Pennsylvania’s Adult Measles Death Leaves the Tally Split

Jefferson County Coroner Greg Furlong said a 40-year-old unvaccinated woman died Sept. 12 of respiratory failure he tied to suspected measles. She had COPD and asthma and had lived on supplemental oxygen around the clock. Pennsylvania still lists two measles-associated deaths. The CDC lists none.

Furlong called the death measles-related in a statement that weekend. The state health department said on Sept. 14 it is reviewing his finding and has not added it to the official count.

Jefferson County’s First Adult Measles Case

The woman lived in rural Jefferson County, northeast of Pittsburgh. Furlong, a Republican elected as coroner, said she was unvaccinated and developed textbook measles symptoms after close contact with a relative who was a neighbor and whose infection had been confirmed by a lab. Those symptoms included fever, cough, white spots inside the mouth, and a rash that began after about 3 to 4 days.

A preliminary death certificate lists the immediate cause as acute on chronic hypoxemic and hypercapnic respiratory failure. Suspected measles is the first underlying cause, followed by COPD and asthma. Furlong said he expected to change “suspected” to “probable” because a lab had already confirmed she had been in direct contact with measles. He said she met every benchmark and criteria to be positive for measles, and that she would likely still be alive had she not caught it.

She declined a lab test while she was ill. Her husband also showed signs of measles, declined a test, and recovered. Furlong said a nasal swab would be sent to the state laboratory. Jason Stiver, the county’s chief deputy coroner, said measles can cause severe illness in people of any age, not only in children.

This is a heartbreaking loss for the family and an unfortunate reminder that measles can be a serious and potentially life-threatening disease.

Greg Furlong, Jefferson County coroner, in a Sept. 12 statement

A death like this will always look, on paper, like the lung disease she already had. Measles kills through pneumonia and respiratory failure. In a patient who already needed oxygen 24 hours a day, the virus and the COPD share the same last page of the certificate. That overlap is now the argument.

WHAT WE KNOW

• The patient: A 40-year-old Jefferson County woman, unvaccinated, with COPD and asthma, on round-the-clock oxygen.
• The exposure: Close contact with a relative whose measles case was lab-confirmed; her husband fell ill and recovered without a test.
• The certificate: Respiratory failure with suspected measles listed first among the underlying causes.

WHAT IS UNCONFIRMED

• The lab: A postmortem nasal swab was headed to the state lab; results were not public.
• The state tally: The Pennsylvania Department of Health has not accepted the death as measles-associated.
• The federal tally: CDC still publishes zero measles deaths for 2026.

Until that swab and that review land, the adult case is a coroner’s finding, not a closed statewide count.

The Three Certificates Do Not Match

Local officials have now tied three 2026 deaths in Pennsylvania to measles. The paperwork is not the same in any of them, which is why one headline number will not sit still.

THREE MEASLES-LINKED DEATHS IN PENNSYLVANIA

Lancaster County Coroner Dr. Stephen Diamantoni said Miller died shortly after birth of a ruptured spleen. The boy tested positive for measles. Diamantoni said the virus did not contribute to the rupture and was noted because it was a significant condition at the time of death. State health officials have called the case measles-associated anyway, saying measles can enlarge the spleen and make it easier to tear.

Stoltzfus died at home. She was born with Amish lethal microcephaly, a genetic condition that causes a very small head and an underdeveloped brain. Children with that condition typically live 6 months or less. Diamantoni said a measles infection killed her. Both infants were too young for the first MMR dose, which is usually given around age 1.

The Jefferson County woman is the first adult a Pennsylvania coroner has placed in that 2026 column, and the first of the three who could have been vaccinated.

Why Pennsylvania Still Lists Two Deaths

On Sept. 14, the Pennsylvania Department of Health said it has confirmed two measles-associated deaths in 2026 and is investigating the Jefferson County report as a possible third. The same update put the outbreak at 693 measles cases across 38 counties, with 17 of those cases new since Sept. 11, and 133 hospitalizations. Four cases, less than 1%, were in people who had been vaccinated.

The department said it will judge the adult death against its own epidemiological definition of a measles-associated death. On Sept. 10 it sent that definition to CDC and to the Council of State and Territorial Epidemiologists, the group that writes uniform disease-death definitions for the country.

Health officials have used “measles-associated” when laboratory or epidemiologic evidence of measles is present, even if a coroner does not name measles as the immediate cause of death. That is a wider net than a classic underlying-cause line on a death certificate. It is also why the infant with the ruptured spleen and the infant who died of measles can sit in the same state column.

On Aug. 25, when the department first confirmed the two Lancaster deaths, it said both people were unvaccinated and that Pennsylvania had not recorded a measles-related death in 35 years. It gave no ages then, citing privacy. Diamantoni later released the names and dates after a state records request.

Zero on the Federal Dashboard

CDC’s measles page, updated Sept. 11, still shows zero U.S. measles deaths for 2026. The note says the National Center for Health Statistics has no 2026 death records listing measles as the underlying cause. The agency also says it is working with CSTE on a standardized case definition for deaths due to measles, and that it will report measles deaths if and when NCHS records show measles as that underlying cause.

