NEW YORK — The recent announcement of Pennsylvania’s first measles-related deaths in decades has ignited a public feud among politicians and health officials who disagree over the role of the contagious disease in the fatalities.

Independent experts say the conflict is a symptom of a social and political debate over how to frame a national surge in measles cases, the worst seen in more than three decades.

Pennsylvania officials this week reported that two unvaccinated residents died after being infected with measles, with Gov. Josh Shapiro stressing that vaccinations could have averted the deaths.

But the announcement quickly came under fire, as a clash erupted between Shapiro, a vaccine-promoting Democrat, and U.S. Health Secretary Robert F. Kennedy Jr., a Trump administration appointee with a history of raising alarms about vaccines. Kennedy said in a social post the deaths “may even have been altogether fabricated.”

Kennedy’s attack echoed statements he made last year, when three measles-related deaths were recorded. Kennedy questioned whether one of the children who died was killed by measles.

Medical experts say the brouhaha has diverted focus from an exploding public health threat.

Count challenges

The U.S. eliminated the domestic spread of measles in 2000 by maintaining high vaccination rates, but those have fallen in recent years to below the 95% coverage needed to prevent outbreaks. In November, international health officials will meet to determine if the U.S. and Mexico have lost their measles-free status.

Complicating the situation in Pennsylvania are questions about what counts as a measles death. The World Health Organization counts a death when a person has tested positive for measles and when the death occurs within a month from when a rash appears and the death is not obviously due to another cause.

State health officials are the ones who report measles cases and measles-associated deaths. The question of defining a measles death hasn’t come up much in recent decades because such deaths had become rare.

Recent trends are driving conversations among health officials about how to better track the consequences of a surging problem.

Unresolved question

In Pennsylvania, what’s not disputed is that both people who died had been infected with measles and they were unvaccinated. The unresolved question is whether measles was the main cause, or a contributing cause, of their deaths.

In one of the deaths, an official has reached a conclusion. The Lancaster County coroner, Dr. Stephen Diamantoni, said he is aware of only one death with evidence of measles infection. It was a newborn baby boy who died Aug. 14 — someone too young to get a recommended measles vaccination.

Because one of the boy’s family members had measles, investigators tested the boy’s lung tissue and found evidence of measles infection, Diamantoni said.

But investigators did not see signs of a swollen spleen or other ravages from a measles infection that would have contributed to the death. The cause is being attributed to a tear in the spleen, but the coroner’s office says the virus did not play a role. No information has been released about the second death.