Tragic Outcome of Measles Outbreak in Amish Community

On Thursday, a headstone had yet to be placed on the freshly dug grave of a 20-year-old Amish woman who was interred this week amidst the serene clover fields bordering suburban Philadelphia.

Married not long ago, she was battling blood cancer and was the last of nine siblings to fall ill as measles spread through their unvaccinated household on a narrow road in Lancaster County.

Initially, the home remedies seemed promising: soothing baths for her fever, coconut oil for the rash, and retreating into dark spaces to alleviate light sensitivity.

But then, her condition worsened. She developed a high fever and struggled to breathe, eventually needing to sleep upright in a recliner, as recalled by her maternal grandmother.

Adhering to Amish customs of not driving, the family hired a driver to transport her to the emergency room at Hershey Medical Center, located about an hour away. She ultimately passed away in the ICU two weeks later.

On her stone farmhouse porch, the grandmother shared the family’s harrowing experience during Pennsylvania’s largest measles outbreak in over 30 years. To maintain privacy, both the grandmother and her granddaughter’s names have been withheld.

It was revealed that the young woman ultimately succumbed to double pneumonia after the family decided to stop using a ventilator.

With preexisting cancer, she was particularly susceptible to the highly contagious measles virus, which can infect 90% of unvaccinated individuals exposed to it.

“Her immune system wasn’t built up,” her grandmother explained. “She just couldn’t withstand the measles.”

Recently, Pennsylvania reported its fifth death associated with measles, indicating that the individual was an unvaccinated resident of Lancaster County, but no further details were disclosed due to privacy regulations.

From the grandmother’s narrative, along with other information, it appears that three of the five fatalities were adults, including another young Amish woman and a person with severe respiratory conditions. The two infants who also died from confirmed measles cases were unvaccinated, either due to personal choice or age constraints.

Paul Offit, who leads the Vaccine Education Center at the Children’s Hospital of Philadelphia, pointed out that the number of adult deaths is particularly alarming. Decades of successful childhood vaccinations had practically eliminated measles, putting very young children at the highest risk. Now, many unvaccinated children have matured into adulthood, creating new vulnerabilities.

“We’re aging out a population that was never vaccinated,” he noted.

After hearing about the young woman’s death, Offit remarked that measles often leads to pneumonia.

“The measles virus can reproduce in the lungs, leading to severe infections, which can sometimes be fatal,” he said.

Missed Vaccination Opportunity

The young woman, the second oldest among her siblings, had been apprehensive about contracting measles during the outbreak. Diagnosed with leukemia two years prior, she had begun treatment with the assistance of a neighbor, an “English” local, as Amish people refer to outsiders.

The chemotherapy and steroids further compromised her immune system. Aware of her heightened risk for severe illness due to measles, which began circulating in her family, she grew increasingly anxious.

All of her siblings, parents, and new husband fell ill. Family members kept hydrated, relying on homemade remedies. Her grandmother recalled that the family wasn’t overly concerned: “Measles just has to take its course.”

While none chose to get vaccinated, the family’s stance isn’t strictly anti-vaccine; the grandmother noted that they view vaccination as a personal decision. Concerns about what’s in vaccines often deter many in the Amish community.

“We wouldn’t discourage people from vaccinating,” she clarified. “It’s a personal choice.”

As illness spread in her household, the young woman’s anxiety about measles grew, overshadowing her concerns about getting vaccinated—a vaccine deemed safe and effective by health authorities.

She inquired about receiving the measles vaccine. Her doctor informed her that she could not due to her chemotherapy treatment. The measles vaccine contains a weakened live virus, which posed risks for someone already immunocompromised.

After contracting measles, she felt slightly better in early September. She picked veggies from the family garden to make soup, even preparing jars for later use.

“She had good days,” her grandmother said thoughtfully.

However, in mid-September, her condition deteriorated as she developed a high fever and struggled to breathe.

Describing her granddaughter’s struggles, she said, “She could hardly breathe. Her lungs were just in bad shape.”

In keeping with Amish practice, they typically seek emergency medical attention only when absolutely necessary and are known for relying on home remedies until conditions become dire. The grandmother mentioned a past incident where her husband faced criticism for delaying essential heart surgery.

“We do what we can at home,” she noted, emphasizing their reliance on natural treatments.

On September 11, the family decided to rush her to Hershey Medical Center’s emergency department. Initially, although doctors took a chest X-ray, they sent her home without pause to assess it.

“They wouldn’t do anything for her. They didn’t want her there,” the grandmother expressed.

After a call asking the family to return, they returned to the hospital, where further tests revealed fluid in her lungs and she was diagnosed with double pneumonia.

She was placed on supplemental oxygen, yet her breathing continued to be laborious.

“They had the oxygen up as far as it could go, and she still had to work to breathe,” her grandmother recounted.

Within a week, she was moved to the ICU and sedated to be placed on a ventilator.

The hospital allowed only a couple of family members to stay at her bedside, where her husband and mother kept vigil.

As her condition worsened, life support became the only viable option, but it posed risks of severe complications, including brain damage. The family weighed this decision carefully.

Ultimately, they chose to turn off the ventilator, gathering to say their goodbyes.

She died with a breathing tube still in, as her family stood close.

Remembering a Joyful Union

More than 300 people attended the funeral service on Monday, and she was laid to rest in a cemetery not far from home, just weeks shy of what would have been her first wedding anniversary.

Her grandmother fondly remembered her granddaughter’s radiant smile and “rosy pink cheeks” on her wedding day, despite her ongoing battle with leukemia.

The wedding in November 2022 was a joyous occasion, featuring generous portions of chicken, vegetables, and traditional sides.

“They had a good year together,” the grandmother remarked softly, expressing her sympathy for the husband, who opted not to speak to the media.

At the young woman’s family home, two black dogs greeted visitors while other family members tended to chores outside, discussing matters in Pennsylvania Dutch before summoning her father, who also chose not to comment.