Pa. reported two measles deaths last week. Here's what Penn experts want you to know

The Pennsylvania Department of Health announced two deaths associated with measles in Lancaster County last week.

The Aug. 25 announcement marked the first measles-related fatalities in Pennsylvania in over three decades, sparking a national debate over the validity of the state’s determination. Here’s what happened, explained by Penn Medicine physicians and other experts.

Shortly after a press conference on the outbreak, United States Secretary of Health and Human Services Robert Kennedy Jr. suggested that the deaths may have been “altogether fabricated” by Pennsylvania Gov. Josh Shapiro’s office.

“Governor Shapiro’s unseemly rush to Lancaster County to convene a national press conference and his giddy delight in announcing two measles deaths was a morose commentary on the contemporary political dialogue,” Kennedy wrote on social media.

After the health department confirmed one victim was an infant, the Lancaster County coroner claimed the baby died from an internal hemorrhage and ruptured spleen.

“Once a spleen is ruptured, it’s difficult to tell whether it was enlarged,” Perelman School of Medicine Professor of Vaccinology Paul Offit wrote in an Aug. 29 article. “We know that measles infections can increase splenic fragility leading to rupture; and we know that splenic rupture is extraordinarily rare in newborns.”

According to Judith O’Donnell, the University of Pennsylvania Health System’s chief medical officer for Healthcare Epidemiology, there are few other reasons “why the baby would have had a ruptured spleen.”

“I don’t think we should be having a significant debate,” O’Donnell said in an interview. “I think it’s unfortunate that we’re parsing this in a way to try to say the baby didn’t die of measles.”

As of Sept. 3, there are 540 reported measles cases in Pennsylvania, with 242 confirmed in Lancaster County. None of those infected are fully vaccinated.

While no cases have been reported in Philadelphia, O’Donnell called for all Pennsylvanians to be “mindful” of the “sustained outbreak.”

“If you’re a Philadelphian and you have somehow not ever been vaccinated, you should be very aware of that, and you should be getting vaccinated,” O’Donnell said.

She explained that this is due to “vast differences in baseline immunization rates.”

“It shows how a high level of immunity in a population like Philadelphia prevents sustained transmission and an outbreak.”

The incidents follow an Aug. 10 executive order to decrease the number of recommended childhood vaccines and separate the measles, mumps, and rubella combination vaccine. No separate measles vaccine is currently available in the United States.

O’Donnell called changes in vaccine recommendations a “contributory factor” to recent measles cases.

Infectious diseases professor David Pegues said that bundling vaccines is a “safe” and “convenient” choice. He added that recommendations to “just get a measles vaccine” have “not been endorsed by physicians or vaccine groups.”

“There would be a real societal cost in terms of needing to take your child more frequently to go see the doctor,” Pegues said.

He also underscored how “highly infectious” the measles virus is.

Philadelphia previously faced a measles epidemic in the 1990s. Six children in religious groups that refused immunizations died from the illness. Three children in the surrounding community also died from measles.

“Measles can cause fatal infections, and is clearly almost 100% preventable when you receive the vaccine,” Pegues added.

In 2000, the United States eliminated measles as a result of widespread vaccination.

According to Professor of Medical Ethics and Health Policy Angela Shen, the number of confirmed measles cases this year has “already exceeded” last year’s total.

“We have not seen the worst of the storm yet,” Shen said.

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