Amid soaring measles cases, the U.S. health secretary and leadership at his CDC have picked a fight with the Commonwealth of Pennsylvania about what counts as a measles death. The last thing public health needs is drama when the focus needs to be on responding to the outbreak itself.

States have a standard process for notifying the CDC about notifiable diseases, using established case definitions. Developing those definitions is usually a long, deliberative process involving epidemiologists, scientists, and agency review through the Council of State and Territorial Epidemiologists and the CDC. Right now, that standard process is under threat and will further drive a wedge between states and how they work with the CDC and the administration.

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