Cattaraugus County hasn’t recorded any cases of measles this year in the largest U.S. outbreak since 1994, which has now spread to 23 states.

But that doesn’t mean area health officials aren’t concerned. While about 94 percent of Cattaraugus County residents are vaccinated against measles and other childhood diseases, the county’s 2,500-member Amish community is largely unvaccinated.

Cattaraugus County Public Health Director Dr. Kevin Watkins warned members of the Board of Health Tuesday that the current national outbreak means local Amish are at risk.

“It’s something we are going to have to deal with,” he said.

The Centers for Disease Control has reported 764 cases of measles this year, with 41 new cases last week among persons in New York City and 11 in Rockland County where there are large unvaccinated Orthodox Jewish communities.

The CDC has added Pennsylvania to the states where measles cases have been reported this year.

This is the highest number of measles cases since 1994 when 963 cases were reported in the U.S.

New York state is proposing to remove religious exemptions from childhood vaccinations, Watkins said.

“This is going to be a problem for our county because of the Amish,” he explained.

The public health director said he wants to sit down with the bishops who lead the county’s Old Order Amish community “to come up with a plan to deal with it.”

Board of Health member James J. Snyder of Olean, the chairman of the County Legislature, said that would apply with children attending public schools.

“If they’re not vaccinated, they won’t be allowed to go to public schools,” he said.

The Amish generally attend small schools scattered throughout their communities.

Health Department Patient Services Director Lynn Moore said two cases of pertussis, or whooping cough, were reported in Amish families in the county last month.

In attempting to check on the condition on one of the youths, a Health Department nurse was locked out of one house, Moore said.

The bishops, Moore added, are still not going to advise community members to get their children vaccinated.

Most U.S. children get an MMR (measles, mumps and rubella) vaccination between the ages of 12 and 15 months, and a second dose between the ages of four and six.

(Contact reporter Rick Miller at rmiller@oleantimesherald.com. Follow him on Twitter, @RMillerOTH)