The Center for Disease Control and Prevention continues to review two infant deaths in Pennsylvania that the state department of health have described as measles-associated. However, the deaths have not been included, at least yet, in the CDC’s current national measles mortality data. The CDC website states that it does not have 2026 death records identifying measles as an underlying cause of death for any measles infections this year, but is reviewing how measles deaths are classified and will update its reporting as additional information becomes available.
The distinction between the CDC and the PA state department of health has brought attention to the complexity of determining whether an infectious disease should be classified as a cause of death, a contributing factor or an associated finding. According to the Lancaster County Coroner Dr. Diamantoni, one infant who tested positive for measles died due to a splenic rupture, while a second infant who had lethal microcephaly died from a measles infection. Neither infant was old enough to receive the routine measles, mumps and rubella vaccine.
There is a distinction between a disease directly causing a death, as well as a disease that contributed to but did not directly cause a death. The PA state health department characterized both infant deaths as measles-related, the Lancaster County coroner reported one infant death as caused by measles, and the CDC has not yet incorporated either death into its national count.
Here’s why this situation is igniting public health concerns.
Why Public Health Data Classification Matters
Differences between state and federal classifications can affect a number of important public health data points including reported mortality, case-fatality calculations as well as assessments of the severity of an outbreak. This data also influences how public health officials and leaders communicate risk to the public about a disease. In this example, reporting no deaths in a year compared to two deaths in the year makes a difference in how officials would communicate how serious or deadly a disease is in real-time.
This issue is particularly relevant for measles because vaccination coverage and public perception of disease severity influences vaccination decisions. Measles cases have increased significantly this year, with the most cases in over three decades, in large part to declining vaccination rates. If public health data on measles deaths is not agreed upon or communicated clearly, vaccination rates could continue to decline further.
Trust In CDC Messaging Has Declined
The measles deaths dispute comes as surveys show declining confidence in federal public health institutions. According to a recent 2026 Annenberg Public Policy Center survey, 61% of Americans currently express confidence in the CDC, down from 72% in September 2024. A recent Harvard School of Public Health survey also found that 50% of U.S. adults said they trusted health recommendations from the CDC, compared to 77% in spring 2025.
The surveys do not mean that the Pennsylvania measles controversy caused declining trust. It does demonstrate that the CDC is operating in an environment where confidence in federal health recommendations is lower than it was several years ago. Continued controversy on measles deaths’ may further erode trust in the agency.
The Future Of Health Data
The broader issue beyond two deaths in Pennsylvania is how the American public interprets public health statistics when federal, state and local authorities use different classifications. For epidemiologists, a transparent distinction between a confirmed infection, an underlying cause of death and a contributing condition allows data to be interpreted appropriately. However, for the general public, unexplained differences can lead to confusion.
If differences in reporting deaths extend beyond measles to other diseases like COVID-19 and flu, then Americans may not know where to find reliable health information to inform their health decisions.
The CDC says its review is intended to promote consistent classification and reporting of measles deaths across jurisdictions. As the review continues, the American public will closely watch how national disease surveillance works and how differences in methodology can affect the numbers appearing on government websites and public understanding of an outbreak.
This article was originally published on Forbes.com