A fourth measles death has been reported in Pennsylvania, where an unvaccinated 18-year-old from Mifflin County died of a rare brain complication of the virus. State health officials confirmed the death Tuesday.
The Mifflin County coroner’s office said the teen died of acute disseminated encephalomyelitis. In that condition, the body’s immune system attacks the brain and spinal cord and causes dangerous swelling. It is rare, but it is one of the most severe complications measles can cause.
Pennsylvania’s fourth measles death came days after a 40-year-old woman from Jefferson County, a rural area in western Pennsylvania, died Saturday from measles complications. Last month, two infants who had measles died in Lancaster County. None of the four were vaccinated. The two babies were too young for the shot under current guidelines, which call for the first dose at 12 months old.
All four deaths happened within about a month. They are the first measles-related deaths in Pennsylvania in 35 years. The state has reported nearly 700 cases this year across 38 counties, including about 100 in the last week alone. So far, 133 people have been hospitalized.
The national numbers are also climbing. The Centers for Disease Control and Prevention has confirmed 3,294 measles cases this year, including 267 hospitalizations, making 2026 the worst year for the disease since 1991. The country recorded three measles deaths last year, so it has now seen seven measles-associated deaths in two years. That is more than the total for the previous three decades combined.
Measles is one of the most contagious diseases there is. It spreads when an infected person talks, coughs, sneezes, or breathes, and it can hang in the air for up to two hours after that person leaves the room. About 90% of unvaccinated people who are exposed will catch it.
Measles was declared eliminated in the United States in 2000, which means the virus had stopped spreading continuously inside the country. In November, international health officials will meet to decide whether the U.S. and Mexico have lost that status.
The fourth measles death also lands in the middle of a bitter public fight between Pennsylvania Gov. Josh Shapiro and Health and Human Services Secretary Robert F. Kennedy Jr., one of the most prominent vaccine skeptics in the country.
The state announced its first two deaths in late August. At the time, Shapiro said he had turned down Kennedy’s offer of federal help. He said he told Kennedy that his “actions and his rhetoric,” including spreading misinformation about vaccines, were harming communities. Kennedy fired back on X and accused Shapiro of fearmongering. He also suggested the deaths “may even have been altogether fabricated” by one of the governor’s staffers, pointing to the Lancaster County coroner, who he said had no record of any measles deaths.
Pennsylvania Health Secretary Dr. Debra Bogen answered that her department’s epidemiology team had investigated both cases and verified that both people tested positive for measles.One of those infant deaths is genuinely in dispute. Lancaster County Coroner Dr. Stephen Diamantoni said a newborn died of a ruptured spleen, and his forensic pathologist concluded that measles did not cause it. Measles was still listed on the death certificate as a contributing condition. The state recorded that death as measles-associated because the baby tested positive, and measles can make the spleen more likely to rupture. Diamantoni said the second infant, a six-week-old with a serious genetic condition, did die from measles.
There is also the question of who is counting. The CDC has not included the fourth measles death or any of the three before it in its official tally. Its website says the agency has no death records from 2026 showing measles as the underlying cause. The decision to leave out the first two deaths came from the CDC’s new director, Dr. Erica Schwartz.
The agency now says it will report measles deaths only after the National Center for Health Statistics lists measles as the underlying cause. That center is the federal office that compiles death records submitted by the states. In the past, the CDC accepted death reports like these directly from state health departments.
Shapiro went after Kennedy again this week. He said the secretary was “playing games with public health and safety” and accused him of personally directing the CDC not to report the Pennsylvania deaths. Kennedy responded that Shapiro was politicizing the outbreak instead of working toward a unified public health response.
The CDC’s own messaging points in two directions. While the agency declines to count the deaths, it is still telling Americans to get vaccinated. Its website calls the measles, mumps, and rubella vaccine, known as MMR, the best way to protect against measles. Two doses are about 97% effective at preventing the disease, and one dose is about 93% effective. Children typically get the first shot at 12 months and the second between ages 4 and 6.
Kennedy himself has recently started saying so publicly. At a press conference in Tampa last month, he said: “Our advice is that people should get the measles vaccination.”
His history in Lancaster County tells a different story. In 2021, he was recorded speaking to the Amish community there, questioning vaccines and downplaying the dangers of measles. Five years later, Lancaster County is where the first two babies died.
Since taking office, Kennedy has also reshaped federal vaccine policy. In 2025, he fired every member of the CDC’s vaccine advisory panel and replaced them with members he picked, several of whom share his skepticism about vaccines.
Bogen said Pennsylvania remains committed to making sure residents have the facts about measles and access to the MMR vaccine, “which kept measles outbreaks at bay for decades.”
