Pennsylvania announced two measles-related deaths there last week, the state’s first in decades. The CDC has not yet counted them in the national total of measles deaths.
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In a highly unusual move, the US Centers for Disease Control and Prevention is not counting two measles-associated deaths reported by the state of Pennsylvania in its measles death tally, saying it doesn’t have enough information to determine whether measles caused or contributed to the fatalities
The decision to exclude the deaths from the weekly update came from the CDC’s new director, Dr. Erica Schwartz, according to two people with knowledge of the decision
The move escalates a feud between US Department of Health and Human Services Secretary Robert F. Kennedy Jr. and the state’s Democratic governor, Josh Shapiro, as the Keystone State seeks to extinguish a growing measles outbreak there
Pennsylvania health officials have said they thoroughly investigated the details of both deaths before announcing them
“Every reported measles case is thoroughly reviewed to confirm it meets the Centers for Disease Control and Prevention’s (CDC) case definition for a measles case. To date, DOH has provided all required epidemiological data to the CDC regarding the two measles-associated deaths in Pennsylvania,” said Neil Ruhland, press secretary for the Pennsylvania Department of Health
The CDC delayed its weekly Friday measles data update, and when it was finally posted over the weekend, the number of deaths for 2026 was listed asan asterisk and a footnote: “This week’s measles outbreaks update will not include the two measles-associated deaths reported by the Pennsylvania Department of Health on August 25 while CDC reviews additional information regarding the circumstances and causes of death. At this time, available information does not establish whether measles caused or contributed to the deaths or whether the individuals died from other causes while infected with measles. CDC will update the national count as additional information becomes available.”
The CDC’s press office directed a request for comment to Kennedy’s office at HHS
“CDC has a responsibility to ensure its reporting accurately and transparently reflects what is known and what remains unconfirmed. The two measles-associated deaths announced by Pennsylvania have not been confirmed based on the information currently available to CDC,” Grace Davis Jamison, a press secretary for HHS, said in a statement
“The information currently posted reflects the best available information and our commitment to transparency and telling the American people the truth – a foundational principle of the Trump Administration.”
Public health experts familiar with the inner workings of the agency said Schwartz’s decision was highly unusual
“The idea that you would second-guess the determination of the state epidemiologist is pretty remarkable,” said Dr. Nirav Shah, who was the CDC’s principal deputy director before he resigned his role in February 2025
Shah said that the total count of deaths related to any infection — not just measles — has long been an umbrella term that includes people who tested positive for an infection and then died close to the time of that positive test, usually within 10 days. It doesn’t usually depend on a determination of whether a person died with an infection or from an infection
“For the CDC, let alone the CDC director, to overrule that sort of determination and just put that vague language up on the website, it’s more than atypical,” Shah said. “It is the definition of the politicization of public health.”
“This is a big deef medical officer before she resigned in protest of Kennedy’s decision to fire Schwartz’s predecessor, Dr. Susan Monarez, in August 2025
Houry pointed out that a measles-associated death reported by New Mexico last year was in an individual who tested positive after death. That death was added to the national total, even while it was under investigation
“States notify the CDC, who then pulls the national picture together. States are the ones who do the investigation and this has been a standard protocol in collaboration with the CDC and the Council of State and Territorial Epidemiologists and states,” she said
Schwartz has been closely watched since she assumed her position in mid-August. Although she is a medical doctor who has expressed strong support for vaccines and science in her previous roles, her public statements since her nomination have cast doubt on her willingness to be an independent voice in the administration. During her confirmation hearing, several senators raised concern that she would not stand up to Kennedy, who has a history of anti-vaccine advocacy
In her first agency-wide meeting last month, she told staff she wouldn’t hesitate to disagree with Kennedy if necessary but would not do so publicly
Dr. Erica Schwartz testified before a Senate Health, Education, Labor and Pensions Committee in July.
Dr. Jeremy Faust, an assistant professor of emergency medicine at Harvard Medical School, said Schwartz had failed her first major test as CDC director
“If she’s overseeing an agency that is only now just a mouthpiece for what her bosses think, then she is absolutely failing in her mandate,” Faust said
“This is where she has to decide: ‘Am I simply a communications attache to Secretary Kennedy, or do I have independence, and Ispeak for science, even when it goes against what my bosses think?’ ” Faust said
After a child with measles died last year in Texas, Children’s Health Defense, the organization Kennedy helped co-found and led for years, said the child had died from bacterial pneumonia that doctors could have managed differently, rather than from the measles. Pneumonia is a common complication of measles. The CDC counted this death in its total number of measles deaths for 2025
In the recent case of the death of an infant in Pennsylvania, Kennedy suggested last weekthe deaths may have been “altogether fabricated,” saying the Lancaster County coroner had no record of measles-related deaths
The coroner, Dr. Stephen Diamantoni, has since saidthat his office is investigating the death of an infant who died from a ruptured spleen. The baby had evidence of measles virus in its lung tissue, Diamantoni said, suggesting that it was infected by its mother before birth. Measles and other viral infections can cause the spleen to swell and become more fragile than normal. Diamantoni has said he hasn’t seen any evidence of enlargement of the spleen, however, although other experts have said it would be difficult to determine whether the spleen was larger than normal after a rupture.
On Sunday, the Atlantic published details from an interview with an Amish couple from Lancaster County whose infant son had died shortly after birth. The couple, who were not identified, said they don’t watch TV or use the internet but agreed that their son’s case sounded like one of the deaths under discussion. The father said he had gotten a voicemail saying a man named Kennedy wanted to speak with him, but he had not returned the call
The mother said she had a severe case of measles while pregnant and went into labor shortly after she went to a clinic for intravenous fluids. The baby was born with a heartbeat but was not breathing, the couple told the Atlantic, and did not survive
The mother assumed the baby had died because of measles, which is what the midwife told them, according to the Atlantic. No one had told them the baby had a lacerated spleen
On Tuesday, Diamantoni said that his office was investigating another recent death in a person who tested positive for the measles. That individual is also a child, according to the New York Times. CNN has not received a response from the Lancaster County coroner’s office to questions about its investigations
Dr. Brian Castrucci, president and chief executive officer of the de Beaumont Foundation, a nonprofit organization that supports public health departments, said that casting doubt on Pennsylvania’s reporting before the review is complete risks turning routine scientific verification into a manufactured controversy
“The rhetoric surrounding it revives the ‘died from versus died with’ playbook used during Covid – a distinction that can be medically legitimate, but was repeatedly weaponized to confuse rather than clarify,” Castrucci said in a statement to CNN
“A death can have multiple contributing causes; that does not make the role of an infectious disease irrelevant.”
Dr. David Margolius, director of public health for Cleveland, said it’s frustrating to see the CDC shift away from sharing information to help inform others to become a “data editorializer.”
“It is extremely sad and frustrating, what’s playing out right now, in terms of these political debates around how this poor baby died,” he said
“This is unprecedented and unfortunately frustrating, and keeps this more of a political debate than what it should be, which is: What’s the right thing to do now to protect our neighbors?”
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