The cause of death of the 6-week-old baby in Pennsylvania was confirmed to be measles by Stephen Diamantoni, the Lancaster County medical examiner. Diamantoni said the baby died at home and that the death may have occurred on “18th of August.” The baby also had a genetic condition called Amish lethal microcephaly, which causes the head and brain to develop smaller than normal. However, Diamantoni said that although the condition was present, the cause of death was measles. The disease occurs in approximately 1 in 500 babies in the Old Order Amish community, and babies with the condition generally live for about six months.
The death was one of two cases that Pennsylvania health officials announced last week were linked to measles. The other case involved a newborn boy from an Amish family living in Lancaster County. His mother was suffering from severe measles during childbirth. Although the baby was born with a pulse, he was not breathing and died in less than a half-hour after paramedics attempted to provide oxygen and perform CPR. Medical evaluations reportedly found that the baby had tested positive for measles and showed signs of an infection in his lungs. Diamantoni, however, said the cause of death was a ruptured spleen. Expert Paul Offit said that measles can enlarge the spleen, making it vulnerable to rupture during delivery, that splenic rupture is extremely rare in newborns, and that no alternative explanation had been presented to the public.
The controversy grew after Health Secretary Robert F. Kennedy Jr. suggested, without presenting evidence, that the deaths could have been “fabricated.” Diamantoni’s statement that she had not received the death reports when the state announcement was made also strengthened that claim; however, Lancaster County does not have its own health department and relies on information from the state health department. Kennedy ordered CDC Director Erica Schwartz to remove the deaths from the agency’s data. Although the cases remain in the CDC’s internal database, they were removed from publicly available data. Pennsylvania Governor Josh Shapiro called for the deaths to be accurately added to the CDC table.
Why it matters
The significance of the development is that measles-related deaths have become a subject of debate not only as a medical matter but also in terms of the reliability of official records and the data presented to the public. In particular, distinguishing between the genetic condition seen in the Amish community and the impact of measles on the deaths brings the question of how causes of death are determined to the forefront. Differences between the forensic evaluations of the two cases create uncertainty over the extent to which medical findings and alternative explanations have been reflected in public accounts. The removal of the cases from publicly available data while they remain in the CDC’s internal database also raises the question of whether health statistics can be changed through political decisions. For this reason, the controversy concerns both the risks of measles and the transparency of official death records.