The U.S. Centers for Disease Control and Prevention (CDC) refreshed its measles surveillance dashboard on Friday, yet the agency still has not added four measles‑related deaths that occurred in Pennsylvania. The omission comes as the state reports a surge in cases and clinicians describe clinical presentations they have not seen in decades.
Congressional and expert concerns
On Monday, members of Congress asked the CDC for an “immediate briefing” on the decision to change how measles deaths are reported. The request follows a reported possible exposure in the neonatal intensive care unit at Children’s Hospital of Philadelphia last week. Former CDC chief medical officer Debra Houry called the delay “curious,” noting that the National Center for Health Statistics (NCHS) typically receives updated death data within one to two days after state investigations are completed. Houry said Pennsylvania had already concluded investigations into the first two deaths, so the records should be in the CDC’s hands.
In Pennsylvania, infectious‑disease specialist Dr. John Goldman of the University of Pittsburgh Medical Center warned that the outbreak “seems to be accelerating” and that clinicians are encountering “types of measles we’ve never seen before.” He highlighted the emergence of congenital measles—newborns infected in utero or at birth—a condition that was once exceedingly rare because most pregnant people were protected by vaccination or prior infection.
Scale of the outbreak and reporting challenges
State health officials have reported 731 measles cases, a figure that Goldman believes underestimates the true burden. He explained that many patients who seek care for measles mention sick household members who have not been tested, suggesting additional uncounted cases. Historically, measles kills between one and three people per 1,000 cases and hospitalizes one in five, but Houry said the current Pennsylvania deaths and hospitalizations are “definitely not proportional to what would be expected,” indicating a likely undercount.
The CDC traditionally gathers death data from states, where death certificates are issued at the local level. The agency is currently working with the Council of State and Territorial Epidemiologists to create a specific definition for measles deaths, moving away from its reliance on the World Health Organization’s broader definition. Until a new definition is finalized, the CDC depends on NCHS data that identifies measles as the underlying cause based on state‑submitted death records, according to HHS spokesperson Emily Hilliard.
CDC Director Erica Schwartz denied that deaths are being excluded for political reasons, comparing the process to how COVID‑19 deaths were classified. Schwartz said that if a person died from an unrelated cause, such as a bus accident, even if they tested positive for COVID‑19, the death would not be counted as COVID‑related. Houry criticized Schwartz’s remarks as unhelpful and contributing to misinformation, urging focus on controlling the outbreak rather than on definitional debates.
HHS Secretary Robert F. Kennedy Jr. reportedly instructed Schwartz not to include the Pennsylvania deaths in the CDC tally, though Kennedy’s public comments on the outbreak were limited to a single mention at an anti‑vaccine conference, where he called for equal attention to vaccine side‑effects and measles mortality.
State response and outlook
Pennsylvania has responded with more than 100 pop‑up vaccination clinics and has asked the CDC for additional vaccine support. Goldman praised the state health department’s rapid testing turnaround—often within 24 hours—and described the overall response as “spectacular.” He emphasized that under‑testing is not due to lack of laboratory capacity but rather to sick individuals staying home and not seeking care.
Goldman, who last saw measles in 1992, now reports seeing at least one case daily and expects the surge to continue for three to six months. He warned that measles could be a “canary in the coal mine” for other vaccine‑preventable diseases such as whooping cough, diphtheria and polio.
Steve Lopez is a Senior Editorial Columnist and Health & Public Policy reporter for News Raise. Steve focuses on healthcare advancements, medical technologies, and public health policies.
