Opinion: Make infectious disease data boring again

With measles cases surging, the U.S. health secretary and CDC leadership have clashed with Pennsylvania over how to count measles deaths. The authors argue that public health needs the standard, deliberative process—case definitions developed with epidemiologists and reviewed through the Council of State and Territorial Epidemiologists and CDC—rather than political drama. That process ensures consistent, trustworthy data; if definitions become subject to political interpretation, trust and effective response are quickly lost.

During outbreaks, states rely on CDC for specialized laboratory testing, contact tracing support, data management, infection-control consultation, and crucial countermeasures like vaccines, including Epi-Aids from the Epidemic Intelligence Service. The authors, who were at CDC during the Texas measles outbreak, describe how Texas followed the standard protocol: state officials investigated cases, made determinations, and notified CDC, which included the deaths in national reporting. CDC also supplied financial support, vaccines, and personnel on the ground. While the first U.S. measles death in a decade and the second were tragic, they were not unexpected given high case numbers—measles kills 1 to 3 per 1,000 infected children.

What was unexpected was an active campaign by Children's Health Defense questioning whether measles caused the deaths and blaming the treating hospital, exploiting grieving families. The health secretary also appeared on national television eating french fries cooked in beef tallow while falsely suggesting that the MMR vaccine causes more deaths than measles and that vaccine protection wanes. The authors warn that such interference undermines the entire reporting system and the nation's ability to respond effectively to outbreaks.