש לצאת מן העיר בתחלת הדבר, ולא בסופו. וכל אלו הדברים הם משום סכנה, ושומר נפשו ירחק מהם ואסור לסמוך אנס או לסכן נפשו בכל כיוצא בזה

Initial growth of an infectious contact network . Colored rectangles denote persons of designated age class, and colored arrows denote groups within which the infectious transmission takes place. In this example, from the adult initial seed (large purple rectangle), 2 household contacts (light purple arrows) bring influenza to the middle or high school (blue arrows) where it spreads to other teenagers. Teenagers then spread influenza to children in households who spread it to other children in the elementary schools. Children and teenagers form the backbone of the infectious contact network and are critical to its spread; infectious transmissions occur mostly in the household, neighborhood, and schools. From Glass, RJ. et al. Targeted Social Distancing Design for Pandemic Influenza.   Emerging Infectious Diseases   2006. 12: (11); 1671-1681.

Initial growth of an infectious contact network. Colored rectangles denote persons of designated age class, and colored arrows denote groups within which the infectious transmission takes place. In this example, from the adult initial seed (large purple rectangle), 2 household contacts (light purple arrows) bring influenza to the middle or high school (blue arrows) where it spreads to other teenagers. Teenagers then spread influenza to children in households who spread it to other children in the elementary schools. Children and teenagers form the backbone of the infectious contact network and are critical to its spread; infectious transmissions occur mostly in the household, neighborhood, and schools. From Glass, RJ. et al. Targeted Social Distancing Design for Pandemic Influenza. Emerging Infectious Diseases 2006. 12: (11); 1671-1681.

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Ketuvot 8b ~ When Some Plagues End, and Others Begin

 כתובות דף ח עמוד ב 

 רבון העולמים, פדה והצל, מלט, הושע עמך ישראל מן הדבר ומן החרב ומן הביזה, ומן השדפון ומן הירקון, ומכל מיני פורעניות המתרגשות ובאות לעולם, טרם נקרא ואתה תענה, ברוך אתה עוצר המגפה

Master of the worlds, redeem and save, deliver and help your nation Israel from pestilence, and from the sword, and from plundering, from the plagues of wind blast and mildew [that destroy the crops], and from all types of misfortunes that may break out and come into the world. Before we call, you answer. Blessed are You, who ends the plague.

In today's Daf Yomi, the secretary of Resh Lakish, a man by called Yehuda bar Nachmani, offers four blessings that may be said as part of the meal eaten at a house of mourning. Although the fourth blessing, "Who ends the plague" (עוצר המגפה) is not said usually today, we do have a tradition of giving thanks when a plague comes to an end.

The Prayer of Thanks After the Cholera Epidemic in London, 1850 

In the nineteenth century, London was ravaged by a series of brief but intense cholera epidemics that killed hundreds at a time in a matter of days. The infectious agent, we know today, was Vibrio Cholerae. If it finds its way into your intestine, its toxin will cause the cells of your gut to excrete water at a remarkable rate. The result is overwhelming dehydration, and death may follow in a matter of hours. (Water-borne cholera epidemics are still common. After the 2012 Haitian earthquake over 4,000 people died from it. That's 4,000 people who survived the earthquake itself, only to die from drinking water that was infected with cholera.)

Like all epidemics, cholera flares up and then disappears, even when no effective medical interventions are available.  It was when one of these devastating outbreaks of cholera had ended, that the Jews of London came together to do what Resh Lakish described. On Nov 1, 1850, they offered a prayer of thanks at the cessation of the plague of cholera.

 

 ידך היתה בבני ארצנו בחלי–רע לאין מרפא רבים חללים הפיל עד שאיש נבוב חת לקול אמות דפק על פתחו וחיל אחז אמין לב בגבורים. אך חנון ירחום אתה, לא לעולם תזנח ולא לנצח תטור אם הבאבת תחבוש, ואם תמחץ ידיך תרפינה. שלחת רוחך ותחלימנו צוית והמגפה נעצרה  

 

 

Your hand lay heavily on the inhabitants of this land. Cholera struck many down. The strongest heart trembled at the voice of death sounding at the threshold, and the boldest among the mighty were seized with terror and anguish. But gracious and and merciful are You; Your wrath does not last long, nor does Your anger last for ever. You strike some and heal. You wound but it is Your hand which prepares the calm. In the depths of our terror and affliction You sent Your spirit and there was a pause. You commanded, and the Plague ceased...
— Service of Thanksgiving on the Cessation of the Cholera, London, Nov 1850.

