CIDRAP-Conflicting information continues in measles-associated death of Pennsylvania newborn

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Conflicting information continues in measles-associated death of Pennsylvania newborn

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Conflicting information continues in measles-associated death of Pennsylvania newborn​

Sarah Boden

August 31, 2026
Measles

Public Health


Dueling narratives on whether measles was at fault for the death of a newborn in Pennsylvania intensified over the weekend.

The baby died of a lacerated spleen, according to the coroner in Lancaster County, Pennsylvania, the epicenter of the largest current measles outbreak in the United States. But there's disagreement on whether a measles infection acquired before birth caused the infant's organ to become inflamed, resulting in the fatal injury.

Pennsylvania Gov. Josh Shapiro, a Democrat, maintains the baby wouldn't have died if the mother had been vaccinated and therefore protected from measles. The state's health secretary, Debra Bogen, MD, said on X that she "thoroughly reviewed the case investigation information."

There are many different types of forces that can cause laceration of the spleen.

But Lancaster County Coroner Stephen Diamantoni, MD, told NBC affiliate WGAL that, according to his office's forensic pathologist, measles was not a factor, as the newborn's spleen was "neither enlarged nor inflamed."

"There are many different types of forces that can cause laceration of the spleen," said Diamantoni. "It's difficult to say exactly what it is. And that's one of the reasons we're continuing to investigate to determine how and why that occurred."

Diamantoni, a Republican who was first elected as county coroner in 2008, shared a similar analysis with The Atlantic, telling the magazine in a story that ran yesterday that he is "very in favor of immunization."

However, that same Atlantic article reports that a Lancaster County mother delivered a stillborn boy after suffering a severe measles illness. The woman was reportedly unvaccinated and assumed that the loss of her son was related to her recent infection.

"She struggled to hold down food and fluids," according to the Atlantic. "For days, she could speak only in a whisper. On August 13, she was taken to a clinic to get an IV for dehydration. The next day, she went into labor."

Splenic ruptures are extremely rare in neonates, explained Paul Offit, MD, a nationally recognized infectious disease expert at Children's Hospital of Philadelphia.

Measles can cause only mild or moderate enlargement of the spleen but still be vulnerable to splenic rupture.

In his Substack, Offit acknowledged that Diamantoni is in a difficult position and therefore his caution is warranted. But he said that it's hard to know if a spleen was enlarged once it ruptures.

"Measles can cause only mild or moderate enlargement of the spleen but still be vulnerable to splenic rupture," wrote Offit. "Also, a fragile splenic capsule can be difficult to determine post-mortem."

He added that other reasons a newborn's spleen might be fragile enough to rupture include "infections like CMV [cytomegalovirus] and rubella, hemolytic disorders, or certain inborn errors of metabolism," and that unless one of these issues was also present, the "only obvious cause left would be measles."

CDC not yet counting newborn as a measles fatality​

Meanwhile, the Centers for Disease Control and Prevention (CDC) is not including the newborn, as well as one other measles-associated death reported last week by the Pennsylvania Department of Health, in its tally of annual measles fatalities.

"At this time, available information does not establish whether measles caused or contributed to the deaths or whether the individuals died from other causes while infected with measles," said the agency in its weekly online update. "CDC will update the national count as additional information becomes available."

Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. has accused Pennsylvania of not cooperating with the CDC. Shapiro, in turn, blames the state's outbreak on Kennedy's anti-vaccine policies and rhetoric.

“There's real-life consequences for spreading misinformation," said the governor during a press conference last week.

There's real-life consequences for spreading misinformation.

But Shapiro is being criticized by some medical experts, who are horrified by the growing measles crisis, for politicizing the tragedy of two measles-associated deaths. They also say Shapiro's lack of transparency has given Kennedy an opening to further spread misinformation. The state has not released any additional information about the two deaths.

Current​

The CDC usually provides a weekly update on measles cases on Friday at noon, Eastern Time. But this week's report was delayed until Sunday, when an additional 126 confirmed infections were reported, bringing the 2026 total to 2,903 across 45 states. There were 2,289 confirmed measles cases in all of 2025.

However, discrepancies exist between what some states' data show and what the CDC is reporting. The CDC last updated its state data on August 21, listing Pennsylvania's year-to-date total as 371 cases while the state's health department reported on Monday that the total is 497. Pennsylvania does not note whether any cases included in its total are probable or if all are confirmed.

Also on Friday, Wisconsin reported that its year-to-date total for measles was now at 94 confirmed cases, and 6 probable, but the CDC's count for the state is 38.

In general, the number of measles cases is believed to be vastly underreported, in part because some communities experiencing the most severe outbreaks have less contact with public health agencies. Roughly 1 to 3 out of every 1,000 unvaccinated people who are infected with measles will die, "even with the best care," according to the National Foundation of Infectious Disease. Therefore, if the two measles-associated deaths reported in Pennsylvania are confirmed to have been caused, at least in part, by measles, this would indicate that the outbreak is far greater than what the current data show.