A newborn baby from Lancaster County was among the two unvaccinated residents whose deaths were associated with measles, Pennsylvania health officials said Wednesday.
The state disclosed the age of one of two Lancaster County residents whose measles-related deaths were announced Tuesday. Their deaths were the first in Pennsylvania in 35 years, and the first in the United States this year, tied to the highly contagious disease.
As vaccination rates decline in the state, an outbreak that began in April this year has sickened more than 400 people in 29 counties — with the epicenter in Lancaster County, where nearly 200 individuals have tested positive for the viral disease. Local physicians and health officials say the true case count is likely much higher.
The state initially declined to share any information about the deaths, citing privacy concerns, and no information has been released about the second Lancaster resident who died.
The Pennsylvania Department of Health confirmed information about the newborn’s death on Wednesday only after the Lancaster County coroner publicly stated his office was investigating a newborn who had tested positive for measles and died from a ruptured spleen.
Lancaster County Coroner Stephen Diamantoni, a physician, said the cause of death was not the measles. The newborn died shortly after birth from a laceration of the spleen. A postmortem test on the baby’s lung tissue showed that the child had a measles infection that was acquired before birth, he said in an interview.
His description of the death, shared with reporters and a local county commissioner, contributed to a growing uproar on social media over the nature of the deaths and the state’s release of information.
President Donald Trump’s secretary of health and human services, Robert F. Kennedy Jr., traded attacks with Gov. Josh Shapiro, a Democrat, on X over the deaths and the safety of the measles vaccine.
In his own posts on X, as well as during a news conference Tuesday, the governor said Kennedy was spreading misinformation about vaccine safety and scaring parents; Kennedy replied that the governor was “gaslighting.”
Late Wednesday, Kennedy went further in another X post. He accused Shapiro’s administration of potentially having “fabricated” the deaths, after saying in an interview on C-Span that “they cannot find any measles deaths in Lancaster County.”
He said that Shapiro was not cooperating with the Centers for Disease Control and Prevention or the county in giving information on the deaths.
Shapiro administration staff said the department has been in regular contact with the agency during the outbreak. Pennsylvania Health Secretary Debra Bogen said in a statement late Wednesday that she “sadly can confirm” two measles-associated deaths in Lancaster County.
Measles deaths are rare. Most patients recover after mild illness, but the virus can cause pneumonia and brain swelling and kills about one to three patients in 1,000. The disease is so contagious that it can infect nine in 10 unvaccinated people.
The Pennsylvania Department of Health explained that it reports deaths where measles are present as “measles-associated,” and it “may not be assessed by the medical examiner or coroner to be the immediate cause of death.”
In Lancaster, the coroner’s office determined that the baby’s primary cause of death was a laceration of the spleen, Diamantoni said.
Despite the baby’s positive measles test, the forensic pathologist who conducted the autopsy “did not feel it was related to measles,” Diamantoni added.
His office is seeking to learn whether the baby’s mother had measles at the time of the baby’s birth.
He said state health officials had not contacted him personally as of Wednesday about the two Lancaster County measles-associated deaths, but his chief deputy spoke to the department prior to Shapiro’s news conference Tuesday.
Paul Offit, a national vaccine safety expert and physician at Children’s Hospital of Philadelphia, said news of the coroner’s investigation “doesn’t really give us more information” on the death.
Children can acquire the disease after birth, or can be born with measles if their mother is infected and develops a rash within 10 days of giving birth, he said.
Measles can cause an enlarged spleen, and birth can cause it to rupture, he said. After a spleen ruptures, Offit said, it is difficult to tell whether it had been enlarged, and he added that the coroner should provide an alternate explanation for the rupture if it had not been caused by measles.
Diamantoni said the doctor who performed the baby’s autopsy did not note that the spleen was enlarged, and the office is still investigating the cause of the rupture.
To prevent speculation, the state could release information about the patients’ age, vaccination status, and cause of death while still protecting their privacy, Offit said.
In conversations with state health officials, he said, he learned that “these patients would not have died were it not for measles.”
Anti-vaccination advocates “try and completely misdirect and say it really wasn’t measles. They try to do everything they can to distance themselves from it,” he said. “You’re making it a lot easier for them when you don’t give more information.”
In her statement, Bogen said the department reported the deaths to the CDC on Tuesday morning and met with CDC staff on Wednesday afternoon to discuss the cases.
“DOH’s Epidemiology team thoroughly investigated and verified both individuals tested positive for measles. The information was not reported to the public until the results of the epidemiological investigations were confirmed,” she said.
She noted that state health officials are prohibited from releasing death certificate information except under limited circumstances that do not apply to this case.
A county commissioner questions measles-associated deaths
The clash over the deaths began within hours of Shapiro’s Tuesday news conference.
Lancaster County Commissioner Josh Parsons, a Republican, shared the coroner’s account on Facebook, suggesting the state was spreading incorrect information on the deaths.
In several posts, Parsons questioned whether the patients had died “OF measles or WITH measles” and suggested the state was spreading incorrect information on the deaths.
“We have ZERO information that corroborates the idea that there were two measles deaths in Lancaster County,” he wrote in a post several hours before the state’s announcement. Later, he shared Kennedy’s remarks on C-Span.
Parsons has not responded to several requests for comment from The Inquirer about the outbreak over the last several months.
Democratic County Commissioner Alice Yoder, a registered nurse, said she has been unable to persuade him and the other county commissioner, Ray D’Agostino, a Republican, to post details about the measles outbreak or information encouraging vaccination on the county website.
Yoder, who attended the Tuesday news conference, said at a Lancaster commissioners meeting Wednesday that she had no additional information on the recent deaths.
Shapiro and Kennedy clash
While announcing the deaths Tuesday, Shapiro blamed the federal government’s rhetoric around vaccination for confusing parents and leading to declining vaccination rates.
The consequences, he said, were apparent in the deaths reported in Pennsylvania. He said he had told Kennedy as much in a recent phone call.
Later that night, on X, Kennedy said that Shapiro had falsely accused him of spreading misinformation and that drops in the state’s high vaccination rates occurred mostly during President Joe Biden’s administration.
Kennedy, a longtime anti-vaccine activist, has for years promoted false claims about vaccines.
Replying to Kennedy on X, Shapiro said that he asked the secretary to help him encourage people to get vaccinated and “stop spreading misinformation.”
The governor joined a lawsuit earlier this year against Kennedy’s department’s decision to scale back federal vaccine recommendations for children.
Shapiro noted that Kennedy had visited Lancaster in 2021, during the Biden administration, and told a crowd there that measles could be cured by “chicken soup and vitamin A.”
Measles has no specific treatments, and although vitamin A is sometimes given to severely ill patients, it cannot prevent the disease and is not a cure.
Shapiro added that measles cases have increased in the United States and Pennsylvania under Kennedy’s watch.
Editor’s note: This story has been updated to clarify that the newborn who died had a measles infection acquired before birth.
