HARRISBURG, Pa. — Pennsylvania’s measles outbreak continued to grow on Monday, with the state reporting 68 new infections since last Wednesday, pushing the total past 900 cases as officials struggle to contain the state’s worst measles resurgence in decades.
Data released by the Pennsylvania Department of Health showed 903 confirmed cases, with 176 patients hospitalized, up from 164 hospitalizations reported on Sept. 23.
Lancaster County, home to a large Amish population, remains the hardest-hit area in the state. The outbreak has also spread through other largely unvaccinated Amish communities in central Pennsylvania, including the area around Belleville in Mifflin County.
Four deaths reported
Pennsylvania has reported four measles-related deaths this year, all among unvaccinated residents. It is the most measles deaths reported in the United States in a single year since 1992.
The first two deaths, reported in August, were infants in Lancaster County. Lancaster County Coroner Stephen Diamantoni, a physician, said one of the infants, a newborn, tested positive for measles but died of a ruptured spleen. He later said the second death, of a 6-week-old Amish girl, was a direct result of measles.
In September, the state reported two more deaths, both in unvaccinated adults. An 18-year-old in Mifflin County died from acute disseminated encephalomyelitis, a rare neurological condition that can occur after an infection, according to county coroner Andrea Alcalde. The Jefferson County coroner reported the death of a 40-year-old woman.
The deaths were the first measles-related fatalities in Pennsylvania in about 35 years.
“We hope, and we pray, that those deaths will be the last,” Gov. Josh Shapiro said after the first deaths were announced. “This illness and death from measles is completely preventable.”
Clash over death counts
The deaths have fueled a bitter public dispute between Shapiro, a Democrat, and U.S. Health and Human Services Secretary Robert F. Kennedy Jr. over how many of the fatalities were directly caused by measles.
State health officials have said they define a “measles-associated death” as one in which measles was present, even if it was not the immediate cause of death. Kennedy has argued that the facts emerging from coroners’ findings justified the federal government’s caution in counting the deaths.
The Centers for Disease Control and Prevention initially did not count any of Pennsylvania’s deaths, saying it did not have enough information to determine whether measles caused or contributed to them. Soon after, the CDC said it was reviewing how it classifies measles-related deaths. The agency’s website now lists one verified measles death, but it did not say where that death occurred.
Shapiro has accused Kennedy of interfering in the process. In a post on X, the governor said it was “deeply concerning to learn that the Secretary personally intervened in an otherwise administrative process to direct the CDC to not report these Pennsylvania deaths.”
Shapiro has also said he declined an offer of federal assistance from Kennedy, telling the secretary that his rhetoric, including spreading misinformation about vaccines, was harming communities. Kennedy has criticized Shapiro for turning down federal help.
Kennedy has maintained that the Trump administration’s response to measles is working. “I’ve sent the CDC in to cooperate with the state health agencies, and we’ve brought it to an end overnight,” he said at a news conference in August.
National surge
Pennsylvania’s outbreak is part of a broader measles resurgence across the United States. The country has recorded 3,659 measles cases this year as of Sept. 24, according to CDC data, the highest level in about 35 years.
Last year, the U.S. recorded three measles deaths, two in Texas and one in New Mexico, during a large outbreak centered in West Texas.
Measles was declared eliminated from the United States in 2000, meaning it was no longer continuously spreading. But public health experts say declining childhood vaccination rates have allowed the virus to return. More families are seeking exemptions from routine immunizations, and vaccine hesitancy has grown in some communities.
Earlier this summer, President Donald Trump signed an order limiting the vaccines recommended for children and splitting the combined measles, mumps and rubella vaccine into separate doses, a move that drew criticism from many medical experts.
Amish communities hit hard
The outbreak has spread quickly through Amish communities, where vaccination rates are often low and families tend to live in close-knit settlements with frequent large gatherings.
Doctors at clinics serving Amish families have described scrambling to contain the spread. Many Amish residents do not have cars or cellphones, making it difficult to follow standard instructions for people with symptoms, such as calling ahead before visiting a doctor’s office. Some clinics have posted signs asking patients with symptoms to wear masks, ring the bell and step back from the door.
Health care providers have warned that the outbreak could strain hospitals as flu season approaches.
Highly contagious but preventable
Measles is one of the most contagious viruses known. It spreads through the air when an infected person coughs or sneezes, and the virus can linger in a room for up to two hours after an infected person leaves.
The disease can cause high fever, rash and respiratory complications, and in severe cases can lead to pneumonia, brain swelling and death. Young children, pregnant women and people with weakened immune systems are at the highest risk of serious complications.
Measles can be easily prevented with the measles, mumps and rubella vaccine, a routine childhood immunization that provides 97% protection after two doses. Health officials recommend that children receive their first dose at 12 to 15 months of age and a second dose at 4 to 6 years old.
Pennsylvania health officials are urging residents to make sure they are up to date on their vaccinations, particularly in affected counties. The state has held vaccination clinics and worked with community leaders in an effort to slow the spread.
With cases still rising and flu season approaching, public health experts warn that the outbreak could continue for months unless vaccination rates improve in the hardest-hit communities.
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