Pa. records 5th measles death with infections over 900

It marks the third measlesrelated fatality in Lancaster County this year.

By JAMES ENGEL
TribLive

Pennsylvania has recorded a fifth measles-associated death as an outbreak that has sickened more than 900 people across the state continues, according to state data released Wednesday.

The state Health Department said the person was an unvaccinated Lancaster County resident who tested positive for measles and died. Neil Ruhland, a department spokesman, declined to say more about the deceased.

Measles infections, which have grown rapidly in recent weeks, were related to the deaths of two infants in Lancaster County last month, according to state health officials.

Lancaster County has been the epicenter of the outbreak, counting nearly 400 cases as of Wednesday afternoon.

Reached Wednesday, Lancaster County’s coroner, Dr. Stephen Diamantoni, told TribLive he was unaware of the death and the state Health Department had not offered him any information on the case.

“We’re always anxious to communicate with anyone who might have information,” Diamantoni said.

The two previous fatalities in Lancaster County were followed by the deaths of a 40-year-old Jefferson County woman and an 18-year-old Mifflin County resident, according to coroners in those counties.

The state Health Department announced two deaths in Lancaster County as “measles- associated” on Aug. 25, though the extent to which measles played a role in one of the deaths has proved contentious.

Diamantoni previously confirmed the two deaths as Ivan Miller, a newborn who died Aug. 14, and Mary Stoltzfus, who suffered from a fatal birth defect but died from measles Aug. 18 at 6 weeks old.

Like the latest death, Diamantoni initially told Trib-Live he was unaware of Stoltzfus, who died at home.

But after later speaking to her medical provider and examining her death certificate, he was confident measles played a direct role in her death.

Stoltzfus was born with Amish lethal microcephaly, a genetic disorder that causes infants to be born with a small head and underdeveloped brain, the coroner said.

The disorder typically leaves patients with a lifespan of four to six months, but Diamantoni said the infant’s life was cut even shorter by the measles infection.

Ivan’s cause of death, however, was a “traumatic laceration of the spleen,” and Dia- mantoni said he does not believe measles was a contributing factor in the infant’s death.

Diamantoni acknowledged, though, measles is listed under Part II of the infant’s death certificate, which reports “other contributing conditions contributing to death but not resulting in the underlying cause.” He said it was placed there to offer “a broader view of the general health of the child.”

Jefferson County Coroner Greg Furlong told TribLive this month that a 40-year-old woman with several chronic health conditions had died as a result of measles.

Reached again Wednesday, Furlong said he plans to release the woman’s name in response to numerous Right-To-Know requests followed by a public statement.

A preliminary death certificate issued by Furlong lists the woman’s immediate cause of death as “acute on chronic hypoxemic and hypercapnic respiratory failure” with “suspected measles” listed as the first underlying cause, followed by COPD and asthma.

Furlong later said test results had shown the woman — who previously refused a laboratory test for measles — was a “positive confirmed measles death.”

The Mifflin County resident died from acute disseminated encephalomyelitis, described Tuesday by the coroner as a “rare and severe neurological complication of measles.”

Mifflin County Coroner Andrea L. Alcalde told TribLive on Wednesday that she would release more information surrounding the death after her “legal team has reviewed the circumstances.”

So far, the federal Centers for Disease Control and Prevention has included only two measles deaths in its data, though it declined to offer any information about them.

The federal agency, overseen by Health and Human Services Secretary Robert F. Kennedy Jr., disputed the nature of Ivan Miller’s death amid ongoing friction between Kennedy and Gov. Josh Shapiro and Pennsylvania Health Secretary Dr. Debra Bogen.

Health experts who spoke to TribLive say the 900-plus confirmed measles cases in Pennsylvania are part of the reestablishment of the previously eliminated virus in the United States and likely a vast undercount.

They attribute the outbreak to sinking vaccination rates in recent years as vaccine skepticism continues to rise.

In the U.S., the vaccine comes as part of the combination measles, mumps and rubella (MMR) vaccine — which has proven safe and effective for decades.

Measles is a virus that infects the lungs and spreads when an infected person breathes, coughs or sneezes.

The virus remains in the air and on surfaces for up to two hours, even after the infected person leaves the area. An individual with measles can spread the virus to others four days before and four days after the distinctive rash begins.