PENNSYLVANIA — The US Centers for Disease Control and Prevention updated its measles dashboard on a Friday but is not counting four measles deaths in Pennsylvania. HHS Secretary Robert F Kennedy Jr reportedly instructed CDC Director Erica Schwartz not to include the Pennsylvania measles deaths in the CDC tally.

The asterisk note on the CDC website states that the National Center for Health Statistics does not currently have any death records from 2026 indicating measles as the underlying cause. Members of Congress requested an immediate briefing on Monday regarding the decision to change how measles deaths are reported.

Pennsylvania has reported 731 measles cases. The state reported 97 measles cases in the past 7 days, bringing the total cumulative cases to 792 in 2026. As of September 14, the Pennsylvania Department of Health confirmed two measles-associated deaths in the state this year during an outbreak reaching 693 cases in 38 counties.

A possible measles exposure was reported in the neonatal intensive care unit at Children’s Hospital of Philadelphia last week. Doctors are treating congenital measles, which involves newborns who contracted the virus in utero or at birth.

"And we’re seeing, actually, types of measles we’ve never seen before," said John Goldman, an infectious disease specialist. "Because of this, we’re literally seeing new forms of measles." He added that medical professionals lack extensive information about the clinical progression of these specific cases. "We don’t have a lot of information about what happens with it," he said. "The state department of health has done a spectacular job of dealing with this," John Goldman said.

Goldman, who saw measles cases in 1988 and 1992 but none between 1992 and 2026, expressed surprise at the resurgence. "Never in my life did I think I was ever going to see measles again," he said. "Now, we’re seeing at least one every day."

"In a way, I think this is a warning. What worries me is measles is conceivably the canary in the coal mine," Goldman said. On average, one to three people for every 1,000 measles cases will die of the disease, and one in five people with measles will be hospitalized.

"It’s not rocket science. If we see more measles, we’ll see more deaths," Goldman said. Former CDC chief medical officer Debra Houry argued that the current data does not align with historical expectations. "The current deaths and hospital admissions in Pennsylvania are definitely not proportional to what would be expected," she said.

Houry criticized the administrative focus on definitions rather than outbreak response. "I would focus less on the definition itself and responding to the measles outbreak, and that’s what the focus of the CDC director should be," she said. She also addressed comments made by Schwartz regarding cause-of-death determinations.

"If someone got hit by a bus, and they happened to have Covid, often that was called a Covid-related death," Schwartz said in an interview. Houry responded that such comparisons were counterproductive. "Dr Schwartz’s comments are not only not helpful, but contribute to misinformation," Houry said.

The CDC is working with the Council of State and Territorial Epidemiologists to define deaths from measles. A CSTE workgroup was launched earlier in the year to develop guidance for measles epidemiology case investigations associated with deaths. Until that definition is created, the agency relies on existing federal data systems. "Until a measles death definition is created, the CDC is relying on NCHS data, which identifies measles as the underlying cause based on death record information submitted by the states," said Emily Hilliard, spokesperson for the US Department of Health and Human Services.

Houry noted that precise definitions were less critical in periods without fatalities. "When there aren’t deaths, you don’t need a precise definition," she said. She also noted delays in data transmission from state investigations to federal databases.

"It takes one to two days for the CDC to receive updated data to the National Center for Health Statistics after states finish death investigations," Houry said. "Pennsylvania concluded the investigation on the first two deaths, so CDC would have these records by now," she said.

Pennsylvania established more than 100 pop-up vaccination clinics in response to the outbreak and requested additional vaccination support from the CDC. Measles tests in the state have a 24-hour turnaround time. Goldman praised the logistical support provided by state authorities.

"I have called them up on a Thursday before the holiday weekend and arranged for them to do testing before it closed at noon the following day," he said. "They have provided us with information, and they have provided us with really really good support." He attributed ongoing transmission to patient behavior rather than diagnostic availability. "It’s not because they couldn’t get a test. It’s because they were sick at home and did not seek medical care," he said. He predicted the outbreak would continue until community immunity levels increased significantly. "I suspect that we’re not going to see a break until most people in most communities are immune either by vaccine or infection," he said.

Robert F Kennedy Jr spoke at an anti-vaccine conference on Thursday. Kennedy is serving as the 26th United States secretary of health and human services since 2025. Schwartz previously served as Deputy Surgeon General from January 2019 to April 2021, with the rank of rear admiral in the U.S. Public Health Service Commissioned Corps. About one to two people in a million experience severe side effects from vaccines.

Why It Matters

The exclusion of confirmed deaths from federal dashboards affects the accuracy of public health monitoring during an active outbreak. Research titled Measles: CDC refuses to record Pennsylvania fatalities in “measles associated deaths” row was published in 2026 in BMJ, documenting the controversy. The discrepancy between state-reported fatalities and federal counts raises questions about resource allocation and risk assessment.

Pennsylvania HB 1611, an act amending the Older Adults Protective Services Act, establishes statewide reporting systems for vulnerable populations, showing the importance of accurate data in protective services. The ongoing development of a standardized case definition by the CSTE and CDC aims to resolve these reporting inconsistencies for future epidemiological investigations.

What's New

Research titled Measles: CDC refuses to record Pennsylvania fatalities in “measles associated deaths” row was published in 2026 in BMJ. CDC Director Erica Schwartz altered public reporting of measles deaths on the CDC website at the request of HHS Secretary Robert F. Kennedy Jr.

The CDC website initially listed two measles-associated deaths recorded by Pennsylvania, but an asterisk replaced the number after Kennedy asked Schwartz to remove them. Pennsylvania reported 97 measles cases in the past 7 days. Pennsylvania HB 1611 (An Act amending the act of November 6, 1987 (P.L.381, No.79), known as the Older Adults Protective Services Act, extensively revising provisions relating to the protection of abused elderly; establishing a uniform Statewide reporting and investigative system for suspected abuse