JONATHAN M. METSCH, Dr.P.H. – Tracking Emerging Public Health Challenges – September 14, 2026– MEASLES
The news comes as Pennsylvania faces a rapidly expanding outbreak that has already sickened more than 670 people and hospitalized 124. The state department of health reported two deaths related to the outbreak last month, which set off a frenzied debate over whether the deaths were a result of measles or merely coincided with the infection.
In this woman’s case, the immediate cause of death was respiratory failure “due to suspected measles,” according to a preliminary death certificate viewed by The Times. Mr. Furlong said that testing had not yet confirmed the woman had measles, though she had many of the symptoms of the virus — including the telltale rash that often starts as flat red spots on the face and travels down the body — and had recently been exposed to someone with measles. A nasal swab will be sent to the state laboratory to be tested for measles, Mr. Furlong said.
The woman had several chronic medical conditions that made her vulnerable to severe complications from measles. She had chronic obstructive pulmonary disease, or C.O.P.D., and was on 24/7 supplemental oxygen.” (1)
“In some of her first public comments about the country’s measles outbreaks, Dr. Erica Schwartz, the newly confirmed director of the US Centers for Disease Control and Prevention, said in a statement that the agency hadn’t been notified by Pennsylvania officials of the death.
“Despite repeated offers of assistance, Pennsylvania has not requested a CDC Epi-Aid, which would deploy epidemiologists and provide on-the-ground measles outbreak support,” Schwartz’s statement, shared with CNN by email, said.
“By contrast, Texas, South Carolina, Virginia, Kansas, New Mexico, and Wisconsin have officially requested CDC Epi-Aids and worked alongside federal teams to help bring their measles outbreaks under control. CDC remains ready to provide Epi-Aid support to Pennsylvania as soon as the state officially requests our help.”” (2)
“The Centers for Disease Control and Prevention has not reported any measles deaths in 2026 on its website, last updated on Friday, while the PA Department of Health has previously reported two measles-associated deaths linked to this outbreak.
CDC Director Dr. Erica Schwartz said in a statement that the agency has not yet been notified of this most recent death reported in Jefferson County.
In late August, Pennsylvania’s top health official, Dr Debra Bogen, had said her staff was having “regular meetings with professional staff at the CDC” in a post on X responding to health secretary Robert F. Kennedy Jr. saying her department had “refused to share information” with the CDC after the first two measles-associated deaths in the state were announced.” (3)
“Just a month into her tenure as director of the Centers for Disease Control and Prevention (CDC), Erica Schwartz is missing in action.
The country is heading into respiratory virus season, and public guidance on COVID-19, flu and RSV vaccines has been muddled, at best.
The worst measles epidemic in more than 30 years continues unabated, while the Health and Human Services (HHS) secretary is downplaying measles deaths and openly feuding with a sitting governor.
Through it all, Schwartz has made no public appearances or remarks.
What little official communication that has come from the agency has been from social media and overtly political.
Current CDC staff, as well as former officials and public health advocates, say they are left questioning Schwartz’s independence and the overall reliability of the nation’s public health agency.
“This is very unusual,” said Debra Houry, a former CDC chief medical officer who resigned last year after Schwartz’s predecessor was ousted.
“Thinking back to all of the prior CDC directors I have worked with, almost all met with media and publicly spoke during their first month. This is especially important during an outbreak and back-to-school when the CDC director should be talking about priorities and how to respond to an ongoing measles crisis,” Houry said.”
“Without directly addressing Schwartz’s role, a CDC spokesperson said the agency is “fully engaged” in the measles response.” (4)
“And you may be aware that despite the county coroner’s confirmation that one infant died due to measles, while the other’s death was “measles-associated,” the measles dashboard on the Centers for Disease Control and Prevention website counts neither death as of Sept. 10.
It’s easy to dismiss the squabble as political posturing between public officials. But as an epidemiologist who studies vaccine-preventable illnesses and health communication, I worry that for people seeking accurate information about how to keep their families safe — in this case, families in Lancaster County — there’s an enormous cost when health authorities no longer speak in one voice.
In the confusion that such rifts create, the public has no way of knowing which disagreements are about evidence and which are driven by ideology and narrative control.”
“Nobody disputes that both infants had measles when they died. The argument is which line on the death certificate “measles” belongs on. The Pennsylvania Department of Health has called both deaths measles-associated. This term is used when there’s evidence the person had measles, but there’s no settled official cause of death yet. It’s a holding category, not a verdict.
The job of determining the official cause — that is, certifying a death — falls to the county coroner. Lancaster County Coroner Stephen Diamantoni concluded that for one of the infants, a newborn boy who died in mid-August, the cause was a ruptured spleen unrelated to the measles infection. For a 6-week-old girl who died Aug. 18, he found that measles was the cause.
These are not competing conclusions. They come from two different systems asking two different questions. County coroners’ decisions on cause of death are legal finding, made one case at a time, that feed national vital statistics.
State health departments, on the other hand, run disease surveillance. They track who got sick and who died during an outbreak so they can contain it. Surveillance moves in days because it has to; death certification moves in weeks because it should. The two rarely line up in real time.” (5)
“The CDC is currently reviewing two infant deaths in Pennsylvania, which the state health department has deemed measles-associated, though they remain uncounted in the CDC’s national mortality data. This discrepancy underscores the complex challenge of classifying infectious disease deaths as direct causes versus contributing factors. One infant died from a splenic rupture, another from a measles infection; both were too young for routine vaccination. Such classification differences significantly impact public health data, affecting reported mortality, outbreak severity assessments, and risk communication, particularly as measles cases surge due to declining vaccination rates. This situation unfolds amidst decreasing public trust in federal health agencies, potentially further eroding confidence if reporting inconsistencies persist. The CDC’s ongoing review aims to promote consistent classification, vital for public understanding and informed health decisions.” (6)
1.Unvaccinated Woman Likely Died of Measles Complications, Pa. County Coroner Says, By Teddy Rosenbluth, https://www.nytimes.com/2026/09/13/well/unvaccinated-woman-measles-complications-death.html?smid=nytcore-ios-share
2.Adult woman dies of measles complications in growing Pennsylvania outbreak, by Meg Tirrell, https://www.cnn.com/2026/09/13/health/measles-death-pennsylvania
3.Another measles-related death reported in Pennsylvania as outbreak grows, By Dr. Jade Cobern, https://abcnews.com/US/measles-related-death-reported-pennsylvania-outbreak-grows/story?id=136410532
4.CDC director’s ‘unusual’ silence draws scrutiny, by Nathaniel Weixel, https://thehill.com/policy/healthcare/6085687-cdc-erica-schwartz-measles-virus-vaccines/\
5.CDC vs. Pennsylvania: Why conflicting public health messages impacts public safety, by Katrine L. Wallace, https://www.wusa9.com/article/syndication/the-conversation/cdc-pennsylvania-measles-related-deaths-confusion/507-07733ad9-28db-43bd-86f3-4191f5479928
6.CDC’s Decision Not To Count Two Pennsylvania Measles Deaths Raises Public Health Concerns, By Omer Awan, https://www.forbes.com/sites/omerawan/2026/09/13/cdcs-decision-not-to-count-two-pennsylvania-measles-deaths-raise-public-health-concerns/
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai