CDC meets six measles deaths in Pennsylvania with one disease detective.
Measles elimination, certified by the United States government in the year 2000, is dead in Pennsylvania. It was twenty-six years old. The cause, by the state's own count, is six.
It was already failing by October 4, when officials in Harrisburg said it was "only a matter of time" before the disease spread past its epicenter — a county that, like most in the Commonwealth, has no health department of its own — citing a fifth death already confirmed among 943 cases across 39 counties. The next day the case count passed 1,000 outright, the largest outbreak Pennsylvania has recorded in more than three decades; the same dispatch noted that New York had declared its own state of emergency about measles rates there. On Friday, October 9, Pennsylvania recorded its sixth death.
By Wednesday the count stood at 1,222 cases, up from the 1,004 confirmed twelve days before. The county at the center of it still has no health department of its own. What it has, as of this week, is one person: a single Centers for Disease Control and Prevention "disease detective," a penny-ante dispatch to a county four months into an outbreak that has already produced six funerals.
It is survived by 1,222 confirmed cases and climbing, by the thirty-nine counties the state was already worried about on October 4, and by six families who were told, in the year 2000, that this particular grief had been retired. It is preceded in death by the county health department it never had; most of the state's counties don't, officials said on October 4, one day before the case count crossed into quadruple digits.
The elimination notice stood for a quarter century on the plain premise that an eliminated disease stays eliminated — not through vigilance that makes the news, but through the structure underneath it. The structure is not there. One detective, sent in October to a county with no department to detect anything, is not a replacement for it. One detective is a sympathy card.
In lieu of flowers, the family asks that the county be given the health department the Commonwealth never built it — before Washington has to send a second detective to find out why the first one was sent alone.