In a surprising development, the US Centers for Disease Control and Prevention (CDC) has decided not to include two measles-associated deaths from Pennsylvania in its official tally, citing insufficient information to ascertain whether measles was a contributing factor in the fatalities, reports BritPanorama.
This decision has intensified an ongoing dispute between US Department of Health and Human Services Secretary Robert F. Kennedy Jr. and Pennsylvania’s Democratic Governor, Josh Shapiro, as the state grapples with a rising measles outbreak.
Pennsylvania health officials insist their investigation into the deaths was thorough prior to their announcement. “Every reported measles case is thoroughly reviewed to confirm it meets the CDC’s case definition for a measles case. To date, the Department of Health has provided all required epidemiological data to the CDC regarding the two measles-associated deaths in Pennsylvania,” stated Neil Ruhland, press secretary for the Pennsylvania Department of Health.
The CDC postponed its routine Friday update on measles data. When the update was finally released over the weekend, the number of deaths for 2026 was preceded by an asterisk and footnote explaining that the two deaths reported on August 25 would not be included pending further review. The footnote noted that available information does not clarify whether measles was a cause or contributor to the deaths or if the individuals died from other underlying causes while infected with measles.
The agency has since directed media inquiries to Kennedy’s office. Grace Davis Jamison, a press secretary for HHS, emphasized the CDC’s obligation to ensure accurate and transparent reporting, stating, “The two measles-associated deaths announced by Pennsylvania have not been confirmed based on the information currently available to the CDC.”
Dr. Erica Schwartz, the newly appointed CDC director, made the call to exclude the deaths, a decision reportedly viewed as highly unusual by public health experts familiar with the internal workings of the agency. Dr. Nirav Shah, the former principal deputy director at the CDC, remarked, “The idea that you would second guess the determination of the state epidemiologist is pretty remarkable.” He further elaborated that excluding deaths under such circumstances could signify the politicization of public health.
First test for new CDC director
Schwartz’s leadership is under scrutiny since she took office in mid-August. Despite being a medical doctor with a strong commitment to vaccines, her public statements have raised concerns over her independence from Kennedy, noted for his historical advocacy against vaccines. In her initial agency meeting, Schwartz confirmed she would not hesitate to voice disagreements with Kennedy but noted such disagreements would not occur publicly.
Dr. Jeremy Faust from Harvard Medical School characterized Schwartz’s performance during this crisis as a failure. “If she’s overseeing an agency that is only now just a mouthpiece for what her bosses think, then she is absolutely failing in her mandate,” Faust stated, urging Schwartz to choose between acting as a communications spokesperson or as an independent advocate for scientific integrity.
Counting measles deaths
The controversy echoes an earlier incident where a Texas child, who died following a measles infection, was included in the CDC’s mortality count despite advocacy claiming a bacterial pneumonia was the cause rather than the measles itself, illustrating the complexities of attributing cause of death in the context of infectious diseases. In the Pennsylvania case, Kennedy insinuated the reported deaths might be fabricated due to a lack of coroner records connecting them to measles.
More recently, Lancaster County Coroner Dr. Stephen Diamantoni has confirmed ongoing investigations into the death of an infant who exhibited signs of measles exposure prior to birth. While examining the circumstances around the infant’s death, issues regarding the role of the spleen in death due to infection have also emerged.
Impacts on public health
Experts express concern that sowing doubt about the state’s reporting can create a damaging narrative surrounding scientific verification. Dr. Brian Castrucci, president of the de Beaumont Foundation, cautioned against “manufactured controversy” reminiscent of discussions seen during the COVID-19 pandemic. He highlighted the importance of accurate data representation for public health.
As these discussions unfold, the impact on public perception and health interventions becomes increasingly critical. The trajectory of this measles outbreak and the responses from health authorities will play a significant role in shaping public trust and health policy moving forward.
