Pennsylvania prepares for wider measles spread as counties grapple with limited health infrastructure
State officials warn that measles cases could move beyond the current hotspot, highlighting low vaccination rates in some communities and the challenges posed by a lack of county health departments.
Pennsylvania reported its fifth measles-related death last week, with 943 confirmed cases across 39 counties. Health officials say the disease is likely to spread beyond the current epicenter in Lancaster County, which has recorded 381 cases, many among Amish communities that historically have low MMR vaccination uptake.
Jeanne Franklin, director of Chester County’s health department, noted that her county, which has 83 cases, is preparing for additional infections from neighboring Lancaster. > "We have a very long border with Lancaster county, and these types of disease don’t care about borders. It’s going to keep going and find a person who isn’t vaccinated," she said. Franklin added that many Amish residents are not anti-vaccine but often lack awareness or regular healthcare access, and that local officials are working to address misinformation about vaccine safety.
Chester County’s own health department, one of only seven in the state, gives officials direct control over staffing and outreach, which Franklin said is an advantage in responding quickly to the outbreak.
In Montgomery County, Dr. Richard Lorraine, medical director of the public health office, warned that measles cases are expected to appear soon. > "It’s a matter of time before we begin to see measles cases," he said, emphasizing immunization as the primary preventive strategy and noting partnerships with pharmacies to provide free vaccinations regardless of insurance status.
Delaware County health director Lora Werner highlighted additional challenges, including the recent bankruptcy of Crozer Health, the region’s largest pediatric provider. Despite generally high vaccination rates, she said there are pockets of lower coverage, and the newly created county health department is working to integrate public-health initiatives within local social networks.
Pennsylvania’s fragmented county health system—only seven of its 67 counties have dedicated health departments—complicates statewide coordination, prompting officials in several counties to consider establishing their own agencies to better manage the outbreak.