Two infants in Lancaster County, Pennsylvania, have been identified as the first measles-related fatalities in the United States this year. The coroner's reports, released following media requests, list Ivan S Miller, who died August 14, and Mary S Stoltzfus, who died August 18, as the victims.
Miller's cause of death was a ruptured spleen, with measles noted as a contributing factor. Stoltzfus's death was attributed to cardiac arrest due to measles. She also had Amish lethal microcephaly, a genetic condition that predisposes infants to infections.
These deaths have ignited controversy, drawing in state officials and federal health authorities. Governor Josh Shapiro blamed the fatalities on federal government messaging surrounding measles, mumps, and rubella (MMR) vaccines, stating that misinformation has had "real-life consequences." Shapiro reported a call with Health and Human Services Secretary Robert F. Kennedy Jr., during which Kennedy allegedly suggested "natural measles" might be preferable.
Republican Lancaster County Commissioner Josh Parsons questioned the official cause of death, suggesting it was important to determine if individuals died "OF measles or WITH measles." Kennedy, in a social media post, disputed allegations of spreading misinformation and questioned the MMR vaccine's manufacturing process.
The Centers for Disease Control and Prevention (CDC) did not initially list the Pennsylvania deaths in its weekly data update. When the data was later released, the fatalities were absent, with an asterisk noting that "available information does not establish whether measles caused or contributed to the (Pennsylvania) deaths or whether the individuals died from other causes while infected with measles."
Measles is a highly contagious disease, particularly serious for young children. According to the CDC, one in 1,000 children who contract measles experience brain swelling, potentially leading to brain damage, and one to three in 1,000 die from complications.
The MMR vaccine is highly effective, with two doses reducing the risk of infection by 97 percent. However, vaccination rates have seen a decline. Data released last month indicated that MMR vaccination rates among kindergarteners had dropped to 92.4 percent, a decrease from the previous year and more than two percent from a decade ago.
This year, the CDC has reported 3,134 measles cases, the highest in three decades and an increase from the 2,289 cases recorded last year. Nearly all reported infections have occurred in unvaccinated individuals. South Carolina leads the nation with 670 cases, followed by Pennsylvania with 557, and Utah with 526. Lancaster County in Pennsylvania has reported the highest number of cases within the state, totaling 268 infections.
Medical Context of Measles Complications
The spleen, a vital organ involved in filtering blood and storing white blood cells, can enlarge during a measles infection. Rupture of an enlarged spleen can lead to life-threatening internal bleeding, requiring emergency surgery. Amish lethal microcephaly is a severe genetic condition that causes infants to have abnormally small heads and underdeveloped brains, predisposing them to infections like measles that can be fatal.
National Measles Case Trends
Meadowcases nationwide have surged, with 3,134 cases reported by the CDC so far this year. This represents a significant increase compared to previous years, with 2,289 cases reported in the prior year. Almost all of these infections have been linked to individuals who have not received the MMR vaccine. South Carolina has recorded the highest number of cases at 670, followed by Pennsylvania with 557, and Utah with 526. Lancaster County, Pennsylvania, specifically, has documented 268 infections, making it the epicenter within the state.