PHILADELPHIA — A fifth person has died amid Pennsylvania’s growing measles outbreak, state health officials confirmed on Wednesday.

The Pennsylvania Department of Health said in a news release that an unvaccinated resident of Lancaster County tested positive for measles and has died.

Health officials said they would not release any additional identifying details about the person who died, citing state privacy laws.

The state has confirmed two other measles-associated deaths this year in Lancaster County, both involving infants in the Amish community.

Mifflin and Jefferson Counties have also reported two measles-associated deaths involving an 18-year-old and a 40-year-old.

The announcement came as confirmed measles cases in Pennsylvania reached 943 so far this year, the largest outbreak in the state in three decades and the highest case count nationwide this year. The state has confirmed 40 new cases in the last two days.

The outbreak is centered in Lancaster, where nearly 400 people have been sickened so far this year, but also expanding in other counties, including Chester County in suburban Philadelphia, which had reported 83 cases as of Wednesday, the third-highest countywide case count in the state.

The death toll reported in Pennsylvania is also the nation’s highest since 1992, but state and federal officials have clashed over how to characterize the four previous deaths reported in the state, all in people who were unvaccinated and confirmed to have measles infections.

The CDC’s public tracking of the toll of measles outbreaks nationally currently only shows two deaths from measles, reflecting decisions made under the leadership of President Donald Trump’s Health Secretary, Robert F. Kennedy, Jr., a longtime anti-vaccine activist. The CDC’s website does not say where the two deaths occurred.

Gov. Josh Shapiro, a Democrat, has accused Kennedy of spreading misinformation about the safety of the measles vaccine, contributing to declining vaccination rates statewide. Kennedy has faulted Shapiro for politicizing the deaths and initially said his administration may have “fabricated” two deaths.

Pennsylvania officials said the latest death also fits the criteria for the state’s definition of a measles-associated death: One that occurred within 30 days of symptom onset in a person with clinical evidence of a measles infection and a positive lab test, that wasn’t due to an unrelated cause, like a car crash.

In confirming measles-associated deaths, the state also considers medical records and whether the person was exposed to measles before their death.

Statewide, nearly one in five people with reported cases have been hospitalized.

About a third of confirmed measles cases have occurred in children under 18.

Physicians and local officials in affected counties have warned that there are likely far more cases than have been officially reported.

Nearly all of the confirmed cases of measles have been in unvaccinated people, state officials said. The state confirmed four cases involving extremely rare “breakthrough” infections in people who were vaccinated, less than 1% of the total cases reported.

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