CDC Holds Pennsylvania Measles Deaths Off the U.S. Tally

The CDC has left two Pennsylvania measles deaths off its 2026 national count, posting an asterisk while it reviews how the people died. Pennsylvania’s health department reported the deaths on August 25 as the first measles-associated deaths in the state since 1991, and the first in the United States this year. Both people were unvaccinated residents of Lancaster County.

Federal officials say they still cannot tell whether measles caused the deaths or whether the two people died of other causes while infected. The hold arrived after Health Secretary Robert F. Kennedy Jr. accused Gov. Josh Shapiro’s office of rushing the announcement, and after the county coroner said one of the dead, a newborn, died of a ruptured spleen.

CDC Leaves Pennsylvania’s Two Deaths Off the National Tally

The agency’s measles page, updated August 30 with figures as of noon on August 27, lists 2,903 confirmed measles cases in 2026 and leaves the death cell blank except for a footnote. That note says the weekly update will not include the two deaths Pennsylvania reported on August 25 while CDC reviews “additional information regarding the circumstances and causes of death.”

People familiar with the decision said CDC Director Dr. Erica Schwartz, confirmed in August, ordered the hold. Grace Davis Jamison, a press secretary at the Department of Health and Human Services, said the two deaths “have not been confirmed based on the information currently available to CDC.”

Neil Ruhland, press secretary for the Pennsylvania Department of Health, said every measles case is reviewed against CDC’s case definition and that the department has sent all required epidemiological data on the two deaths. States have long been the ones who classify measles cases and deaths. CDC’s job, in ordinary years, is to add those reports up.

THE TWO OFFICIAL TALLIES

CDC’s Pennsylvania figure lags the state’s own dashboard because the federal page counts only confirmed cases already notified to Atlanta. The death dispute is separate. Pennsylvania is still publishing two measles-associated deaths. CDC is still publishing none for 2026.

What “Measles-Associated” Means in Pennsylvania

The August 25 release confirmed two measles-associated deaths in Pennsylvania and gave almost no other medical detail, citing privacy. Secretary of Health Dr. Debra Bogen used that same phrase, and she tied it to a disease most people in the state have not seen in decades.

Because measles was largely eliminated in the Commonwealth for more than three decades, people are not familiar with this disease and don’t fully understand the potential severity of the illness.

Dr. Debra Bogen, Pennsylvania secretary of health, August 25 statement

The department later spelled out the label. It uses “measles-associated” when laboratory or epidemiologic evidence of measles is present, even if a medical certifier or coroner does not list measles as the immediate cause of death. That is a surveillance term, not a coroner’s verdict.

HOW THE STATE COUNTS A MEASLES DEATH

• The test: A death is measles-associated when lab work or an epidemiologic link shows measles infection.
• The certificate: Measles does not have to be the immediate cause on the death certificate.
• The case rule: Each measles illness is checked against CDC’s confirmed-case definition, which is built for rash illness, not for how a death is certified.
• The privacy bar: Names, ages, and most clinical details were withheld, which left the coroner and federal officials arguing in public about cases they could not fully describe.

Amesh Adalja, an infectious disease physician at the Johns Hopkins Center for Health Security, has described the split this way: coroners write death certificates, and state epidemiologists count outbreak deaths under a faster standard so a health department can act before a final certificate is done. Almost no measles death lists measles as the last event on the form, because the last event is usually pneumonia, brain swelling, or another failure measles set in motion.

A Newborn, a Ruptured Spleen, and a Death Certificate

One of the two deaths was a male newborn who died on August 14 at a birthing center in Strasburg Township. Lancaster County Coroner Dr. Stephen Diamantoni, a family physician first elected in 2007, said lung tissue sent for PCR testing confirmed measles. He also said the immediate cause was a laceration of the spleen and massive blood loss.

At the time of the autopsy, we did obtain some tissue from the newborn and sent it for PCR testing that did confirm the presence of measles. But measles was not the cause of death.

