A Pennsylvania coroner has confirmed a second measles death in a child in the state.

The measles deaths are the first reported in the United States this year amid a 35-year high in infections.

“Just today, we received a report of another child who died with measles, and we’re in the process of doing an investigation,” Lancaster County Coroner, Dr. Stephen Diamantoni, told WHTM Wednesday.

It is unclear if the second death reported by the coroner is further clarification of two deaths already reported, or if this brings the death toll to three.

There has been unusual friction between the state and the federal government after Health Secretary Robert F. Kennedy Jr. asked his newly appointed CDC director to remove a reference to two Pennsylvania fatalities from the agency’s online measles tracker after questioning whether the virus contributed to the deaths, according to a new report.

A spokesperson for the Pennsylvania Health Department told The Independent Tuesday that every reported measles case is “thoroughly reviewed to confirm it meets the CDC’s case definition for a measles case.”

The Independent has contacted Diamantoni for comment on the new reported death. The measles deaths are Pennsylvania’s first in 35 years.

The CDC tracker still states zero deaths from measles nationwide this year.

The CDC told The Independent earlier this week that the deaths have not been confirmed based on the information currently available to CDC.

The resurgence in measles cases is fueled by rising vaccine hesitancy, experts tell The Independent.

Pennsylvania is one of the states with the highest number of cases, CDC data last updated August 30 shows. The state reported 540 cases on Tuesday, with 242 in Lancaster County alone.