Measles deaths reported in Pennsylvania spark fight among politicians and health officials

NEW YORK (AP) — The recent announcement of Pennsylvania’s first measles-related deaths in decades has ignited a public feud among politicians and health officials who disagree over the role of the contagious disease in the fatalities.

Independent experts say the conflict is a symptom of a social and political debate over how to frame a national surge in measles cases, the worst seen in more than three decades.

Pennsylvania officials this week reported that two unvaccinated residents died after being infected with measles, with Gov. Josh Shapiro stressing that vaccinations could have averted the deaths.

But the announcement quickly came under fire, as a clash erupted between Shapiro, a vaccine-promoting Democrat, and U.S. Health Secretary Robert F. Kennedy Jr., a Trump administration appointee with a history of raising alarms about established vaccines. Kennedy said in a social post the deaths “may even have been altogether fabricated.”

Kennedy’s attack echoed statements he made last year, when three measles-related deaths were recorded. Kennedy questioned whether one of the children who died was killed by measles.

Medical experts say the brouhaha has diverted focus from an exploding public health threat.

“Now it’s turned political,” said Dr. Amesh Adalja, an infectious disease doctor in the Pittsburgh area and a senior scholar at the Johns Hopkins Center for Health Security. “It’s no longer about getting answers and figuring this out.”

The challenges of tallying measles deaths

The U.S. eliminated the domestic spread of measles in 2000 by maintaining high vaccination rates, but they have fallen in recent years to below the 95% coverage needed to prevent outbreaks. In November, international health officials will meet to determine if the U.S. and Mexico have lost their measles-free status.

Complicating the situation in Pennsylvania are questions about what counts as a measles death, which is rare in the United States. The World Health Organization counts a death when a person has tested positive for measles and when the death occurs within a month from when a rash appears and the death is not obviously due to another cause such as trauma.

State health officials are the ones who report measles cases and measles-associated deaths. The question of defining a measles death hasn’t come up much in recent decades because vaccination rates were high and measles illnesses and deaths had become rare.

Recent trends are driving conversations among health officials about how to better track the consequences of a surging problem.

“As measles infections increase, we also need to prepare for more of the tragic complications we have largely avoided in this country for decades,” including not only deaths but also hospitalizations and brain injuries, said Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists, in a statement.

What’s known and not known about the measles deaths

In Pennsylvania, what’s not disputed is that both people who died had been infected with measles and they were unvaccinated. The unresolved question is whether measles was the main cause, or a contributing cause, of their deaths.

In one of the deaths, an official has reached a conclusion. The Lancaster County Coroner, Dr. Stephen Diamantoni, said he is aware of only one death with evidence of measles infection. It was a newborn baby boy who died August 14 — someone too young to get a recommended measles vaccination.

Because one of the boy’s family members had measles, investigators tested the boy’s lung tissue and found evidence of measles infection, Diamantoni said.

But investigators did not see signs of a swollen spleen or other ravages from a measles infection that would have contributed to the death. The cause is being attributed to a tear in the spleen, but the coroner’s office says the virus did not play a role.

The baby “did not die as a result of measles,” Diamantoni said.

The Pennsylvania Department of Health initially refused to disclose any details about the two people who died. But on Wednesday night, state health officials posted on social media that one of the deaths is under investigation by the coroner’s office. No information has been released about the second death.

The department said it stands by its announcement, adding that it relies on two questions to determine if a death was measles-related: Did the person have measles and did they die?

As of Friday, the Centers for Disease Control and Prevention has not updated the latest national tally of measles cases and deaths. The agency said on its website that the scheduled update was delayed, but did not disclose why.

Dr. Paul Offit said he’s worried that two measles-related deaths are an unusually high number in a county that reportedly has about 400 cases. The expected death rate for measles is 1 in 1,000 cases.

That suggests there are a large number of other unreported infections in the Lancaster County area, said Offit, a Children’s Hospital of Philadelphia vaccine researcher.

That’s worrisome, given that this is the time of year when kids go back to school, which could increase the spread of an extremely transmissible disease. Vaccination efforts need to be stepped up “to prevent what I think is a coming disaster,” Offit said.

Adalja faulted Pennsylvania officials for how they announced the deaths earlier this week. It should have only been health and medical officials, stating what is known and not yet known.

“They should learn to keep the politicians out of it,” he said.

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