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Measles OutbreakPolicy Shift· 4 min read· in Health

CDC Changes Measles Mortality Tracking Method, Reporting Zero Deaths for 2026 Amid Pennsylvania Outbreak

The Centers for Disease Control and Prevention has altered how it tracks measles fatalities, shifting to a long-term mortality database that currently lists zero deaths for the year. The change comes as Pennsylvania health officials and local coroners confirm multiple measles-associated deaths during an escalating statewide outbreak.

By Sophie Garnier

How this story has developed

This report is part of a developing story — read the earlier chapters below.

  1. Pennsylvania Proposes First Disease Outbreak Rules in 25 Years Amid Measles Crisis and Political Feud
  2. CDC Changes Measles Mortality Tracking Method, Reporting Zero Deaths for 2026 Amid Pennsylvania Outbreak (this article)
State and Local Authorities 40%Federal Administration 30%Public Health Advocates 30%
State and Local Authorities
Focuses on real-time outbreak management and clinical assessments of fatalities.
Federal Administration
Prioritizes standardized, long-term mortality data over real-time state reporting.
Public Health Advocates
Warns that data suppression undermines vaccination efforts and public trust.

Perspectives this story doesn't cover

  • Families of the deceased patients
  • Frontline pediatricians treating the outbreak

Why it matters

The CDC's tracking methodology determines how federal resources are allocated and how the public perceives the severity of an ongoing outbreak. A discrepancy between state-reported fatalities and federal data can complicate local public health responses and fuel vaccine hesitancy.

The Centers for Disease Control and Prevention (CDC) has changed its methodology for counting measles fatalities, resulting in an official federal tally of zero deaths for 2026. The agency announced on September 4 that it will now rely on the National Center for Health Statistics (NCHS) to identify measles as an underlying cause of death, rather than drawing from the National Notifiable Diseases Surveillance System (NNDSS) that routes real-time case data from state and local jurisdictions.[1][4]

The shift occurs as Pennsylvania battles one of the largest measles outbreaks in recent history, with the state recording 676 confirmed cases as of mid-September. During this outbreak, Pennsylvania health officials and local coroners have reported at least three measles-associated deaths, including a newborn, a six-week-old infant, and a 40-year-old woman.[1][5]

Under the new reporting framework, the CDC's measles dashboard features an asterisk in place of a death count. A corresponding footnote states that the NCHS "does not currently have any death records from 2026 that indicate measles is the underlying cause." Emily Hilliard, a spokesperson for the U.S. Department of Health and Human Services (HHS), confirmed that the CDC will only report measles deaths if and when the NCHS officially designates the virus as the underlying cause.[1][2]

Public health experts have questioned the timing and utility of the change. Debra Houry, a former CDC chief medical officer, described the move as "puzzling," noting that the NCHS system is "usually focused on high-quality, long-term mortality trend analysis" rather than confirming individual cases during an active outbreak. During previous outbreaks in Texas and New Mexico in 2025, the CDC included state-reported deaths in its national tally while investigations were still ongoing.[1][4]

U.S. measles cases in 2026 have already surpassed the total for all of 2025, driven largely by localized outbreaks.

The methodological shift follows public friction between federal and state officials over the classification of the Pennsylvania fatalities. In late August, Health and Human Services Secretary Robert F. Kennedy Jr. publicly questioned whether the infant deaths in Lancaster County were genuinely caused by measles, suggesting the reports might have been fabricated.[1][5]

The methodological shift follows public friction between federal and state officials over the classification of the Pennsylvania fatalities.

Local authorities have pushed back against the federal skepticism. Stephen Diamantoni, the Lancaster County coroner, confirmed to medical journals that the August 18 death of a six-week-old girl with Amish lethal microcephaly was "caused by measles." Diamantoni noted that while the child had a compromised state, respiratory infections driven by the virus were the deciding factor.[5]

Over the weekend, Jefferson County Coroner Greg Furlong announced the state's third probable measles-related death: an unvaccinated 40-year-old woman who required round-the-clock oxygen for chronic obstructive pulmonary disease. Furlong stated that the woman exhibited a characteristic measles rash and had a confirmed epidemiological link to a positive case, adding that she would not have died without the measles infection despite her underlying conditions.[1]

The discrepancy between state and federal reporting has drawn scrutiny from lawmakers. Democratic leaders on the House Energy and Commerce Committee demanded a briefing from CDC Director Erica Schwartz, characterizing the data shift as an attempt to conceal public health information.[1]

The new tracking method relies on long-term mortality records rather than real-time state surveillance data.

