Pennsylvania coroner says infant's death was due to spleen rupture, not measles

Lancaster County coroner Dr. Stephen Diamantoni told reporters the newborn died shortly after birth from an internal hemorrhage and a traumatic rupture of the spleen, despite laboratory evidence of measles virus in the infant’s lung tissue. He said the autopsy showed no enlargement of the spleen, a condition that can increase rupture risk, and noted the baby was delivered at a birthing center attended by an uncertified lay midwife.

State health secretary Dr. Debra Bogen said the department’s investigation confirms the case as “measles-associated,” meaning laboratory or epidemiologic evidence links the infection to the death. "As a pediatrician with more than 30 years of caring for children, I have thoroughly reviewed the case investigation information and sadly can confirm that there were two recent measles-associated deaths in Lancaster County," she said.

The health department has not disclosed details about the second measles-linked death but said both individuals were unvaccinated. Newborns are not eligible for the measles, mumps and rubella vaccine, which is first given at 12 to 15 months of age.

Pennsylvania has reported 424 measles cases this year, including 94 in the past week, with 73 hospitalizations. Nationwide, 2,777 cases have been confirmed, the highest number in 35 years. Pediatrician Dr. Paul Offit noted that two deaths among 494 reported cases represent a higher fatality rate than historically observed for measles.