That is a change from the old outbreak habit, in which states investigated deaths and CDC compiled what the states sent. CDC Director Dr. Erica Schwartz, new in the job, ordered the Pennsylvania deaths held off the weekly dashboard in late August after HHS Secretary Robert F. Kennedy Jr. questioned them. A CDC spokesperson later said Schwartz is working with CSTE on the new definition and that NCHS is the holding pattern until that work is done.

NCHS mortality files are built for long-term cause-of-death trends. They lag outbreak dashboards by weeks or months. Former CDC principal deputy director Dr. Nirav Shah called the second-guessing of a state epidemiologist “pretty remarkable.” Former CDC chief medical officer Debra Houry called the NCHS shift puzzling. As of Sept. 10, CDC had recorded 3,294 confirmed measles cases in the United States in 2026, across 47 jurisdictions, plus 16 cases in international visitors, with 95% of cases tied to outbreaks.

The federal page does count three confirmed measles deaths in 2025, including two unvaccinated school-age children in Texas and an unvaccinated adult in New Mexico. The bar that those deaths cleared is the bar Pennsylvania’s 2026 cases have not yet cleared in Atlanta.

The Virus Has Reached Western Pennsylvania

The outbreak began in late April in the Lancaster and Lebanon area, in communities with large Amish and Mennonite populations and uneven MMR coverage. It is no longer only that map.

OUTBREAK SNAPSHOT

• Statewide, Sept. 14: 693 confirmed cases in 38 of Pennsylvania’s 67 counties, 133 people hospitalized, 2 measles-associated deaths confirmed.
• Hospital share: 133 of 693 is about 19%, in line with the department’s general figure that measles puts nearly 20% of patients in the hospital.
• As of Sept. 11: Lancaster County had 295 cases and Jefferson County had 26, when the statewide total still stood at 676 cases in 37 counties.
• Deaths in measles: The department says death, though rare, occurs in 1 to 3 patients per 1,000 cases.

Jefferson County is about a three-and-a-half-hour drive northwest of Lancaster. Twenty-six cases there already made it a local hotspot before the adult death. The virus remains infectious in air and on surfaces for up to 2 hours. Symptoms can start 7 to 21 days after exposure.

Two doses of MMR are 97% effective at preventing measles, the department says. The four vaccinated people identified in this outbreak are the exception that the percentages already admit, not evidence that the shot failed as a rule.

Kennedy Questioned Whether the Deaths Were Real

The adult case lands on a fight that started over the infants, not over Jefferson County.

HOW THE DEATH COUNT SPLIT

1. Aug. 14, 2026: Ivan Miller dies shortly after birth in Lancaster County of a ruptured spleen and tests positive for measles.
2. Aug. 18, 2026: Mary Stoltzfus, 6 weeks old, dies at home. Diamantoni later says measles killed her.
3. Aug. 25, 2026: The Pennsylvania Department of Health announces two measles-associated deaths, the first in the state in 35 years.
4. Late August 2026: Diamantoni says measles did not cause the spleen rupture. Kennedy suggests the deaths may have been fabricated. CDC thanks him for raising questions, then parks the deaths behind an asterisk, then behind an NCHS note of zero.
5. Sept. 4, 2026: Diamantoni confirms the girl died of measles. Gov. Josh Shapiro says Kennedy chose to sow doubt, play politics, direct CDC not to acknowledge the deaths, and accuse him of fabricating the tragedies.
6. Sept. 10, 2026: Pennsylvania sends CDC and CSTE its measles-associated death definition.
7. Sept. 12, 2026: The Jefferson County woman dies. Furlong reports a measles-related death. The state opens a review. CDC’s public death total stays at zero.

Kennedy and Shapiro were already arguing about help as well as about bodies. Other states have asked CDC for outbreak support. Pennsylvania health officials have said they will keep evaluating any additional federal help. The adult certificate does not end that argument. It hands both sides a new page. One side will read suspected measles as the cause. The other will read COPD, an unconfirmed swab, and a woman who declined a test.

4,300 Shots From Pop-Up Clinics

The department’s own response has been a vaccine drive, not a waiting game for NCHS.

MMR DOSES IN THE OUTBREAK

• Pop-up clinics: State crews have given nearly 4,300 MMR shots at 130 pop-up clinics in affected communities since the outbreak began in late April.
• State health centers: Staff have given more than 6,300 MMR doses to residents across Pennsylvania in 2026.
• All providers: Doctors and clinics usually give about 25,000 MMR doses in a typical month in the state. In August 2026 they gave more than 46,000.

Residents can get MMR from a doctor, a county or municipal health department, a state health center, a federally qualified health center, or the Vaccines for Children program. People who think they were exposed and have symptoms are told to call ahead before walking into a clinic, then to call the department’s hotline at 877-PA-HEALTH.

The Jefferson County swab is still a lab result, not a press conference. The CSTE definition is still unwritten. Until those two things move, Pennsylvania can keep two names on its death line, a coroner can keep a third on a certificate, and CDC can keep a zero on the national board, and each of those numbers can be accurate inside the rule that produced it.

Disclaimer: This article is news reporting on public health statements, death certificates, and outbreak counts. It is for information only and is not medical advice, a diagnosis, or a recommendation about vaccination for any person. Readers should talk with a licensed physician or their local health department before making decisions about MMR vaccination, exposure, or treatment. Case counts, death classifications, and lab findings reflect the official sources cited here as of their stated dates and can change as investigations close.