We know that measles often causes a ruptured spleen. Team Epstein argues that maybe it is just a coincidence that the ruptured spleen happened in a baby with measles. How rare are ruptured spleens? It seems like a farfetched coincidence, but I suppose it is possible. Is it helpful to argue each possible cause? Measles kills people, and it is important to stop it. There is a one percent chance that measles did not kill one of the two babies killed probably by measles... But is it helpful to be making that an important argument?
Walt just invented a measles complication that textbooks do not list.
“We know that measles often causes a ruptured spleen.”
No.
Standard complication lists (CDC, AAP, UpToDate, recent NEJM-style reviews) are pneumonia, diarrhea, otitis, encephalitis, SSPE, and death.
Splenic rupture is not on those lists. Mild splenomegaly can occur with many viral illnesses, including measles.
Atraumatic splenic rupture is rare. The infection classically tied to it is EBV/mono (~0.1% of cases), not measles. Systematic reviews of atraumatic rupture list infectious and neoplastic causes; measles is not a featured etiology.
Neonatal ruptured spleen is itself uncommon. Reported causes are birth trauma, difficult delivery, coagulopathy, prematurity — not “measles often does this.” A newborn dying minutes after delivery from a lacerated spleen is a trauma/forensic question first.
What the people who actually examined the body said
Lancaster County Coroner Diamantoni and the forensic pathologist (Dr. Wayne Ross) attributed death to traumatic laceration of the spleen and stated they did not consider measles a contributing cause.
State health and Democrat Governor Shapiro still use “measles-associated" anyway — “we know it often causes rupture” plus “1% chance measles didn’t kill one of the two babies” — is not what the autopsy said and is not what the literature says.
“Two babies killed probably by measles”
Public reporting: two measles-associated deaths in Lancaster County, both unvaccinated. One is the newborn. Details on the second case have been thinner. Treating both as settled pediatric measles deaths while the coroner is on the record against measles as the cause of the first one is the rhetorical move, not the medical record. BTW, MMR is not given to newborns, and it is not FDA-approved under 12 months.
The useful public-health point does not require inflating a rare (or disputed) mechanism. That stands without “Doctor Walt” rewriting the spleen literature or the autopsy.