Dr. Stephen Diamantoni, Lancaster County coroner

Diamantoni said forensic pathologist Dr. Wayne Ross did not find the spleen enlarged or inflamed, which is the change measles can produce when it makes the organ easier to tear. Measles was still entered under Part II of the death certificate, the section for other conditions that contribute to death but do not start the chain. Diamantoni has said he listed it to give a broader view of the child’s health, and that he still does not believe measles caused the rupture.

A ruptured spleen is rare in a newborn. Measles can enlarge the spleen and thin the capsule around it, so a tear during birth is a known, if uncommon, path. Diamantoni’s office has not said what else could have cut the organ. The infant was too young for routine MMR, which starts at 12 months. The mother also tested positive for measles.

Paul Offit, a vaccine scientist at Children’s Hospital of Philadelphia, has said the two patients would not have died were it not for measles, and he has asked the coroner for another explanation of the tear. That is the medical fight inside the political one: a PCR-positive newborn, a spleen that a pathologist says was not measles-changed, and a state health department that still files the death as measles-associated.

The Second Death Still Has No Public Story

The coroner’s office has said it has no information on the second death Pennsylvania counted. Diamantoni has also said that, as far as his office is concerned, Lancaster County does not have a death caused by measles. County Commissioner Josh Parsons put the same point in public language after talking with the coroner: one patient died with measles, not of measles, and the office had zero measles deaths on its own books.

That of-versus-with line is now the entire argument. It is also a poor fit for measles, a virus that rarely appears as the last line on a certificate and still kills through the complications it causes. The second file is the weaker of the two public cases, because Pennsylvania has not said whether that person was a child or an adult, what organ failed, or which office certified the death.

WHAT WE KNOW

• Shared facts: Both people were unvaccinated Lancaster County residents, and both had laboratory or epidemiologic evidence of measles, according to the state health department.
• The infant: Died August 14 at a Strasburg Township birthing center, tested positive after death, and has a spleen laceration listed as the cause, with measles on Part II.
• State total: Pennsylvania has kept both deaths on its dashboard through the September 2 update.

WHAT IS UNCONFIRMED

• The second person: No age, no cause, no certifying office, and no coroner file in Lancaster County has been made public.
• The spleen: The pathologist says the organ was not enlarged; other physicians say a measles-damaged spleen can rupture without looking big.
• Federal review: CDC has not said what extra records it wants or when the asterisk comes off.

Privacy rules explain some of the silence. They do not explain why one of two statewide deaths left no trace in the county that was named as home to both.

Kennedy Accused Shapiro of Fabricating the Count

Shapiro announced the deaths in Lancaster on August 25 and said Kennedy had called that morning to offer federal help. The governor declined extra staff and told Kennedy that federal rhetoric on vaccines was making the outbreak harder to fight. Kennedy answered on X the next day, calling the press event a replay of “the Democrats’ COVID playbook” and then going further.

The deaths may even have been altogether fabricated by one of the Governor’s hopeful staffers.

Robert F. Kennedy Jr., U.S. secretary of health and human services, on X, August 26

Shapiro called those claims inaccurate and misleading. Kennedy said CDC could not get the records it needed. Pennsylvania said the records had already gone. The federal footnote landed days later, after that exchange, and after local officials had already put “died with, not of” on camera.

Kennedy has also said people should get the measles vaccine, and he has blamed earlier drops in coverage on the Biden years and on lost trust after COVID lockdowns. Shapiro’s department, in the same week, was running pop-up shot clinics and telling parents the MMR vaccine is safe. The death count became the scoreboard for that fight.

CDC’s Own Manual Already Counts Deaths Like These

CDC’s measles surveillance chapter, updated June 3, 2025, still tells health departments that measles can end in diarrhea, dehydration, pneumonia, encephalitis, and death, with about 20 percent of U.S. cases needing hospital care. It also gives the old fatality math: about one encephalitis case and two to three deaths per 1,000 measles cases.

Pennsylvania used the same range in its August 25 release. Death related to measles, the department wrote, occurs in one to three patients per 1,000 cases. That is associated-death language. It counts people who die of the complications measles causes, not only people whose last heartbeat is labeled “measles” in isolation.

