The Claim:
Reports about two deaths linked to a large measles outbreak in Lancaster County, Pennsylvania, do not agree. The county coroner says the people had measles when they died, but measles did not cause their deaths. State health officials disagree.
The Facts:
- The newborn had measles before birth and died from a ruptured spleen.
- Measles can weaken the spleen, making it more likely to rupture.
- These facts suggest measles may have played a crucial role in the baby’s death.
The Lancaster County coroner is an elected official. Dr. Stephen Diamantoni became board-certified in family medicine in 1985, but he does not have special training in investigating deaths. He did not perform the baby’s autopsy himself. He reported the findings of the forensic pathologist who did.
According to news reports, the pathologist listed a ruptured spleen as the cause of death, not measles. However, the baby had measles in the lungs after getting the infection from the mother before birth. Measles can enlarge and weaken the spleen, which may make it more likely to rupture. The pathologist reportedly did not find signs that the baby’s spleen had been enlarged.
Dr. Paul Offit explained that a ruptured spleen is very rare in newborns. He also said it may be difficult to tell whether a spleen was enlarged after it has ruptured, just as it can be hard to know the original size of a balloon after it bursts.
Offit said the available facts leave an important question. The baby had measles before birth, died from a ruptured spleen, and measles can weaken the spleen. However, Diamantoni has been careful about saying whether measles led to the rupture. Offit believes more evidence or explanation is needed before concluding that measles did not play a role in the baby’s death.


