Is Measles Spreading In Amish Communities? Nobody Will Officially Say, But Stories Suggest “Yes” (Updated)
Stories about measles in places where the Amish live keep popping up on my news feed, at a seemingly increasing pace. They’re showing up in different regions of the country – the East coast, Northeast, Midwest.
Some stories have sections suggesting or leaving readers to draw the conclusion that an outbreak may be happening in or around “Amish Country”, but nothing really directly saying “the Amish are experiencing a measles outbreak”.
So most of them mainly allude to a possible Amish connection, most never actually making it. They point out lower general vaccination rates among the Amish, and note how cases have been occurring in areas with significant Amish or Plain Mennonite populations.
Suggestive, But Never Stated
We saw an example last week in a story out of Wisconsin, where an outbreak is growing in Iowa, Grant and Lafayette counties. Wisconsin Public Radio noted that more than 3,000 Amish live across those three counties, but only went as far as this: “One community in the region that may be affected by lower vaccination rates are the Amish and Mennonite faith groups.”
The most prominent story so far was the New York Times reporting two deaths of “unvaccinated people” from measles in Lancaster County, PA earlier this week, but no direct Amish connection was made there either.
There is often a privacy roadblock – understandable – where the local health authority says they will not disclose further details. The closest official direct communication that I have seen – still not directly naming members of the Amish community as suffering from measles – was the June story where the Virginia Department of Health publicly warned people to “stay away” from an upcoming Amish-run auction.
Still, that was framed more as an “avoid large crowds” warning, as the Buckingham County area where the auction was being held was experiencing an outbreak. This also feels a good bit different than the 2014 Ohio measles outbreak, which was directly tied to the Amish community and pretty heavily covered in that context.
Direct Claims Of Measles Among The Amish
So all that noted, I’ve only come across two stories where there is a direct connection, anecdotally (Note: see update at end of post for a third). One of them was published today at CNN, with commentary from an Amish taxi driver (a person who drives the Amish places) named Kimberly Reichenbach:
For the past few years, she’s made a little money driving Amish customers on their regular errands. Many Amish people shun certain kinds of modern technology, and Reichenbach says many now use ride services to get around.
But Reichenbach said she quit driving altogether last week after she and her longtime partner, who has type 1 diabetes, separately drove clients who were sick or who had been exposed to measles.
At the end of one trip, one woman said she was grateful to be able to pick up groceries because her whole family had measles and she wanted to restock her pantry before she too became too sick to get out of bed.
Reichenbach expressed understandable concerns about getting sick herself – leading her to shut down rides:
Last week, another client she drives to and from her job at a bakery got into the car coughing and sneezing.
Her client said that it was just a cold and that was getting better, but Reichenbach said her explanation didn’t ring true.
“I even came home that day and said to my boyfriend, ‘I’m really concerned about this because I know that, especially in Lancaster, it’s starting to get bad,’” she added. “I canceled everybody.”
Another came out yesterday in the Finger Lakes Times, referencing an outbreak in an Amish community in Seneca County, New York. This was briefer, and the Seneca County Public Health Director Scott King, while acknowledging there are dozens of community members likely sick with measles, also refuses to identify anyone.
However, the paper reports that “it is known” through conversations that members of the Amish have been among those ill:
King was asked for an update at Tuesday’s Board of Supervisors’ Health and Human Services Committee meeting. For privacy concerns, he has said he could not and would not identify the county’s large Amish community specifically as being the group of unvaccinated individuals.
However, it is known that most members, for religious reasons, have been resistant to receiving the MMR vaccine, as well as others vaccines. And, through anecdotal conversations since July, it is also known that members throughout the Amish community have been ill with measles.
What I’ve been hearing suggests something similar, that there are cases among the Amish, maybe a lot. Other stories suggest Amish connections, but without a direct claim of illness, such as this report of an Amish mother inquiring about vaccination in Tioga County, New York.
Reasons For Caution
We’re not getting official direct confirmation due to privacy concerns, but local people are saying Amish folks they know are dealing with it. That said, when the measles topic is prominent in the media, as it is right now, people are probably more likely to think “measles” when they encounter an ill person from one of these afflicted communities.
That doesn’t mean they’re wrong, but it could lead some to assume that an illness is measles when it isn’t. And we need to emphasize again that it’s not that all Amish reject vaccination – some in the greater community do get vaccinated against measles and the like.
A doctor in Lancaster County also has a counter-take on the matter – Pia Fenimore, vice chair of pediatrics at Lancaster General Health, has said the current outbreak there is not centered in Amish households, and that vaccine skepticism has spread widely across Lancaster County generally.
Mark Louden, a UW-Madison professor who works as an interpreter for Wisconsin’s Plain communities, put it this way in that same WPR story:
“Even the most conservative or traditional groups out there do access Western healthcare. While there may be some families that have their kids not vaccinated at all, that’s pretty exceptional.”
He calls them “vaccine cautious” rather than anti-vaccine – more likely to pick and choose among the shots than refuse them all.
Louden also notes the connections between Wisconsin Amish communities and Lancaster County, PA:
“There’s a lot of back and forth, just like people traveling back and forth, visiting and so forth, especially this time of year,” he said.
That’s a common thing among Amish around the country, with many having ties to communities in other states. And that may be why we’re seeing reports of measles in areas with Amish populations that are quite far from one another.
