Pennsylvania's measles outbreak has reached 693 confirmed cases across 38 counties, the Pennsylvania Department of Health reported on September 14, with 17 new cases since its September 11 update. Hospitalizations rose to 133. The update came one day after the director of the Centers for Disease Control and Prevention (CDC) said the state has not asked for the federal field team the agency sends to help investigate outbreaks.
In a statement shared with CNN and published by WKOW, CDC Director Dr. Erica Schwartz said, "Despite repeated offers of assistance, Pennsylvania has not requested a CDC Epi-Aid, which would deploy epidemiologists and provide on-the-ground measles outbreak support." She said Texas, South Carolina, Virginia, Kansas, New Mexico, and Wisconsin had officially requested Epi-Aids and that the CDC is ready to help Pennsylvania once the state formally asks.
For families in the 38 affected counties, the dispute is not abstract. Controlling measles depends on finding exposed people quickly, and the open question is whether Pennsylvania is using every form of help available. State officials say they already work closely with federal staff.
The Epi-Aid Dispute Behind the New Numbers
State health officials said on September 14 that the department "maintains a strong working relationship" with CDC professional staff and meets with them regularly, The Philadelphia Inquirer reported. They said they would "continue to evaluate any additional CDC support" but have not said whether they will file a formal request.
The tension predates this week. When Pennsylvania announced its first two measles-associated deaths in late August, Gov. Josh Shapiro said he had declined an offer of federal help from Health and Human Services Secretary Robert F. Kennedy Jr., CNN reported. Kennedy then accused the state of fabricating the deaths, although he later acknowledged that one had been caused by measles, according to the Inquirer.
The death count remains unsettled. The state has confirmed two measles-associated deaths this year, both in infants in Lancaster County. The Lancaster County coroner has said measles caused one of those deaths but disputes whether it caused the other, CNN reported. As of the CDC's September 11 update, the agency still had not listed either death in its national measles data, the Inquirer reported.
The state's September 14 update said it is reviewing a possible third death, which the Jefferson County coroner reported on September 13. The department said it will rely on its written case definition for a measles-associated death, which it provided to the CDC and the Council of State and Territorial Epidemiologists on September 10. Under that definition, the death must occur within 30 days of symptom onset in a person with clinical evidence of measles and a positive laboratory test, according to the Inquirer.
MedicalDaily previously reported on the Jefferson County death of an unvaccinated 40-year-old woman who had chronic obstructive pulmonary disease (COPD) and asthma and used supplemental oxygen around the clock. Coroner Greg Furlong told the Inquirer he is changing her death certificate from "suspected" to "probable" measles after receiving paperwork showing she had been exposed to someone with a positive lab test. She had declined a measles test while alive, and results of a postmortem test were still pending on September 14. Schwartz said state officials had not notified the CDC of that death.
What a CDC Epi-Aid Involves
An Epi-Aid is a specific tool: a short-term field deployment, not a general promise of federal support. According to the CDC's Epidemic Intelligence Service, it provides rapid technical help, usually for one to three weeks and generally on-site, from Epidemic Intelligence Service officers and other CDC experts. The goal is to help local partners make fast, practical decisions to control and prevent a public health problem.
The arrangement has limits. The health authority that asks for help keeps overall leadership of the investigation, and the federal team works closely with local staff. State health authorities can request an Epi-Aid, and so can local health departments, with the state kept informed and involved. The process ends with a written invitation from the requesting official, so a deployment depends on a formal request.
Neither side has publicly detailed what a federal team would add beyond the coordination already underway.
What Families in 38 Counties Should Know
The practical picture for households has not changed with the dispute. Nearly all of Pennsylvania's cases this year have been in people who were not fully vaccinated, the Inquirer reported. Only four cases, fewer than 1 percent, involved people who were vaccinated appropriately for their age, according to the state. Two doses of the measles, mumps, and rubella (MMR) vaccine are about 97 percent effective at preventing measles.
Demand for the vaccine is rising. Pennsylvania providers gave more than 46,000 MMR doses in August, compared with about 25,000 in a typical month, the health department said.
The state says babies 6 to 11 months old who live in or will travel to affected areas can get an early MMR dose. Adults and teens who have never had measles or the vaccine should get two doses at least 28 days apart. Infants younger than 6 months cannot be vaccinated, and pregnant people and anyone with a severely weakened immune system should talk with a clinician about their options.
Symptoms can start 7 to 21 days after exposure, beginning with fever, cough, runny nose, and red, watery eyes, followed by a rash that starts on the head and spreads downward. Anyone who may have been exposed and has symptoms should call a health care provider before arriving or call the state's toll-free hotline at 877-PA-HEALTH (877-724-3258). Trouble breathing, confusion, or rapidly worsening illness needs urgent care.
Several questions remain open: whether the Jefferson County death will meet the state's definition, whether the CDC will add Pennsylvania's deaths to its national count, and whether a formal Epi-Aid request is coming. The state posts county-level figures on its measles dashboard, and MedicalDaily will track its next update.
The outbreak is still growing, and the standoff concerns who helps investigate cases, not whether families should act now.
Developing Story Timeline
September 14, 2026: The Pennsylvania Department of Health reported 693 confirmed cases in 38 counties and 133 hospitalizations and said it is reviewing the Jefferson County death. The county coroner said he is revising the death certificate to list probable measles.
September 13, 2026: The Jefferson County coroner reported that an unvaccinated 40-year-old woman died September 12 from measles complications. CDC Director Erica Schwartz said Pennsylvania has not requested an Epi-Aid.
September 11, 2026: The state reported 676 confirmed cases in 37 counties and 124 hospitalizations.
September 10, 2026: The state provided its definition of a measles-associated death to the CDC and the Council of State and Territorial Epidemiologists.
Late August 2026: Pennsylvania announced its first two measles-associated deaths, both in Lancaster County, and Gov. Shapiro said he had declined federal help offered by Secretary Kennedy.
Key Questions Answered
What changed in Pennsylvania's outbreak this week? The state reported 693 confirmed cases in 38 counties and 133 hospitalizations on September 14, up from 676 cases in 37 counties and 124 hospitalizations on September 11.
What is a CDC Epi-Aid? It is short-term, generally on-site technical help from CDC outbreak investigators, usually lasting one to three weeks. The health department that requests it keeps overall leadership of the investigation.
Has Pennsylvania asked for one? No. The CDC director said the state has not requested an Epi-Aid despite repeated offers. State officials say they already meet regularly with CDC staff and will continue to evaluate additional support.
Is the Jefferson County death officially counted? Not yet. The state has confirmed two measles-associated deaths and is reviewing the Jefferson County case. The coroner is updating the death certificate to probable measles while a postmortem test is pending.
Who faces the highest risk? Unvaccinated people, infants too young for the vaccine, children under 5, adults older than 20, pregnant people, and anyone with a weakened immune system face a higher risk of complications. Chronic lung disease can also make measles more dangerous.
Where can Pennsylvanians get the MMR vaccine? Through health care providers, county or municipal health departments, state health centers, federally qualified health centers, and the Vaccines for Children program. The state hotline is 877-PA-HEALTH.
When should someone seek urgent care? Difficulty breathing, confusion, or rapidly worsening illness after a possible exposure calls for urgent evaluation. Call ahead so the facility can avoid exposing others. This article is general information and is not a diagnosis.