Last year CDC did count deaths written that way. Its 2026 tracker still shows three U.S. measles deaths for 2025. Two were unvaccinated school-age children in the West Texas outbreak, which Texas closed on August 18, 2025, at 762 confirmed cases, 99 hospital stays, and a second measles-associated death. The third 2025 death was an unvaccinated adult in New Mexico. Those files were added to the national total. Pennsylvania’s two files, using the same associated-death wording, are the ones now parked behind an asterisk.

WHAT THE FEDERAL TRACKER WILL SAY OUT LOUD

• 2026 cases: 2,903 confirmed, 94 percent unvaccinated or unknown, 94 percent tied to outbreaks.
• 2026 hospital care: 223 of 2,903 cases, or 8 percent, including 57 of 541 children under 5.
• 2026 deaths: Blank, pending review of the Pennsylvania reports.
• 2025 deaths: 3, on the same page, with no asterisk.

In the decade before live measles vaccine was licensed in 1963, CDC’s chapter says the United States averaged 549,000 reported cases and 495 measles deaths a year. The 1989-1991 resurgence brought more than 55,000 cases and 123 deaths. Endemic measles was declared eliminated in 2000, meaning no continuous U.S. spread for at least 12 months with adequate surveillance. The 2026 case load is already above 2025’s full-year total of 2,289. The death cell is the number the federal government will not yet write.

The Outbreak Grew Past 500 Cases Anyway

While Atlanta and Harrisburg argue about two files, the outbreak that produced them has kept moving. CDC’s map for August 27 already had Pennsylvania at 443 confirmed cases, behind South Carolina at 670 and Utah at 526. The state’s own September 2 update listed 540 cases across 36 counties and 91 hospital stays, and it still counted two measles-associated deaths.

School coverage is high in most buildings and thin in others. For the 2025-2026 school year, 93.2 percent of kindergarten students, 94.6 percent of seventh graders, and 96.9 percent of twelfth graders had both required MMR doses. Public health agencies treat 95 percent two-dose coverage as the usual line for stopping community spread. Shapiro’s office said state staff had given more than 4,100 MMR doses at 91 pop-up clinics since the outbreak began in April, with 40 more clinics planned, and that more than 35,000 Pennsylvanians received MMR in July, about 10,000 more than a typical month.

THE WEEK THE COUNT SPLIT

1. August 14, 2026: A newborn dies at a Strasburg Township birthing center; later testing finds measles in tissue.
2. August 25, 2026: Pennsylvania confirms two measles-associated deaths and 393 cases; Shapiro briefs in Lancaster.
3. August 26, 2026: Kennedy says the deaths may have been fabricated; Shapiro calls that claim false.
4. August 27, 2026: Diamantoni describes the spleen laceration; CDC’s case file for the week stands at 2,903 U.S. cases.
5. August 30, 2026: CDC posts the footnote holding the two deaths out of the national total.
6. September 2, 2026: Pennsylvania reports 540 cases, 91 hospital stays, and the same two deaths.

Dr. Jeffrey Martin, chair of family and community medicine at Penn Medicine Lancaster General Health, told the state’s August 25 briefing that the deaths show measles is not a harmless illness. Michael D. Barber, the health system’s chief executive, said vaccination is for neighbors who cannot take the shot, including newborns and pregnant women. Those are the people the argument is supposed to be about. The federal tracker still will not say whether two of them died of measles.

CDC says it will change the national count when more information comes in. Pennsylvania has already written the number 2. Until one of those ledgers moves, the United States is living with two official measles death totals for the same year, and an asterisk where a body count used to go.

Disclaimer: This article is news reporting on public health statements, death classification, and outbreak figures. It is informational only and is not medical advice, a diagnosis, or a recommendation about vaccination, autopsy findings, or individual care. Readers who have questions about measles exposure, MMR shots, pregnancy, or a child’s symptoms should speak with a licensed physician, pediatrician, or local health department before making health decisions. Case counts, death classifications, and federal review status are those published by the cited agencies as of the dates given in this article and can change as investigations continue.