Lancaster County Coroner Names the Two Infants Who Died in Pennsylvania's Measles Outbreak

Since the CDC confirmed its first U.S. measles death on September 23 and then updated that figure to two deaths six days later, disagreement over which deaths count has sharpened. Now we know two of the names.

Dr. Stephen Diamantoni, the coroner for Lancaster County, Pennsylvania, released autopsy and cause-of-death findings this week for two infants whose deaths were part of Pennsylvania's measles outbreak, according to the Associated Press. He did so in response to a state right-to-know request filed by Fox 43 affiliate WPMT-TV.

Ivan Miller died August 14, shortly after birth, from a ruptured spleen, Diamantoni said. Measles is listed on his death certificate as a contributing factor, but the coroner told the AP the virus did not cause the spleen rupture itself. He said measles was noted only because it was "a significant condition" the infant had at the time of death. Exactly how and when the spleen injury occurred is still under investigation.

Mary Stoltzfus was six weeks old when she died August 18 at home. She was born with Amish lethal microcephaly, a genetic condition that typically kills infants within six months. No autopsy was performed. Diamantoni told the AP that despite the underlying condition, a measles infection is what killed her.

Neither infant was old enough to receive the first MMR dose, typically given around age one.

The dispute over which deaths get counted

Pennsylvania has reported four measles-associated deaths total this year, according to the state health department, cited by CIDRAP. Local coroners have found one of the four was not measles-related, and the other three appeared to be or were caused by the disease, according to the Epoch Times. The Miller and Stoltzfus cases are two of those four; the coroner findings on the remaining two haven't been made public.

The CDC's own count sits at two nationwide measles deaths for 2026, confirmed Tuesday, September 29, according to the Guardian and Al Jazeera. The agency has not said which states those deaths occurred in, and has declined to say whether either matches the Pennsylvania cases, according to the Epoch Times.

Pennsylvania Health Secretary Dr. Debra Bogen wrote to CDC Director Dr. Erica Schwartz on September 16 demanding the agency "acknowledge the loss of four Pennsylvanians to this virus" and warning the state could rescind its request for federal outbreak assistance if the deaths weren't recognized. Neil Ruhland, the department's press secretary, told the Epoch Times that Pennsylvania officials still don't know which death the CDC is even citing.

HHS Secretary Robert F. Kennedy Jr. has publicly clashed with Pennsylvania Governor Josh Shapiro over the numbers, at one point suggesting the deaths "may even have been altogether fabricated," according to the Associated Press. Kennedy made similar claims last year about a set of three measles deaths, questioning whether one child was actually killed by the virus.

The coroner's findings complicate that framing in both directions. Diamantoni's determination that measles genuinely killed Mary Stoltzfus undercuts any suggestion the deaths were invented. But his finding that measles did not cause Ivan Miller's fatal spleen rupture, despite the virus being listed on the certificate, shows that not every death associated with an active measles infection is necessarily caused by it. A federal push for a consistent, verified definition of a "measles death" across states isn't unreasonable on its face, particularly when a local coroner independently concluded one of Pennsylvania's four deaths wasn't measles-related at all.

The CDC has said it's now working with state epidemiologists to build a standardized death definition, according to HHS, and that the current count "is subject to change" as reviews continue.

Where the numbers stand

Pennsylvania's outbreak had reached 903 cases and 176 hospitalizations as of the most recent state dashboard update cited by CIDRAP, with 31% of patients being children and less than 1% fully vaccinated. Nationally, the CDC's count stood at 3,659 confirmed cases as of September 24, the highest since 1991, according to the Guardian.

The CDC has shed close to 30% of its workforce, with the American Federation of Government Employees putting the reduction at 3,810 fewer civil service employees over the past year, according to the Guardian.

What's still unresolved: the coroner findings on Pennsylvania's other two deaths haven't been released, and the CDC hasn't said whether it will ever specify which state either of its two counted deaths occurred in. Pennsylvania has not said whether it's following through on Bogen's threat to withdraw its request for federal outbreak help.