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An outbreak tied to New York's Orthodox Jewish community has grown to 390 cases.
The likely exposure was inoculated rabbit skins, but airborne spread cannot be ruled out.
The vaccine "has the potential to save tens of thousands of children's lives."
The outbreak has grown to 1,340 cases and 874 deaths.
Cases have now reached 626 and could soon top the ignomious post-elimination record of 667, reached in 2014.
The Virginia finding is 40 miles from any other detections in the area.
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