Pennsylvania Reports Fifth Measles-Associated Death as Cases Reach 943

A fifth person has died in Pennsylvania's measles outbreak, and confirmed cases have reached 943 across 39 of the state's 67 counties.

The Pennsylvania Department of Health (DOH) said on Wednesday 30 September that an unvaccinated resident of Lancaster County, in the south-central part of the state, tested positive for measles and died.

DOH passed the death to the US Centers for Disease Control and Prevention (CDC), the federal government's main public health agency. It withheld further details, citing privacy law.

Five deaths since August

DOH confirmed the first two deaths on 25 August, both in unvaccinated Lancaster County residents.

They were the first measles-associated deaths in the state in 35 years, and the Associated Press said both were infants.

On 15 September DOH confirmed two more, an 18-year-old in Mifflin County and a 40-year-old woman in Jefferson County, according to the Associated Press.

Reuters said all five people who died were unvaccinated.

Two tallies, two numbers

The CDC listed two measles deaths nationwide as of Tuesday and did not say which states, Reuters said.

CNN noted that the CDC's own dashboard says the number can change.

Reuters added that the CDC recently began taking its death count from National Center for Health Statistics mortality data instead of state health department reports.

On Wednesday 16 September, the Inquirer said, Pennsylvania's Health Secretary, Debra Bogen, wrote to the CDC about the state's request for Epi-Aid, the CDC's short-term technical help for states in a health crisis.

She said the request would be withdrawn unless the CDC communicated the deaths transparently, CNN said.

US Department of Health and Human Services (HHS), which oversees the CDC, said the CDC stood ready to send epidemiologists if asked, spokesperson Emily Hilliard told CNN.

ABC27 said HHS also stated the CDC had not received the request through its normal channels. DOH spokesperson Neil Ruhland told CNN that talks were continuing.

Where the outbreak stands

DOH counted 40 new cases in the two days since 28 September. Of the 943 cases, 176 people, nearly one in five, have been in hospital.

Four cases were in vaccinated people, under 1%.

The Philadelphia Inquirer put nearly 400 of the cases in Lancaster County.

DOH says the outbreak began in late April and that between one and three of every 1,000 people who catch measles die.

Across the country

The CDC has counted 3,659 confirmed cases nationwide as of 24 September, according to Reuters.

The Associated Press called this the worst year for measles since 1991.

It counted eight reported measles-associated deaths in two years, more than the previous three decades combined.

Vaccine doses have more than doubled

Pennsylvania providers give about 25,000 doses of the MMR vaccine, which protects against measles, mumps and rubella, in a typical month, DOH said.

They gave more than 49,000 in August and more than 53,000 so far in September. DOH says two doses are 97% effective at preventing measles.