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Pennsylvania, which is battling a measles outbreak that's seen 767 cases in 38 counties and four deaths as of Sept. 18, is locked in a fight with the Centers for Disease Control (CDC) over how to count those fatalities. Now, the commonwealth has asked the CDC for help, Reuters reported. The request comes on condition that the federal agency recognizes four measles-associated deaths reported by the commonwealth. The commonwealth’s measles outbreak has become the focus of a standoff between Health Secretary Robert F. Kennedy Jr. and Pennsylvania Governor Josh Shapiro, a Democrat. Kennedy has cast doubt on whether deaths reported in U.S. measles outbreaks since he took office were due to the virus or another cause, and instructed the CDC not to include the Pennsylvania fatalities in a national tally. On Sept. 15, the Pennsylvania health department confirmed two additional measles-associated deaths in Pennsylvania. Both individuals were unvaccinated. One individual lived in Jefferson County and the other lived in Mifflin County. As CMM previously reported, the Jefferson County coroner confirmed that county’s fatality was a 40-year-old unvaccinated woman with underlying conditions. CNN reported that the Mifflin County coroner confirmed an 18-year-old died from acute disseminated encephalomyelitis, a rare neurological condition that can occur after an infection. One of every 1,000 kids with measles will develop encephalitis, or brain swelling, according to the CDC. Before announcing these cases as measles-associated deaths, Pennsylvania health officials conducted rigorous investigations in cooperation with the Jefferson and Mifflin County coroner’s offices. These investigations included confirming clinical evidence of a measles infection, a positive laboratory test and that the death was not due to an unrelated cause. That process aligns with the health department’s detailed epidemiological case definition for determining a measles-associated death, which is available at pa.gov/measles. Additional factors, such as whether the individual was exposed to measles prior to their death and supporting medical records, were also considered, it said. The Pennsylvania health department completed similar investigations when it reported two measles-associated deaths in Lancaster County on August 25, Pennsylvania’s first deaths of this kind in 35 years. One of the fatalities announced last week occurred in Mifflin County, which now has the second-highest number of cases in the state (83 confirmed) and is located over 100 miles from the outbreak's initial epicenter in Lancaster County, which has reported 308 cases, the health department reported. Doctors recommend two doses of the MMR vaccine as the best way to protect against measles, mumps and rubella, the CDC said. As of Sept. 16, the Pennsylvania health department has administered nearly 7,000 MMR vaccine doses this year. As CMM previously reported, the U.S. is experiencing its worst year for measles since 1991. Additionally, CNN reported the last time there were four deaths related to measles in one year was 1992. Last year, three U.S. deaths were confirmed from measles—two in Texas and one in New Mexico. As of Sept. 17, the CDC has confirmed 3,347 measles cases in 45 states and the District of Columbia. For 2025, a total of 2,289 confirmed measles cases were reported in the U.S.

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