As A 6th Person Reportedly Dies In Pennsylvania, Measles Continues To Rage In The USA

Pennsylvania state officials recently reported a sixth death following a recent measles infection, a 39-year-old woman with underlying health conditions. The Washington Post reports that she was not vaccinated.

“This is the first death in Franklin County in many years with a patient with a recent history of a measles diagnosis and meets the definition set forth by the Pennsylvania Department of Health for a measles-associated death,” the local coroner’s office said in a statement posted on social media.

Pennsylvania state health authorities reported the state’s first two measles-associated deaths in 35 years back in August; but the cases were immediately shrouded in controversy after Health and Human Services Secretary Robert F. Kennedy, Jr., reportedly suggested the deaths may have been “fabricated”. 

The dispute stems from differences in the way jurisdictions record causes of death. In Pennsylvania, a death is recorded as “measles-associated” if the deceased had measles at the time of their death, even if the disease is not assessed to be the immediate cause of death by a medical examiner.

The situation has sparked an ongoing war of words between Kennedy and Pennsylvania governor Josh Shapiro, with Shapiro reportedly labeling Kennedy as “incompetent”. The CDC declined to include the Pennsylvania figures in its official mortality counts

At time of writing, the official CDC figures still only include two confirmed deaths from measles this year, though the website notes that “CDC will update its reporting as additional information becomes available and relevant reviews are completed.”

Meanwhile, Pennsylvania state-level data shows that prior to the latest death of the 39-year-old, a total of five other people died, including two infants too young to have received their vaccines. 

The problem of vaccine coverage

As to why the outbreak in Pennsylvania has reached such heights, there are various factors that can influence this.

“Risk of measles is generally quite concentrated in certain locations that have a confluence of factors, such as low vaccination rates, high travel (leading to risk of an introduced case of measles), and other factors that facilitate disease spread,” infectious disease expert Dr Nathan Lo previously told IFLScience.

With 415 cases, Lancaster County has seen the worst of the outbreak so far. It has large Mennonite and Amish communities, both religious groups that eschew various aspects of modern life and often have limited contact with the healthcare system.

“They're not a community that's as easy to reach – we can't just put up a social media post,” nurse Dale Weiser, who has been trying to reach out to the Amish community and offer vaccinations, told the BBC.

Following a confirmed case of measles in a child in Allegheny County, Pittsburgh’s Public Source reported that the school the child attended had a vaccination rate of 81 percent, well below the target for measles immunity.

Pockets of low MMR vaccine coverage – the vaccine that protects against measles as well as rubella and mumps – are a known issue across the US. Public confidence in the vaccine has been badly shaken by spurious allegations that it causes autism, something that’s been thoroughly disproven in many scientific studies.

The vaccine is safe and effective, with the recommended two doses offering around 97 percent protection against infection. Measles is among the most contagious diseases we know of, so a high level of vaccine coverage in the community is essential to stop outbreaks growing. Young children are at particular risk of serious complications.

But the effort to increase trust in the vaccine has not been helped by statements from Kennedy himself. An outspoken antivaxxer for many years, since taking office he has incorrectly claimed that the MMR vaccine contains “aborted fetus debris” and misleadingly suggested that vitamin A can be used as a home remedy for measles.

The Trump Administration has also repeatedly called for the MMR shot to be split up into separate vaccines because of unfounded suggestions that this could be somehow “safer” than giving a combined vaccine. There is no evidence that the combined vaccine is unsafe, and splitting up the shots risks leaving children vulnerable to the different infections for much longer while they wait for all the doses.

Having officially eliminated measles back in 2000 – something the CDC calls “a historic public health achievement” – the USA now looks set to lose this status, following in the footsteps of Canada, the UK, and several other European countries.