Pennsylvania measles toll reaches four as outbreak spreads across 38 counties

Pennsylvania health authorities have confirmed two additional measles-associated deaths, both in unvaccinated people, raising the state's total linked to the ongoing outbreak to four. The individuals lived in Jefferson and Mifflin counties, the state health department said, withholding further details to protect patient privacy. On Sunday, Jefferson County had announced that a 40-year-old woman died from complications of measles.

The department said it reached its conclusions after thorough investigations conducted with the Jefferson and Mifflin County coroner's offices. It classifies a fatality as a measles-associated death when someone with an active infection dies within 30 days of symptom onset, has clinical evidence of measles and a positive laboratory test, and the death is not attributable to unrelated causes such as an accident. Possible exposure history and supporting medical records are also weighed.

The state had reported two deaths last month — the first measles fatalities in the United States this year. The department has notified the Centers for Disease Control and Prevention of the two latest deaths, and the federal agency said it remains in contact with state officials as the cases are assessed.

The outbreak has drawn political attention, with Pennsylvania Governor Josh Shapiro and U.S. Health Secretary Robert F. Kennedy Jr. publicly disputing the cases. Kennedy has said only one of the deaths was caused by measles and, in a post on X, said the CDC would add measles-related deaths to its tally once the National Center for Health Statistics determines measles was the underlying cause based on death records submitted by the state. He also accused Shapiro of politicizing the response and declining federal assistance, saying Washington had offered to send CDC epidemiologists through its Epi-Aid program. The CDC's current tally does not include the 2026 deaths, and its website says it is reviewing how it classifies measles fatalities.

William Moss, an epidemiology professor at the Johns Hopkins Bloomberg School of Public Health, warned against allowing disputes over classification to obscure the clinical reality of the virus. Determining whether measles caused a death can be complicated because the infection can trigger complications that ultimately prove fatal, he said, adding that such deaths should not become politicized. "They're tragic enough for the family and community," he said.

Nationally, the CDC has recorded 3,294 confirmed measles cases in 2026 through September 10, with Pennsylvania the hardest hit at 693 cases across 38 counties. Measles is highly contagious and can cause fever, rash and respiratory problems, but is easily prevented with the measles, mumps and rubella combination vaccine, a routine childhood shot that is 97% effective against infection after two doses. A recent poll found that Americans' trust in vaccines for deadly childhood diseases, including measles, has declined in recent years, and President Donald Trump last month issued an executive order criticizing the MMR vaccine and calling for the combination shot to be split into three separate doses.