By Yasmeen Abutaleb and Dan Levine
WASHINGTON, Sept 17 (Reuters) – The Pennsylvania health department has requested emergency support from the US CDC as it grapples with one of the country’s largest and most deadly measles outbreaks, though with certain terms, according to a document reviewed by Reuters on Thursday.
The request comes on condition that the federal agency recognize four measles-associated deaths reported by the state, raising the stakes in a dispute with the Trump administration.
The state’s measles outbreak has become the focus of a standoff between US Health Secretary Robert F. Kennedy Jr. and Governor Josh Shapiro, a Democrat. Kennedy has cast doubt on whether deaths reported in US measles outbreaks since he took office were due to the virus or another cause, and instructed the CDC not to include the Pennsylvania fatalities in a national tally.
Disease experts say the move represented highly unusual interference by a health secretary in the determination by state health officials and could minimize the risks of measles in the eyes of the public. Kennedy has accused Shapiro of politicizing the outbreak in his state and of failing to request federal help.
In a letter sent to Centers for Disease Control and Prevention director Erica Schwartz on Wednesday evening, reviewed by Reuters, Pennsylvania secretary of health Debra Bogen said the state had begun the process to request emergency assistance from the CDC, known as Epi-Aid.
“The CDC’s choice not to publicly recognize the deaths undermines our response,” Bogen wrote. “For this reason, if CDC is unable to transparently and accurately communicate information about those measles-associated deaths, the Department will respectfully rescind our request for a CDC Epi-Aid.”
The request from the state health department comes after it had resisted CDC help, arguing it had the outbreak under control.
In a statement, HHS spokesperson Grace Davis Jamison said CDC had not received Pennsylvania’s request through “normal channels,” and that federal outbreak assistance is a separate issue from the way CDC chooses to tabulate fatality data.
“CDC will not submit to political blackmail that conditions critical public health assistance,” said Jamison.
GROWING OUTBREAK
When the Pennsylvania health department announced the first two measles-associated fatalities on August 25, the disease had sickened 393 people across 28 counties. Shapiro praised his health department’s efforts to vaccinate more people, and the state health department opted not to ask the CDC to send personnel to help on the ground.
Shapiro has criticized Kennedy, a long-time anti-vaccine activist who has promoted policies to reduce US childhood immunization, for amplifying public fears about vaccines without scientific evidence. Kennedy and Schwartz have blamed Shapiro for not accepting their offers of Epi-Aid, a form of short-term CDC assistance during public health emergencies. The agency sends experts to the site of a disease outbreak, typically for one to three weeks, to provide additional support to state and local health departments.
Pennsylvania’s outbreak has since ballooned, growing to more than 700 confirmed cases across 37 counties and four measles-associated deaths, according to the state health department. It is the latest state to grapple with the worst US resurgence of measles in more than three decades, fueled by rising vaccine hesitancy, and coincides with President Donald Trump’s return to office in early 2025.
The disease’s spread in Pennsylvania is accelerating and could be 10 times larger than the official numbers, said Matthew Ferrari, director of the Center for Infectious Disease Dynamics at Penn State. Still, the state’s caution on CDC deployment is understandable, Ferrari said, as it could cause more problems if state and federal political leadership are not aligned on an issue as critical as what counts as a measles-related death.
The state “doesn’t want someone coming in, giving them advice and also telling them that the things that they’re experiencing are not as severe as they’re seeing with their own eyes,” he said. If the CDC ultimately doesn’t provide more assistance, he said, public health experts from other states could help.
One of the fatalities announced this week occurred in Mifflin County, which now has the second-highest number of cases in the state and is located over 100 miles from the outbreak’s initial epicenter in Lancaster County. At the same time, the pace of measles vaccinations provided by the state appears to be slowing, according to health department data. In August, the health department administered over 3,500 doses of the measles, mumps and rubella (MMR) vaccine, which provides 97% protection against infection after two doses. For the first half of September, that number dropped to around 1,100 doses.
(Reporting by Yasmeen Abutaleb and Dan Levine; Editing by Michele Gershberg and Nick Zieminski)
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