I think we may have seen a version of this during COVID. There was no real way to precisely count what was happening in Amish communities. A team of West Virginia University sociologists ended up going through obituaries published in The Budget newspaper to build an idea of how the Amish were impacted. Nobody had a clear picture at the time, though later studies were able to piece some of it together.
Even without official confirmation, I think it’s reasonable to assume that measles outbreaks to varying degrees have been happening in different Amish communities. And it may not become clear to what degree until (and only if) someone is able to take a more systematic look into the story.
Update: Amish Couple Who Lost Newborn Amid Lancaster County Measles Outbreak Speak With The Atlantic
Yesterday (August 30) The Atlantic released a story on an Amish couple in Lancaster County who lost an infant, which appears to be one of the two “measles-associated” deaths reported by the New York Times and other outlets last week.
First, two notes. For one, “measles-associated” is a precisely chosen term used in the public reporting of the two deaths. It is not 100% certain that measles is the cause here; more on that below.
Second, though there is discussion over the actual cause of this infant’s death, the story gives confirmation of further cases of measles in the Amish community.
It also provides a figure related to vaccination in this community: last year the Pennsylvania Department of Health estimated that only 25% of the Lancaster County Amish population had gotten the MMR (measles, mumps, and rubella) vaccine.
Tom Bartlett spoke with “John” and “Anna” (not their real names), parents of 13 children. They give the sad account of what happened to their infant:
About a month ago, John and Anna became aware that measles was spreading in their community. At last count, Lancaster County has recorded 210 cases so far this year. Besides John, no one in the family had been vaccinated against the virus. John told me he’d heard from someone that this strain of measles wasn’t dangerous for pregnant women, but he wasn’t sure whether to believe it. (In fact, measles, regardless of the strain, can cause serious pregnancy complications.)
Anna, who was pregnant, worried about the effect measles might have on her baby, but she didn’t think she could avoid being exposed. “I saw we can’t even get away from it because so many people have it,” she told me. Even if Anna had wanted to get vaccinated then, it would have been too late: The CDC recommends against giving the vaccine to pregnant women.
Sure enough, a few weeks ago, one of John and Anna’s older children got sick. The rest of them soon followed. Two of the children became dehydrated and required IVs. Anna became extremely ill, at one point spiking a fever of 102 degrees. She struggled to hold down food and fluids. For days, she could speak only in a whisper. On August 13, she was taken to a clinic to get an IV for dehydration.
The baby was delivered the next day at a birthing center by a midwife who had delivered Anna’s other children:
They knew right away that something was wrong: He had a pulse, but he wasn’t breathing. The midwife contacted paramedics, who arrived within minutes. John recalled them giving the newborn oxygen and gentle chest compressions with two thumbs, to no avail. It was all over in less than half an hour. The paramedics told them that the county coroner would need to be contacted to take the body.
But the story is not as clear-cut as “the baby died from measles.” The Atlantic piece notes that cause of death is said to have been a ruptured spleen. Measles can lead to an enlarged spleen in children, more likely to burst.
However, Lancaster County coroner Stephen Diamantoni “has publicly maintained that his office believes that the spleen was not enlarged and therefore that the cause of death was not related to measles.”
As a counterpoint, the story adds that “Prominent physicians have since pointed out that a ruptured spleen may not look enlarged even if it was affected by measles.” They also note that a ruptured spleen is very rare in a newborn under any circumstances.
So that is going to be a gray area, and likely why they are using the “measles-associated” language here. For the grieving family, I’m not sure how much it matters at the moment. John, keeping with his religious culture’s common response to loss, says he views his son’s death as part of God’s plan. Prayers for this family.
As the doctor said, the cases of measles in Lancaster is not centered in Amish communities.
The cases of measles didn’t start in the Amish communities. Outsiders most likely brought it in.
Tourism being strong this year(world cup soccer as one example), there were a lot of people from other countries visiting.
Also, the demographics of Lancaster is changing. There are more people from other countries living in the area. Not getting into to political issues, however, the demographics have changed greatly and many new people in the area may not have been vaccinated.
I am a bit confused – being that most Amish do not vaccinate – wouldn’t there always be some type of measles “outbreak” (or mumps or chickenpox) especially among the children? I imagine these illnesses would not ring alarm bells for them.
Also the taxi driver is concerned about catching measles from the Amish – isn’t she vaccinated?
This is text-book example of a biased and agenda-driven journalism where no scientific proof or verified statistics are presented to show the Amish have a measles problem. But hearsay and assumptions are cited as reason to conclude that the “outbreaks” must have started there or are growing among the Amish. All to sell the MMR vaccine.
It is most definitely spreading through Lancaster County’s community. Botschaft scribes have been writing of it for weeks now. One described how measles were “closing in” on their district and it wasn’t a matter of if but when it would show up in families there. Another from an adjacent county was imploring people to take quarantine and isolation seriously, saying “haven’t we learned anything from these last few years?” The mentions aren’t just from one area of the county but rather pretty spread out.
I wouldn’t go so far as to say the OOA are the bulk of Lancaster cases, that would be an unfair assumption, but it is widespread within the community.
And the best part is, after 7-10 days, people recovered.
Again, the timeline matches summer tourism, changing demographics in Lancaster(not just summer seasonal workers), world cup soccer(people from other countries) bringing measles into the area.
People can talk about the Amish all they want, but the cases of measles came from the outside. That means it came from non-Amish people, including those from other countries.
Also, 1 death was the result of a ruptured/lacerated spleen.