Pennsylvania has reported its fourth death linked to a measles outbreak, according to state health officials. All four deaths were reported within the past month as the outbreak continued to grow. These are the first measles-related deaths in Pennsylvania in 35 years. Pennsylvania said the current outbreak began in late April.
The most recent deaths were from Jefferson and Mifflin counties, with both individuals unvaccinated against measles, according to NBC New York. An 18-year-old resident of Mifflin County died from complications related to measles, including a rare neurological condition called acute disseminated encephalomyelitis. A 40-year-old woman from Jefferson County who had chronic obstructive pulmonary disease and asthma died of respiratory failure due to measles, according to the county coroner.
Two infants in Lancaster County also died from measles-related issues, though the circumstances were different for each case. One was a newborn who died shortly after birth, while the other was a six-week-old baby. The infant who died at birth had evidence of measles in lung tissue but the actual cause of death was determined to be internal bleeding and spleen rupture. The six-week-old baby’s death was attributed to measles infection, according to the county coroner, though the child also had a severe genetic condition called Amish lethal microcephaly.
Neither infant had received their first dose of the MMR vaccine, which is typically given around one year of age. Two doses of the MMR vaccine provide about 97% protection against measles, often for life. As of September 14, Pennsylvania had recorded 133 hospitalizations and only four measles cases among people who were appropriately vaccinated for their age.
State health officials define a death as measles-associated if there is clinical evidence of infection, lab confirmation, and the person died within 30 days of showing symptoms. The investigation into these recent deaths involved county coroners and was confirmed by Pennsylvania’s health department. State officials also consider medical records and whether another unrelated event caused the death.
Nearly 700 cases of measles have been reported across the state this year, with most cases concentrated in Lancaster and Mifflin counties. Public health experts have linked the outbreak to declining vaccination rates among residents.
Nationwide, the Centers for Disease Control and Prevention had confirmed 3,294 cases of measles by September 10th. The CDC has not yet confirmed Pennsylvania’s reported deaths in its national tally due to a change in how it counts such cases. This shift in reporting standards is unusual for the agency and has caused confusion among public health experts. The CDC has shifted toward using National Center for Health Statistics death records rather than relying only on the faster infectious-disease reporting system traditionally used for outbreak surveillance.
CDC Director Erica Schwartz said that Pennsylvania had not asked for federal help during this outbreak. The Pennsylvania health department also said it submits death records to the CDC’s National Center for Health Statistics daily, including recent measles-related deaths. Pennsylvania officials said they continue to work regularly with professional staff at the CDC.
Political debate arose after the infant deaths in Lancaster County, with Governor Josh Shapiro criticizing Health and Human Services Secretary Robert F. Kennedy Jr. for spreading misinformation about vaccines. Kennedy suggested that the reported deaths may have been fabricated and accused Shapiro of political gain from the situation. Reuters reported that Kennedy later acknowledged that measles caused one of the infant deaths.
Anti-vaccine advocates often argue that a positive measles test does not prove someone died directly from the virus if another illness or injury occurred. Medical professionals, however, maintain that measles remains the underlying cause in many of these cases. State and county authorities can also use different definitions because public health surveillance and legal death certificates serve different purposes.
Pennsylvania’s health secretary, Dr. Debra Bogen, expressed her condolences and emphasized the need for continued efforts to stop the outbreak, according to a report from Yahoo News. She said that measles is a highly contagious disease that spreads through breathing, coughing, or sneezing. The virus initially causes symptoms like high fever, cough, and red eyes before progressing to more serious complications.
So far, the outbreak has affected 693 people in 38 counties. These deaths mark the first measles-related fatalities in the state since 1991.
Health officials say that one to three people per 1,000 die from measles-related complications such as pneumonia or brain inflammation, The Guardian reported. The state’s agricultural regions in Lancaster and Mifflin counties have been the center of the outbreak.
Globally, measles remains an important cause of death among young children despite the availability of a safe and effective vaccine. The U.S. eliminated measles in 2000, but recent outbreaks raise questions about whether that status can be maintained. International health officials are expected to review whether the United States has maintained its measles elimination status.
Measles is considered one of the most contagious diseases known to medicine. The MMR vaccine is highly effective at preventing infection and has been a key tool in controlling outbreaks.
Despite the CDC’s current reporting changes, public health experts continue to stress the importance of vaccination. They warn that low vaccination rates not only increase individual risk but also threaten community immunity.
IMAGE: Allegheny County Director Dr. Debra Bogen speaking to the press. As Pennsylvania’s vaccination plan accelerates and more than a third of the state’s eligible population is vaccinated, Governor Tom Wolf today visited a new vaccination clinic in McKeesport to talk about vaccine equity and progress. McKeesport, PA – April 7, 2021. Photo: governortomwolf / Wikimedia, taken 2021-04-07, CC BY 2.0