ALBANY, N.Y. (VINnews) — Gov. Kathy Hochul declared a statewide disaster emergency Monday as measles cases continued to rise in rural New York, the first such declaration by a U.S. state since infections began surging in 2025.

Executive Order No. 65 took effect Monday and runs through Nov. 4. It expands who may give the measles-mumps-rubella vaccine and gives nurses more authority to order tests, according to the governor’s office.

“After reviewing the latest data on measles cases in New York State, I am declaring a State Disaster Emergency to strengthen our ongoing efforts to confront this disease,” Hochul said. “No one should get seriously ill or die from a vaccine-preventable disease.”

The state had recorded 108 measles cases among residents through Oct. 3, including seven in New York City and 101 elsewhere in the state, the governor’s office said. Ninety-two of those cases have been reported since July 15 in under-immunized rural communities across 18 counties.

That is more than double the 48 cases reported in all of 2025, Newsday reported. State tallies show about a fifth of this year’s cases in Otsego County, and local officials have said most of the recent infections are concentrated in Otsego, Seneca and Steuben counties. Long Island has recorded one case this year, a young unvaccinated child in Nassau County, Newsday reported.

Local health departments have given more than 1,000 MMR doses in rural areas since July 15, the state said.

The order lets paramedics, advanced EMS providers, midwives and pharmacists administer the vaccine, and allows nurses, not only physicians, to order measles testing. Vaccination still requires the consent of the patient or a legal guardian. The order also directs that MMR vaccinations be reported to state or New York City immunization registries within 72 hours.

State Health Commissioner Dr. James McDonald said department staff are working with local health departments to track and contain the outbreak, and he urged New Yorkers to check their vaccination status.

“The measles, mumps, and rubella vaccine is the best protection — protecting nearly all people against disease who receive the recommended doses,” McDonald said.

Neighboring Pennsylvania is dealing with a much larger outbreak. Hochul’s order cites 977 cases and five deaths there as of Oct. 2, mostly in rural counties along the New York border. Pennsylvania health officials said Monday the state total had passed 1,000, the largest state outbreak in more than three decades, Reuters reported. Nationally, the Centers for Disease Control and Prevention has logged nearly 3,900 cases this year, the country’s worst measles year since 1991.

The Health Department has also posted a measles dashboard so residents can follow county case counts. Officials said a person with measles can spread the virus from four days before a rash appears until four days after, and that the incubation period can run as long as 21 days. People who are exposed are advised to quarantine for 21 days. Infants 6 to 11 months old can receive an early MMR dose before travel or if they are otherwise at risk of exposure, the state said.

Healthcare providers are required to report suspected cases to their local health department.