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ABSTRACT

Pennsylvania health officials said Tuesday that the state has recorded a fourth measles-associated death for the year, an unvaccinated 18-year-old from Mifflin County whose cause of death the county coroner determined to be acute disseminated encephalomyelitis (ADEM), described as a rare and severe neurological complication of measles. The state health department also confirmed the death of an unvaccinated 40-year-old woman from Jefferson County, who died Saturday, and had previously reported the deaths of two infants in Lancaster County — a newborn boy and a 6-week-old girl — both too young to be vaccinated under current recommendations. The four deaths are the first associated with measles in the state in 35 years, according to state officials, and all four were reported within the last month.

NBC News

Pennsylvania reports fourth measles-associated death, an unvaccinated 18-year-old

Sep 15, 2026, 2:41 PM

Pennsylvania health officials said Tuesday that the state has recorded a fourth measles-associated death for the year, an unvaccinated 18-year-old from Mifflin County whose cause of death the county coroner determined to be acute disseminated encephalomyelitis (ADEM), described as a rare and severe neurological complication of measles. The state health department also confirmed the death of an unvaccinated 40-year-old woman from Jefferson County, who died Saturday, and had previously reported the deaths of two infants in Lancaster County — a newborn boy and a 6-week-old girl — both too young to be vaccinated under current recommendations. The four deaths are the first associated with measles in the state in 35 years, according to state officials, and all four were reported within the last month.

Context

State figures put the Pennsylvania outbreak at 693 cases across 38 counties this year, with 99 cases reported in the last seven days and 133 people hospitalized, according to Ars Technica. PBS NewsHour reported nearly 700 illnesses across 38 counties, including about 100 cases in the last seven days; NBC News also reported nearly 700 cases and 133 hospitalizations. The state health department said the two most recent deaths would be added to its outbreak data dashboard on Wednesday as part of its regular update.

The Associated Press, in reporting carried by PBS NewsHour, described the national picture as the worst year for measles since 1991, with seven reported measles-associated deaths over the last two years — more than the combined total of reported deaths over the previous three decades. NBC News reported that in all of last year the U.S. recorded three measles deaths. Nationwide, the Centers for Disease Control and Prevention has confirmed 3,294 measles cases, including 267 hospitalizations, as of Thursday, according to NBC News.

Measles was eliminated from domestic spread in the U.S. in 2000 through high vaccination rates, but those rates have fallen below the 95% coverage level needed to prevent outbreaks, according to PBS NewsHour, which reported that international health officials will meet in November to determine whether the U.S. and Mexico have lost measles-free status. Two doses of the MMR vaccine offer 97% protection against measles, usually for life, with the first dose typically given at around age 1 and the second at around age 5, according to NBC News.

Mifflin County coroner Andrea L. Alcalde said the 18-year-old's death was determined after a review of medical records and all available information, and that no other information about the deceased would be released, according to Ars Technica. The coroner's office said in a Facebook post that the cause was ADEM, per PBS NewsHour. Ars Technica described ADEM as a rapidly progressing autoimmune disorder in which inflammation from an infection strips away the protective coverings of nerve cells in the brain and spinal cord, and noted it was commonly associated with measles before widespread vaccination.

NBC News reported that the CDC has not confirmed any of the Pennsylvania deaths and states on its website that it has no death records from 2026 indicating measles was the underlying cause — a departure from the agency's past practice of accepting such reports from state health departments. CDC Director Erica Schwartz said Monday that Pennsylvania, unlike other states with outbreaks, had not requested the CDC's assistance, according to NBC News. The Pennsylvania Health Department said it "maintains a strong working relationship with the professional staff at the CDC" and submits death records to the CDC's National Center for Health Statistics "daily," including for the recent measles-associated deaths, NBC News reported.

The state health department considers a death "measles associated" if there is clinical evidence of a measles infection, a positive laboratory test, and death within 30 days of the onset of symptoms, and it also weighs medical records and possible exposure, according to NBC News. The department said the two latest deaths were linked to measles after rigorous investigations involving county coroners' offices, and that the infants' deaths involved similar investigations.

The Lancaster County infant deaths last month prompted online misinformation and political sparring between Pennsylvania Gov. Josh Shapiro and Health Secretary Robert F. Kennedy Jr., according to NBC News and the Washington Post. Anti-vaccine activists commonly argue that a positive measles test does not necessarily mean the virus caused a death if a secondary illness or injury was involved; doctors say measles is still the underlying cause in many such cases because patients would not have died otherwise, NBC News reported.

PBS NewsHour reported that fewer children are receiving routine vaccines because of parental waivers, health care access issues and what it described as rampant disinformation, and that Trump administration health officials, including Kennedy, have questioned and sown doubt about the established safety of vaccines while also defunding local efforts to improve vaccination rates.