Why did the cholera epidemic end so quickly? There is, of course a scientific explanation:

[I]t's possible that the V. Cholerae's dramatic reproductive success...had been the agent of its own demise...it quickly burned through its primary fuel supply. There weren't enough small intestines to colonize....It's also possible that the Vibrio cholerae had not been able to survive more than a few days in the well water... With no sunlight penetrating the well, the water would have been free of plankton, and so the bacteria that didn't escape might have slowly starved to death in the the dark, twenty feet below street level...But the most likely scenario is that the bacterium was itself in a life-or-death struggle with another organism: a viral phage that exploits V. cholerae for its own reproductive ends the way V. cholerae exploits the human small intestine. One phage injected into a bacterial cell yields about a hundred new viral particles, and kills the bacterium in the process. After several days of that replication, the population of V. cholerae might have been replaced by phages that were harmless to humans. (Steven Johnson, The Ghost Map, 152).

But this explanation lessens not one bit the religious impulse to give thanks.  

THE END OF ONE PLAGUE, THE BEGINNING OF ANOTHER

In West Africa, the Ebola epidemic is slowly ending. Although there is neither an effective vaccine to prevent Ebola, nor an effective anti-viral to treat it, public health interventions have paid off, and life is slowly returning to normal.

Meanwhile, back in the US, another plague begins. This one, while far less lethal that Ebola, is all the more tragic; all the more tragic  because it is entirely preventable.  There have been more than 100 cases of measles in January alone (compared to about 600 for all of 2014), most of them linked to exposure in December at Disneyland in California.  I had the measles as a kid. If you were born before the 1970s, it's likely you've had it too. My aunt caught it when she was carrying my cousin, who was born deaf, the result of congenital measles infection.  Back then, there was no vaccine.  There is now.  And don't start with the autism-vaccination thing.  There is no link between autism and vaccination. None.  Yet in significant numbers, Jewish parents - and some of them educated, are refusing to vaccinate their children.  Vaccine denial is not limited to some haredi communities, (though in many cases their vaccination rates are remarkably  low).  It is seen in affluent neighborhoods with highly educated parents, where the vaccine denial movement has become a cult in which any and all scientific evidence is ignored. (And in an odd coincidence, see this op-ed in The New York Times.  Apparently, Jesus would have gotten the measles vaccine.)

In today's daf, the secretary of Resh Lakish offered a Prayer of Thanks when a plague ended. But precisely when did he say these words?  At a funeral. The funeral of a young child (ינוקא). The secretary of Resh Lakish offered these words of thanks at a child's funeral, and directed them towards "all Israel" (כנגד כל ישראל), that is, towards the survivors.  How ironic it is that it is the children who are most at risk in this measles epidemic. And how tragic that they face the complications of this illness (including pneumonia, diarrhea, encephalitis, subacute sclerosing pan-encephalitis, and death,) because of the reckless behavior of their parents.

Risk factors of underutilization of childhood immunizations in ultra-orthodox populations.  From Muhsen K.  el at . Risk factors of underutilization of childhood immunizations in ultraorthodox Jewish communities in Israel despite high access to health care services.    Vaccine    2012. 30; 2109–2115

Risk factors of underutilization of childhood immunizations in ultra-orthodox populations. From Muhsen K. el at. Risk factors of underutilization of childhood immunizations in ultraorthodox Jewish communities in Israel despite high access to health care services. Vaccine 2012. 30; 2109–2115

Characteristics of parents who reported vaccine doubts . From Gust D.  et al.  Parents With Doubts About Vaccines: Which Vaccines and Reasons Why. Gust D. et al.    Pediatrics    2008;122: 718–725

Characteristics of parents who reported vaccine doubts. From Gust D. et al. Parents With Doubts About Vaccines: Which Vaccines and Reasons Why. Gust D. et al. Pediatrics 2008;122: 718–725

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