A fourth person in Pennsylvania has died of measles, the state health department confirmed Tuesday. The latest death was in an unvaccinated 18-year-old resident of Mifflin County.
In the announcement, the state health department also confirmed a county coroner’s report over the weekend of the death of an unvaccinated 40-year-old woman in Jefferson County. The state had previously reported two deaths in Lancaster County, both were in infants—a newborn boy and a 6-week-old girl, both too young to be vaccinated.
According to the Mifflin County coroner, Andrea L. Alcalde, the 18-year-old’s cause of death was determined to be acute disseminated encephalomyelitis (ADEM), which is a rare but known severe complication of measles. The condition is characterized by a rapidly progressing autoimmune disorder in which aberrant inflammation from an infection strips away the protective coverings of nerve cells in the brain and spinal cord. Before measles vaccines were widely used, ADEM was commonly associated with measles, though other viral infections can also spur its development.
In a new release posted to the coroner’s Facebook page Tuesday, Alcalde said the death determination was made after a review of medical records and all available information. Alcalde said no other information would be released about the deceased.
The state health department released a statement confirming the measles death of the 18-year-old, as well as the death of the 40-year-old. The two deaths will be added to the state’s outbreak data dashboard Wednesday as part of the regular update, the department noted.
Death reporting
So far, the state has reported 693 measles cases in 38 counties this year. There have been 99 cases reported in the last seven days. In all, 133 people have been hospitalized.
“My thoughts are with the two families who lost loved ones to this highly contagious virus, as Pennsylvania faces the worst measles outbreak in more than three decades,” Pennsylvania Secretary of Health Debra Bogen said in a statement, referring to the two latest deaths. “We remain committed to working with our partners across Pennsylvania to stem this outbreak and prevent more deaths. That means ensuring people have the facts about measles and access to the MMR [measles, mumps, and rubella] vaccine—which kept measles outbreaks at bay for decades.”
The deaths are unlikely to be quickly included in national data collected by the Centers for Disease Control and Prevention, which is under the tight control of anti-vaccine Health Secretary Robert F. Kennedy Jr. Amid Pennsylvania’s deadly outbreak, Kennedy has disputed deaths, spread misinformation about the MMR vaccine, and reportedly ordered the CDC director to exclude reports of the two babies’ deaths.
The CDC has also changed how it counts measles deaths in national reporting. The agency previously relied on determinations and reporting from state and local health officials. Now, it says, it will only report death records received by the National Center for Health Statistics (NCHS), which is a system designed not to monitor ongoing outbreaks but to track death trends over long periods. The US Department of Health and Human Services, which oversees the CDC, did not respond to questions from Ars Technica about the new rule.
Pennsylvania’s state health department noted in its announcement today that its determinations of measles-associated deaths were made after thorough investigations. The state uses a measles-associated death definition modeled after criteria for illness-associated death determinations set by the Council of State and Territorial Epidemiologists (CSTE).
Even with changes to the CDC’s measles data reporting and suspicions that many cases are going undetected, the CDC is still reporting nearly 3,300 measles cases this year. That’s higher than last year’s record tally of 2,289 cases, which led to three deaths. It’s also the highest total seen since 1991, when there were 9,643 cases. The US declared measles eliminated in 2000 after blocking domestic transmission over a 12-month period via high vaccination rates. With vaccination rates slipping well below the target of 95 percent, measles is roaring back, and the US is on track to lose its elimination status.
