A Pennsylvania coroner has confirmed that one of two infants whose deaths were linked to the state’s measles outbreak died from the virus, while the other died from a ruptured spleen after testing positive for measles.
Dr Stephen Diamantoni, Lancaster County’s coroner, said Mary Stoltzfus, who was six weeks old, died at home on 18 August after contracting measles. She had been born with Amish lethal microcephaly, a rare genetic condition involving an unusually small head and underdeveloped brain.
Children with the condition typically live for six months or less, but Dr Diamantoni said the immediate cause of her death was a measles infection.
Coroner disputes measles link to second infant’s death
Ivan Miller died on 14 August, shortly after his birth, from a ruptured spleen. Measles was detected in his body and listed on his death certificate as a significant contributing condition, but Dr Diamantoni said the infection did not cause or contribute to the spleen injury.
His office carried out an autopsy, although exactly how the spleen ruptured remains under investigation. The coroner said measles was recorded because the infant had the infection at the time of his death, rather than because it was believed to have caused the fatal injury.
Neither child was old enough to have received the measles, mumps and rubella vaccine, which is normally given in a first dose at about 12 months.
Dr Diamantoni said he had shared his conclusions with the US Centers for Disease Control and Prevention (CDC). The agency has not said whether it will classify either death as measles-associated, and its public data still carries a disclaimer saying the cases are awaiting further review.
Pennsylvania’s Department of Health continues to list two measles-associated deaths. Its latest published update, issued on 8 September, recorded 582 confirmed cases across 37 counties, along with 102 hospitalisations. ([pa.gov](https://www.pa.gov/agencies/health/newsroom/pa-department-of-health-provides-statewide-update-on-measles-out0?utm_source=openai))
Deaths become focus of political dispute
The deaths have become the centre of a dispute between Pennsylvania Governor Josh Shapiro and Robert F Kennedy Jr, the US health secretary.
When the deaths were first announced, Mr Shapiro said vaccination could have prevented them. Mr Kennedy subsequently challenged the governor’s account and suggested that the deaths might have been fabricated, before later acknowledging Dr Diamantoni’s conclusion that measles caused one of them.
The CDC’s handling of the cases has also attracted scrutiny. The agency’s measles webpage initially referred to two associated deaths before being amended to say that the cases would not be counted until additional information had been reviewed.
Dr Georges Benjamin, executive director of the American Public Health Association, said last week that the CDC could no longer be trusted to share information without questions being raised about its motives.
Public health officials say the outbreak is being fuelled by falling vaccination rates, with most infections occurring among people who have not been immunised. The US ended sustained domestic transmission of measles in 2000, after years of maintaining vaccination coverage high enough to prevent outbreaks.
Dr Jennifer Janco, chair of St Luke Pediatrics, told CBS News Philadelphia last month that the outbreak was the worst she had seen in 26 years of practising in Pennsylvania.
