CDC, Epidemiologists Work on Definition for Measles Deaths

The CDC is indeed working with the Council of State and Territorial Epidemiologists (CSTE) on a definition for measles deaths, but the initiative was launched earlier this year and it was not at the request of the CDC.

That’s according to CSTE spokesperson Amy Heldman, MPH, who explained that a CSTE workgroup was launched earlier this summer “to develop future guidance to inform measles epidemiology case investigations associated with deaths.”

“The workgroup will work collaboratively with CSTE leadership and CDC to apply CSTE’s consensus-building processes to develop a standardized case definition related to measles deaths,” Heldman said in an email to MedPage Today.

Convening the workgroup was part of an established and longstanding consensus-building process, not something requested by CDC, she added. CSTE hosts a number of workgroups with CDC, and this is standard practice based on the needs of jurisdictions, she said.

“Determining how diseases and conditions are monitored and investigated and how data are shared at the national level is a rigorous, collaborative process involving CDC, state, tribal, local, and territorial applied epidemiologists, and other partners,” Heldman said. “It is CSTE’s role to convene applied epidemiologists in states and territories to reach consensus and develop guidance, criteria, and resources for public health surveillance activities.”

Working on a new definition for measles deaths raised eyebrows because of the way it was announced. Earlier this month, CDC Director Erica Schwartz, MD, MPH, JD, altered public reporting of measles deaths on the CDC website at the request of HHS Secretary Robert F. Kennedy Jr.

The CDC’s website initially listed the two measles-associated deaths recorded by Pennsylvania, but Kennedy asked Schwartz to remove them. In place of the number appeared an asterisk, which remains on the site today.

That asterisk section includes a note that CDC is working with CSTE to “develop a standardized case definition for deaths due to measles.”

The section also says that the National Center for Health Statistics (NCHS) “does not currently have any death records from 2026 that indicate measles is the underlying cause” — which confused experts because NCHS is not intended for outbreak data.

Instead, the National Notifiable Diseases Surveillance System has historically been used to track outbreaks by collecting state data.

“Typically, the CDC goes with whatever the state reports,” said one CDC source familiar with the process who did not want to be named.

The CDC source said the move raises red flags; notably, why should the definition of a measles death change for this outbreak?

“It’s almost like the CDC wants to make it more difficult to count confirmed deaths,” the source said. “I suppose Kennedy wants the definition to be as restrictive as possible so that it appears practically no one is dying from measles.”

Pennsylvania currently reports four measles-associated deaths. It reported 97 cases in the past 7 days, and a total of 792 cases in 2026, making it one of the hardest-hit states during a measles resurgence that began in 2025. Other states that have been hit particularly hard include Texas, South Carolina, and Utah.

Last year, Texas had three measles-associated deaths. Those are acknowledged on the CDC’s website.