Lancaster County, Pennsylvania

Pennsylvania health officials confirmed a fifth measles-associated death this year, involving an unvaccinated Lancaster County resident whose identity was not released. Two prior Lancaster County deaths involved Amish infants, while Mifflin and Jefferson counties each reported one death, an 18-year-old and a 40-year-old. Confirmed cases statewide have reached 943, the largest outbreak in the state in three decades and the highest case count nationwide this year, with 40 new cases added in the past two days. Lancaster County remains the epicenter with nearly 400 cases, while Chester County has reported 83.

The toll is the nation's highest since 1992, but state and federal officials disagree on how to count it. The CDC currently lists only two measles deaths nationally, a discrepancy tied to decisions under Health Secretary Robert F. Kennedy Jr., who has clashed publicly with Gov. Josh Shapiro over the state's death count and vaccine messaging. Nearly one in five confirmed patients has been hospitalized, about a third are children, and almost all cases involve unvaccinated individuals.

Pennsylvania officials, led by Gov. Josh Shapiro, announced this week that two unvaccinated people in Lancaster County had died from measles, calling them the state's first measles deaths in more than 35 years. Officials withheld details about the victims, citing family privacy, while Shapiro publicly criticized Health and Human Services Secretary Robert F. Kennedy Jr., accusing him of spreading vaccine misinformation that he said carries "real-life consequences."

Subsequent reporting complicated the initial claims. One victim was reportedly a newborn who could not have been vaccinated, and Lancaster County Coroner Stephen Diamantoni said the infant's cause of death was a ruptured spleen, not measles, though measles antibodies were detected postmortem. Diamantoni said no enlarged spleen — a rare but documented complication of measles — was found, and further analysis is pending. The discrepancy has fueled criticism of how officials characterized the deaths and drawn political scrutiny over the handling of public health messaging amid ongoing measles outbreaks.