Measles Cases Pass 4,400 as Experts Question How the CDC Reports Deaths

The United States has recorded more than 4,400 confirmed measles cases so far this year, about twice last year’s total, as the worst resurgence of the disease in decades keeps spreading, and public health experts are questioning why the Centers for Disease Control and Prevention has become less open about the deaths it counts.

The CDC’s tally rose by about 8 percent in a single week to 4,410 cases, The Guardian reported, and later data cited by NPR put the count above 4,580 as of October 22. Almost all of the people infected this year, about 96 percent, were unvaccinated or had an unknown vaccination status, according to the agency.

Pennsylvania is the center of the outbreak. The state health department has confirmed at least 1,338 cases in 44 counties this year, more than 250 hospitalizations and five deaths, with a sixth death under investigation. The heaviest toll has fallen on Amish communities in Lancaster and Mifflin counties, where vaccination rates are low; three of the five people who died lived in Lancaster County.

The CDC added a third measles death to its national dashboard on Tuesday but declined to say which state it occurred in. A spokesperson for the Department of Health and Human Services told The Guardian that privacy laws prevent the National Center for Health Statistics from identifying the state or giving other details, and did not answer the newspaper’s follow-up questions about which laws apply.

Legal scholars quoted by The Guardian disputed that reasoning. Dorit Reiss, a law professor at UC Law San Francisco, noted that the agency already publishes case counts by state. Lindsay Wiley of UCLA Law said the federal Privacy Act generally protects only information that could reveal a person’s identity, and that it is hard to see how naming a state would do so.

Experts also pointed to a change in how deaths are tracked. In September the CDC moved death reporting to the National Center for Health Statistics from the notifiable disease surveillance system, which usually reports deaths quickly and names the state. The agency has not clearly explained the switch. The national dashboard still lists three deaths this year, though Pennsylvania alone has confirmed five.

There is a reasonable argument for the federal approach: the statistics center typically withholds location details when only a few deaths have occurred, a practice meant to avoid identifying individuals in small numbers, and Pennsylvania officials themselves take time to confirm a cause of death before reporting it. Debra Houry, a former CDC chief medical officer, told The Guardian that the state was right to be careful but that the deaths were already in the news.

Paul Offit, an infectious disease physician at Children’s Hospital of Philadelphia, told The Guardian that families need to know how much measles is circulating in their own state to judge their risk.

Vaccination remains the main defense. Two doses of the measles, mumps and rubella vaccine are about 97 percent effective, according to the CDC. Pennsylvania officials said more than 39,000 measles vaccines were given in the state in the first three weeks of October, well above the usual monthly average of about 25,000. New York’s governor declared a disaster emergency this month over rising cases there.