A 20-year-old Amish woman with leukemia has died during the largest measles outbreak the state has seen in decades.

The headstone had not yet been placed Thursday on the freshly dug grave where a 20-year-old Amish woman was buried this week. among the clover fields and dairy farms on the outskirts of Philadelphia.

Recently married and receiving treatment for blood cancer, she was the last of nine siblings who fell ill when measles swept through her unvaccinated family’s home on a one-lane road in Lancaster County.

At first, the home remedies that eased their symptoms also seemed to help: easing the fever with soaks. Soothe the rash with coconut or olive oil. Cloister in a dark room to reduce sensitivity to light.

Then his fever skyrocketed. She had trouble breathing and had to sleep sitting in a recliner in the living room, her maternal grandmother recalled.

His family doesn’t work cars, in keeping with Amish beliefs, so they hired a driver to take him to the emergency department at Hershey Medical Center, about an hour away. She died about two weeks later in the intensive care unit, her grandmother said.

Speaking on the porch of her stone farmhouse, the grandmother described the family’s experience dealing with the largest measles outbreak Pennsylvania has seen in three decades, now the largest in the nation. At his request, The Inquirer withheld his name and that of his deceased granddaughter to protect the family’s privacy.

She said her granddaughter ultimately developed double pneumonia and died after the family decided to stop using a ventilator.

Cancer has made her particularly vulnerable to a virus as contagious as measles, which will infect 9 out of 10 exposed unvaccinated people.

“Her immune system was not developed,” the grandmother said. “She just couldn’t stand it because of the measles.”

Pennsylvania reported its fifth measles-related death on Wednesday, revealing only that the latest death was an unvaccinated resident of Lancaster County. Health officials did not provide further details, citing privacy laws.

But it appears from the grandmother’s account, as well as other documents and reports, that three of the five deaths occurred among adults with measles. Other reported deaths include an 18-year-old Amish woman from Mifflin County and a 40-year-old man from Jefferson County suffering from severe respiratory problems. Two Amish infants in Lancaster County who had confirmed cases of measles also died. All five cases involved people who were not vaccinated, either by choice or because they were too young to receive vaccines.

The number of deaths among adults is striking, said Paul Offit, who directs the Vaccine Education Center at Children’s Hospital of Philadelphia. Widespread childhood vaccination has eradicated the disease in the United States, leaving most children too young to be vaccinated at high risk in recent decades. Today, several generations of unvaccinated children are adults, exposing broader vulnerabilities across the state, Offit said.

“We are aging a population that has never been vaccinated,” he said.

After learning the details of the 20-year-old’s death from The Inquirer, Offit explained that measles usually leads to pneumonia.

“The measles virus reproduces in the lungs and can cause a serious, sometimes fatal, infection,” he said.

Too late to get vaccinated

The young woman, the second eldest in a line of nine brothers and sisters aged 6 to 22, feared contracted measles during the outbreak in Lancaster County, his grandmother said.

About two years ago, she was diagnosed with leukemia, a blood cancer, and began medical treatment with the help of an “English” neighbor – as the Amish call foreigners – to drive her to medical appointments.

The treatment with chemotherapy and steroids further weakened his immune system. She knew she was at risk of more serious illness from a viral infection like measles, which began spreading in her family in late summer.

Her eight siblings, parents and new husband all fell ill, the grandmother said.

In addition to home remedies, family members drank more fluids to stay hydrated, the grandmother said.

“They weren’t worried,” the grandmother said. “Measles must simply run its course. »

Although no one in the family has been vaccinated, they are not opposed to the vaccine based on Amish beliefs. They think it’s an individual choice, she said, and many Amish choose not to get vaccinated because they “don’t know what’s in it.”

“We wouldn’t tell people not to get vaccinated,” the grandmother said. “It’s up to everyone to decide.”

As the disease spread through her home, her granddaughter grew more worried about contracting the virus than about the vaccine that medical authorities have long considered safe and effective.

She asked her doctor if she could get vaccinated against measles. His doctor said no. “She was not allowed to get vaccinated because she was on chemo,” the grandmother explained.

The measles vaccine contains a live but weakened virus, and her granddaughter was already immunocompromised from leukemia treatment.

After contracting measles, her granddaughter started feeling better in early September. She picked vegetables from the family garden to make soup using tomato juice as broth. She was canning jars for the cold months ahead, her grandmother said.

“She had good days,” said the grandmother.

» LEARN MORE: Read more: Pennsylvania coroner doubts measles-related death, sparking anti-vaccine outcry. Records show the state tried to contact him.

Then, in mid-September, she experienced a high fever and her breathing became difficult.

“She could barely breathe. Her lungs were just in bad shape,” she said.

The Amish usually only seek emergency treatment at the hospital until “sometimes we die,” the grandmother said, recalling how her husband was reprimanded by a doctor in 2018 for waiting too long to have desperately needed heart surgery.

“We do what we can at home,” she said. “We have so many natural things we can do. »

On September 11, the family knew it was time to take their granddaughter to urgent care at Hershey Medical Center.

At the Hershey emergency room, doctors gave her a chest X-ray, but sent her home before reading it, the grandmother said.

“They wouldn’t do anything for her. They didn’t want her there,” she said. said. (A Hershey spokesperson did not respond to a request for comment Friday.)

A Hershey supplier then called and left a voicemail asking the family to bring her back. Although the family had a phone at home, the grandmother said she rarely used it. With the ringer muted, all calls go to voicemail, she said.

A driver took them back to the hospital, where she was admitted on September 14. An ultrasound showed fluid between the lining of his lungs and in his lungs. He was diagnosed with double pneumonia, his grandmother said.

Hospital staff put her on oxygen.

“They had as much oxygen as they could and she still had to work to breathe,” the grandmother said.

About a week later, they moved her to the intensive care unit, where they sedated her so they could put her on a ventilator while she was intubated.

The hospital allowed two family members at a time to sit by his bed. Her granddaughter’s young husband and the girl’s mother were keeping watch, the grandmother said.

As his condition continued to deteriorate, life support was the only option left, and this carried the risk of neurological complications, including brain death.

The family didn’t want that, the grandmother said. “There was nothing more they could do,” she said.

They turned off the oxygen and turned off the ventilator. Family members, including her new husband’s parents, gathered around her bed.

She died with a breathing tube still in her mouth, the grandmother said.

A good first year of marriage

More than 300 people came to the family home Monday for the funeral and visitation. She was buried in a cemetery near the family home, about a month before what would have been her first wedding anniversary.

Although she had leukemia, her granddaughter’s characteristic “pink cheeks” and “beautiful smile” beamed on her wedding day, her grandmother recalled.

The November 2025 wedding, held at the family home, was a celebratory affair, with plates piled high with chicken and vegetables, chicken and garnish, pickled cabbage and cooked celery.

She feels sorry for her granddaughter’s husband, who declined to be interviewed. “They had a good year together,” she said.

At the young woman’s home, two black dogs, with hay in their curly, matted hair, greeted an Inquirer reporter on Thursday. Some of his family members were outside, unloading corn stalks from a horse-drawn wagon and putting them into a John Deere harvesting machine.

They stopped working and spoke in Pennsylvania Dutch, a centuries-old German dialect, before picking up the young woman’s father, who declined to be interviewed.

Staff writers Aubrey Whelan and Sarah Gantz contributed to this article.