Pennsylvania has asked the United States Centers for Disease Control and Prevention (CDC) for help containing an expanding measles outbreak that has seen several people die, but says it will withdraw the request unless the federal agency recognises four measles-associated deaths reported by the state.
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agency → ask → state
The CDC, however, said it has not been properly notified of any such request.
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it → say → request
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senator → slam → deaths
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officials → dispute → US
The US is currently seeing the worst measles outbreak in the country since 1991, with several deaths over the last couple of years.
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US → see → years
Measles was declared eliminated in the US in 2000, but has made a comeback in recent years, which some have linked to a rise in vaccine scepticism.
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some → declare → scepticism
The US state of Pennsylvania has been hit especially hard.
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state → hit → Pennsylvania
In a letter sent to CDC Director Erica Schwartz on Wednesday, Pennsylvania Health Secretary Debra Bogen said the state had begun the process of requesting emergency assistance from the CDC, known as an Epi-Aid.
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state → send → Aid
“The CDC’s choice not to publicly recognize the deaths undermines our response,” Bogen wrote.
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Bogen → recognize → response
“For this reason, if CDC is unable to transparently and accurately communicate information about those measles-associated deaths, the Department will respectfully rescind our request for a CDC Epi-Aid.”
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Department → communicate → Aid
However, in a statement to Al Jazeera, Grace Davis Jamison, press secretary for the US Department of Health and Human Services (HHS), said that the CDC had not received Pennsylvania’s request through its normal channels and that federal outbreak assistance was separate from how the agency tabulates deaths.
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agency → say → deaths
“CDC will not allow [Pennsylvania Democratic] Governor [Josh] Shapiro to politicize this process.
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Shapiro → allow → process
We owe the American people accurate, consistent, and transparent public health information,” Jamison said.
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Jamison → owe → information
“CDC will not submit to political blackmail that conditions critical public health assistance.
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that → submit → assistance
The people of Pennsylvania should never be used as leverage in a political dispute over how deaths are classified.”
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deaths → use → dispute
Disagreement grows as Pennsylvania’s measles outbreak spreads
The dispute over the deaths began in August, when Pennsylvania reported that two unvaccinated people died of measles in Lancaster County, which is located in the South Central part of the state.
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which → grow → state
Lancaster is considered the centre of Pennsylvania Dutch Country and home to the nation’s oldest Amish and Mennonite communities.
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Lancaster → consider → communities
Both communities have under-vaccinated populations.
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communities → have → populations
The CDC initially included the deaths in its national tally, but subsequently removed them after Health Secretary Robert F Kennedy Jr questioned whether measles had caused or contributed to the fatalities.
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measles → include → fatalities
The agency said at the time that available information did not establish whether measles caused or contributed to the deaths.
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measles → say → deaths
Pennsylvania continued to stand by its determination.
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Pennsylvania → continue → determination
The outbreak has spread well beyond its initial epicentre in Lancaster County.
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outbreak → spread → County
On September 13, a county coroner reported that a 40-year-old woman had died from complications associated with measles.
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woman → report → measles
The state later confirmed the death as measles-associated and announced two additional deaths on September 15.
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state → confirm → September
All four people were unvaccinated, according to the state.
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people → accord → state
The state reported 393 cases across 28 counties when the first two deaths were announced on August 25.
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deaths → report → August
Pennsylvania now reports 731 confirmed cases across 38 counties and 141 hospitalisations.
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Pennsylvania → report → counties
Of those reported cases, only four people, or less than one percent, are vaccinated.
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people → report → cases
What are officials arguing about?
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officials → argue → What
The disagreement between Pennsylvania and the CDC centres on the distinction between a “measles-associated” death versus a death “caused” by measles.
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disagreement → centre → measles
Pennsylvania uses “measles-associated” under its state surveillance definition, while HHS said it is working with the Council of State and Territorial Epidemiologists to establish a standardised definition for measles deaths.
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it → use → deaths
Infectious disease experts warn that the dispute over how to classify the deaths puts the CDC at odds with a long-standing approach to tracking the consequences of measles.
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dispute → warn → measles
Matthew Ferrari, director of Pennsylvania State University’s Center for Infectious Disease Dynamics, told Al Jazeera that “measles-associated” death has long been a standard used by the World Health Organization and CDC.
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death → tell → Organization
“It’s the most useful distinction because it is a case that could have been prevented by a measles vaccination, or by early detection and isolation,” Ferrari said.
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Ferrari → ’ → detection
Experts say the CDC’s dispute with Pennsylvania risks distracting from efforts to contain the outbreak.
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dispute → say → outbreak
Dr Andrew Pavia, spokesperson for the Infectious Diseases Society of America and professor at the University of Utah, told Al Jazeera the distinction should not be controversial.
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distinction → tell → Jazeera
“The impact, though, is confusion for the public and erosion of trust in the ability of CDC staff to communicate to the public without political interference,” Pavia said.
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Pavia → communicate → interference
HHS said federal outbreak assistance and national mortality reporting are separate processes and rejected the idea that the two should be linked.
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two → say → idea
How would an Epi-Aid help Pennsylvania?
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Aid → help → Pennsylvania
An Epi-Aid is a CDC mechanism for providing rapid, short-term assistance during an urgent public health problem.
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Aid → provide → problem
…and 4 more, not listed.
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