All Perspectives
Pennsylvania Secretary of Health Debra Bogen: "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," she said in a statement, referring to the two most recent deaths, those of the adults. "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 vaccine, which kept measles outbreaks at bay for decades."
Mifflin County Coroner Andrea L. Alcalde: She said the 18-year-old resident's death was determined to be caused by acute disseminated encephalomyelitis, a rare but known severe complication of measles, after a review of medical records and all available information, and that no other information would be released about the deceased.
Pennsylvania Gov. Josh Shapiro: He accused Health Secretary Robert F. Kennedy Jr. of spreading falsehoods about vaccines, according to NBC News.
Health Secretary Robert F. Kennedy Jr.: He suggested that the Lancaster County deaths may have been "fabricated" and that Shapiro was seeking to profit from them politically, according to NBC News.
Lancaster County coroner: He has said he believes measles was only the cause of death for the 6-week-old baby. In the newborn's case, he said he found evidence of the measles virus in the infant's lung tissue but considered the cause of death to be an internal hemorrhage and "traumatic rupture" of the spleen, and said he did not find evidence that the newborn's spleen had been enlarged, though that can be difficult to detect in an autopsy.
CDC Director Erica Schwartz: She said Monday that Pennsylvania, unlike other states with measles outbreaks, had not requested the CDC's assistance, according to NBC News.
Pennsylvania Health Department: It said it "maintains a strong working relationship with the professional staff at the CDC" and that it submits death records to the CDC's National Center for Health Statistics "daily," including for the recent measles-associated deaths. It also said the two latest deaths were linked to measles after rigorous investigations involving county coroners' offices, and that the infants' deaths involved similar investigations.
Anti-vaccine activists: They commonly argue that testing positive for measles does not necessarily mean someone died from the virus if a secondary illness or injury was involved, according to NBC News.
Doctors: They say measles is still the underlying cause in many of those cases, since patients would not have died otherwise, according to NBC News.
Father of the Lancaster County newborn: He told NBC News that the baby had been born prematurely and that his mother had measles. Premature birth is a known complication of measles during pregnancy, and measles can also cause the spleen to enlarge, raising the risk of rupture, according to NBC News.

Where sources differ

  • Case counts: Ars Technica reported 693 cases in 38 counties and 99 cases in the last seven days; PBS NewsHour and NBC News reported nearly 700 cases, with PBS describing about 100 cases in the last seven days.
  • Federal confirmation: NBC News reported that the CDC has not confirmed any Pennsylvania measles deaths and says it has no 2026 death records indicating measles as the underlying cause, while the Pennsylvania Health Department says it submits death records to the CDC's National Center for Health Statistics daily and that the deaths were linked to measles after rigorous investigation.
  • CDC assistance: CDC Director Erica Schwartz said Monday that Pennsylvania had not requested the CDC's assistance, according to NBC News, while the Pennsylvania Health Department said it maintains a strong working relationship with CDC professional staff.
  • Lancaster County infant deaths: the state counts both infants as measles-associated, but the Lancaster County coroner said he believes measles was the cause of death only for the 6-week-old baby. In the newborn's case, the coroner said he found evidence of measles virus in the infant's lung tissue but considered the cause of death to be an internal hemorrhage and "traumatic rupture" of the spleen, according to NBC News; the coroner said he did not find evidence that the newborn's spleen had been enlarged, though that can be difficult to detect in an autopsy.
Gaps & Unknowns
  • None of the sources establishes whether the CDC will ultimately confirm any of the four Pennsylvania deaths, or when that review would conclude.
  • The sources do not identify the deceased individuals beyond age and county, and no comment from the families of the 18-year-old or the 40-year-old woman appears in any source; the Mifflin County coroner said no further information would be released.
  • Whether the Pennsylvania outbreak is slowing or expanding beyond the reported figures is not established; the sources give case totals only.
  • The outcome of the November international meeting on whether the U.S. and Mexico have lost measles-free status is not established.
  • No source establishes the basis for Kennedy's suggestion that the deaths were fabricated beyond the characterisation of his remarks.
  • No source states whether Kennedy or the CDC has responded directly to Shapiro's accusation that Kennedy spread falsehoods about vaccines.
  • The sources do not establish the full scope of the reported federal defunding of local vaccination efforts referenced by PBS NewsHour.
  • No source indicates how many of the Pennsylvania cases involve vaccinated versus unvaccinated individuals.
Sources & Further Reading
  1. PBS NewsHour — original — by Mike Stobbe, Associated Press
  2. Ars Technica — by Beth Mole
  3. NBC News — by Aria Bendix
  4. Washington Post Politics — by Rachel Roubein, Daniel Wu

Read the original at PBS NewsHour

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