Pennsylvania records a fourth measles death as the state count hits 693 cases

Pennsylvania health officials said this week that two more residents have died after measles infections, bringing the state’s 2026 death toll from the virus to four. The dead are an unvaccinated 18-year-old in Mifflin County and an unvaccinated 40-year-old woman in Jefferson County. Two unvaccinated infants in Lancaster County had already died. The United States has not recorded four measles deaths in a single year since 1992.

The Pennsylvania Department of Health’s 14 September bulletin listed 693 confirmed cases in 38 of the state’s 67 counties, 17 of them new since 11 September, and 133 hospitalisations. Only four cases, less than 1 percent, were in people vaccinated on schedule for their age. A public dashboard at pa.gov/measles carries the running totals. In all of 2025 the state logged 16 cases.

Mifflin County’s coroner said a review of medical records pointed to acute disseminated encephalomyelitis, a rare swelling of the brain and spinal cord that can follow measles. Jefferson County’s coroner reported the woman’s death on 12 September and moved to list measles as the probable cause. The state department said it was working through that paperwork when the 14 September update went out. By Tuesday, 15 September, officials were treating both deaths as confirmed for public count.

Governor Josh Shapiro called the deaths tragedies and said Pennsylvania is living through the worst measles outbreak in the country. The disease was declared eliminated in the United States in 2000. Shapiro blamed falling vaccination rates for the return. Nationally the Centres for Disease Control and Prevention have tallied more than 3,200 cases this year, more than in any year since elimination was declared.

A separate quarrel has opened between Harrisburg and Atlanta. CDC Director Dr Erica Schwartz said Pennsylvania has not requested an Epi-Aid, the field team the agency sends to help a state trace an outbreak, despite repeated offers. State officials have not treated that remark as a request they intend to accept on Washington’s timetable. Families in the 38 counties still face the same instruction they faced in August: check vaccination cards, isolate after exposure, and treat a fever with a rash as a reason to call ahead before walking into a waiting room.

Allegheny County logged its first cases tied to this outbreak in late August after a possible exposure at the emergency department of UPMC Children’s Hospital. The patients later left the county. Pittsburgh’s kindergarten measles-vaccination rate has dropped below the 95 percent line that public-health offices treat as the floor for herd protection. That local number, more than any press conference, explains why a virus that needs a dense cluster of unprotected people has found them.

Measles hospitalises about one in five unvaccinated patients, according to long-standing CDC figures. Pennsylvania’s 133 admissions from 693 cases sit close to that ratio. Two doses of vaccine prevent infection in about 97 percent of people who receive them. The four vaccinated cases in the state file are the remainder.

The political fight over federal help does not change those ratios. It may change how fast a county finds the next exposure site. An Epi-Aid puts extra epidemiologists in cars. Pennsylvania says it is running its own dashboard and its own call lists. Four deaths is the number both sides now have to explain to the same parents.