The Pennsylvania outbreak accounts for a significant portion of the 3,134 measles cases reported nationwide in 2026, a figure that has already surpassed the 2,289 cases recorded in 2025. The national surge coincides with declining vaccination rates; the CDC reports that MMR vaccine coverage among U.S. kindergarteners fell to 92.4% in the 2025-2026 school year, well below the 95% threshold required for community immunity.[2][5]

As local health departments continue to manage the outbreak, the federal death count remains at zero. The CDC has stated it is working with the Council of State and Territorial Epidemiologists to develop a standardized case definition for deaths due to measles, a process intended to promote consistent classification across jurisdictions. Until that review is complete, state-confirmed fatalities will not appear in the national mortality statistics.[1][2]

What to know

  1. The CDC has shifted its measles mortality tracking to the National Center for Health Statistics, resulting in an official count of zero deaths for 2026.
  2. The change departs from the previous method of using state and local surveillance data, which the agency used to track deaths during 2025 outbreaks.
  3. Pennsylvania officials have reported at least three measles-associated deaths this year, including two infants and a 40-year-old woman.
  4. Former CDC officials and public health experts warn the new system is designed for long-term trend analysis, not real-time outbreak monitoring.
  5. The U.S. has recorded over 3,100 measles cases in 2026, driven by declining MMR vaccination rates and localized outbreaks.

Where opinion splits

Federal Health Officials

Argue that the new tracking method ensures high-quality, standardized mortality data.

HHS and CDC representatives maintain that relying on the National Center for Health Statistics prevents the premature classification of deaths. By waiting for official death records to list measles as the underlying cause, the agency aims to establish a standardized case definition that avoids conflating measles-associated deaths with fatalities primarily driven by other underlying conditions.

Local Coroners and State Officials

Emphasize the immediate reality of the outbreak and the clinical evidence of measles as a deciding factor in recent deaths.

State health departments and local coroners argue that the NCHS system is too slow for active outbreak management. They point to clinical symptoms, epidemiological links, and the fact that vulnerable patients—such as infants and those with chronic conditions—would not have died when they did if they had not contracted the highly contagious virus.

Public Health Experts

Warn that changing data methodologies during an outbreak breeds mistrust and hinders response efforts.

Former CDC officials and pediatricians stress that the National Notifiable Diseases Surveillance System was specifically designed to route real-time case data from states to the federal government. They argue that omitting state-confirmed deaths from the national tally downplays the severity of the outbreak and undermines efforts to boost declining MMR vaccination rates.

Unanswered questions

  • It remains unclear how long the National Center for Health Statistics will take to process the 2026 death records and whether they will ultimately list measles as the underlying cause.
  • The exact criteria the CDC and the Council of State and Territorial Epidemiologists will use for their new standardized case definition of a measles death have not been finalized.
  • It is unknown if the methodological change will be applied retroactively to previous years' data or if it will affect the tracking of other infectious diseases.

Sources

Source coverage

5 outlets

3 viewpoints surfaced

State and Local Authorities 40%Federal Administration 30%Public Health Advocates 30%
  1. [1]The GuardianState and Local Authorities

    Trump administration changes how it counts measles deaths amid Pennsylvania outbreak

    Read on The Guardian
  2. [2]CDCFederal Administration

    Measles Cases and Outbreaks - CDC

    Read on CDC
  3. [3]WGRZPublic Health Advocates

    Daily Dose: CDC changes how it counts measles deaths, while rabies exposures and skipped care rise

    Read on WGRZ
  4. [4]KFF Health NewsPublic Health Advocates

    CDC Lists No Measles Deaths For 2026 After It Changes Its Tracking Method

    Read on KFF Health News
  5. [5]The BMJState and Local Authorities

    Coroner confirms US measles death while CDC count remains at zero amid row over the fatalities

    Read on The BMJ

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