The two measles-related deaths in Pennsylvania last month involved infants, and the virus itself caused one of the deaths, a Pennsylvania coroner confirmed Wednesday.

Lancaster County’s coroner, Dr. Stephen Diamantoni, said he told the U.S. Centers for Disease Control and Prevention of his conclusions. CDC officials, however, have not said whether they will count either death as measles-associated, and the agency’s website still carries a disclaimer about them.

Ivan Miller died on Aug. 14 shortly after his birth of a ruptured spleen, Diamantoni said.

Mary Stoltzfus was 6 weeks old when she died Aug. 18 at her home. She was born with a genetic birth defect that left her highly vulnerable to an infection. A measles infection killed her, Diamantoni told The Associated Press.

He said he was releasing the information in response to a state right-to-know law request by WPMT-TV, Fox 43.

The causes of death differed

Diamantoni’s office didn’t perform an autopsy on the girl. The cause of death was determined by the doctors caring for her, he said.

She had been born with a condition called Amish lethal microcephaly that causes an unusually small head and underdeveloped brain. Children with the condition typically live 6 months or less.

His office did an autopsy on the boy and determined he died from a ruptured spleen. Exactly how and when that happened is still under investigation, Diamantoni said.

The boy was infected with measles, which is listed on the death certificate as a contributing factor. But Diamantoni said measles did not contribute to what happened to the spleen, and that measles is noted only because it was considered “a significant condition” that the boy had at the time of death.

Neither was old enough to be vaccinated. The first dose is typically given at around 1 year of age.

The deaths have received outsized attention

Details of the deaths have come under unusual national scrutiny and became the focus of a furious political battle between Pennsylvania’s Democratic governor, Josh Shapiro, and officials in President Trump’s administration.

Pennsylvania officials announced the deaths last month, with Shapiro stressing that vaccinations could have averted the deaths.

Soon after, Health Secretary Robert F. Kennedy Jr., a Trump administration appointee with a history of raising alarms about established vaccines, attacked Shapiro and suggested the deaths “may even have been altogether fabricated.”

Kennedy’s statements echoed ones he made last year, when three measles-related deaths were recorded. Kennedy questioned whether one of the children who died was killed by measles.

In an interview with “Face the Nation with Margaret Brennan” in July, former CDC Chief Medical Officer Dr. Debra Houry, one of four senior CDC officials who resigned in protest last summer, said Kennedy and his allies sought backward-looking data on measles cases and were pushing out information “not based on science or reality, but trying to answer an agenda that was already in place.”

The health secretary oversees the CDC, and some public health experts have voiced concern about whether the CDC can still be counted on to post public health data that clashes with Kennedy’s worldview.

“Frankly, the CDC is not to be trusted in sharing information,” Dr. Georges Benjamin, executive director of the American Public Health Association, told The Associated Press last week. “People are questioning their motives.”

CDC website still doesn’t show the deaths

That worry was fueled by some unusual edits to the CDC’s measles webpage. At one point, the webpage noted two measles-associated deaths but then was changed to say that the CDC was not counting the two deaths until it reviewed additional information. 

The page, which was last updated Friday, now says, “CDC will update its reporting as additional information becomes available and relevant reviews are completed.” There are three measles deaths listed for 2025, but none for 2026. It still doesn’t reflect either Pennsylvania death.

In a social media post last week, Kennedy acknowledged Diamantoni’s conclusion that one of the deaths was due to measles.

Meanwhile, Pennsylvania’s measles outbreak continues to expand, with at least 624 cases across 37 counties this year, state officials said Wednesday.  

“I’ve been practicing in Pennsylvania for 26 years,” Dr. Jennifer Janco, chair of St. Luke Pediatrics, told CBS News Philadelphia last month. “This is the worst it’s ever been. I have a front row seat to a show I don’t want.”

The U.S. eliminated the domestic spread of measles in 2000 by maintaining high vaccination rates, but they have fallen in recent years to below the 95% coverage needed to prevent outbreaks. Meanwhile, measles infections have been surging in recent years.

Health experts have pointed to a decline in vaccination rates as the main reason for increases in preventable infectious diseases like measles. The vast majority of cases have been in people who were unvaccinated, and outbreaks have spread in communities with lower vaccination rates.

In November, international health officials will meet to determine if the U.S. and Mexico have lost their measles-free status.