South Carolina is currently grappling with a severe measles outbreak, marking the largest such event in the United States since the disease was officially eliminated in 2000. This escalating public health crisis, primarily concentrated in the Upstate region, has health officials working tirelessly to contain its rapid spread. With hundreds of cases reported and ongoing community transmission, understanding the outbreak’s scope, causes, and critical prevention strategies is more vital than ever for residents and the nation. This comprehensive guide breaks down the situation, from local impacts to national implications, offering essential insights for protecting public health.
South Carolina’s Unprecedented Measles Surge: A Public Health Warning
The scale of South Carolina’s current measles outbreak is alarming. As of late January 2026, the South Carolina Department of Public Health (SCDPH) has reported a total of 847 cases in the ongoing Upstate outbreak. This includes a confirmed 58 new cases since a recent update, highlighting the dynamic and persistent nature of the virus. Earlier reports had already pegged the total at 789 cases by January 27, with a significant jump of 89 new infections in just a few days. These numbers firmly establish it as the nation’s largest measles outbreak in 25 years, surpassing even the 762 cases seen in Texas during an outbreak that concluded in August of the previous year.
The vast majority of these infections, 756 cases, are centered in Spartanburg County. Adjacent Greenville County has reported 28 cases, with Anderson and Cherokee counties each noting fewer than five. This severe concentration underscores the intense local transmission occurring within these communities. The outbreak, which first began in October, continues to prompt extensive public health measures, including quarantines and isolation protocols for affected individuals.
The Alarming Decline in Immunity: Why Measles is Back
The resurgence of measles in South Carolina can be directly attributed to a decline in community vaccination rates. Medical experts consistently emphasize that measles is extremely contagious, particularly among individuals lacking immunity. The two-dose Measles, Mumps, and Rubella (MMR) vaccine offers the most effective protection against infection. To prevent widespread transmission and achieve what’s known as “herd immunity,” a vaccination rate of approximately 95% is considered essential.
Unfortunately, Spartanburg County’s school-age vaccination rate for the 2024-2025 academic year stood at 90%. This figure falls below the critical threshold required to stop the virus from circulating effectively. Some educational institutions show even more concerning statistics; for instance, Global Academy of South Carolina, a charter school with 607 students, reported a vaccination rate of only 21.5%. This specific school has been identified as an exposure site during the outbreak. Furthermore, officials have noted that a significant portion of cases are occurring within an undervaccinated immigrant community in the Spartanburg area. Of the total cases, 692 were among unvaccinated individuals, and 63 had an unknown vaccination status. This means a staggering 96% of cases involved individuals who were either unvaccinated or whose status could not be confirmed, starkly contrasting with only 20 cases in fully vaccinated individuals. The Centers for Disease Control and Prevention (CDC) declared measles eliminated in the U.S. in 2000, a testament to robust vaccination efforts. However, declining vaccination rates in recent years have regrettably paved the way for the disease’s return.
Understanding Measles: Symptoms, Risks, and Prevention
Measles is a serious and highly contagious viral infection that can lead to severe health complications. Recognizing the symptoms and understanding how to protect yourself and others is crucial during an outbreak.
Identifying Measles Symptoms and Risks
Initial symptoms typically manifest between seven and twelve days after exposure, though this period can extend up to 21 days. These early signs often mimic a common cold, including:
A persistent cough
Runny nose
- Red, watery eyes
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These symptoms are usually followed two to three days later by a fever, often reaching 101 degrees Fahrenheit or higher. Shortly after the fever develops, the characteristic measles rash appears, first on the face and then spreading across the rest of the body.
While no deaths have been reported in South Carolina’s current outbreak, 19 individuals have required hospitalization, affecting both children and adults. This underscores the potential severity of the illness. For comparison, the 2025 Texas outbreak, with fewer overall cases, resulted in two deaths, highlighting the critical risks associated with widespread measles. The current outbreak disproportionately affects younger age groups: children aged 5 to 11 represent the largest affected cohort (345 cases), followed by children aged 0 to 4 (201 cases), and adolescents aged 12 to 17 (149 cases).
Identifying Exposure Zones and Staying Safe
The SCDPH has identified several new public exposure sites related to the latest confirmed cases. Lyman Elementary School was named as a potential exposure location, and students continue to be quarantined across multiple schools in the Upstate region. Another specific public exposure occurred at the Burger King on U.S. 221 in Roebuck. Individuals who were at this Burger King on Wednesday, January 28, between 11:30 a.m. and 2:30 p.m., and lack immunity (either through vaccination or prior illness), are strongly advised to monitor themselves for symptoms through February 18.
If you suspect you may have been exposed to measles and subsequently develop symptoms such as a fever of 101 degrees Fahrenheit or higher, cough, runny nose, or red eyes (with or without a rash), it is critical to contact a healthcare provider immediately. Inform them about your potential exposure and current symptoms so they can advise on the next steps. To prevent further transmission, you may need to wear a mask or isolate yourself from others in waiting areas during evaluation. Healthcare providers might also recommend staying home until cleared, ensuring public safety and helping to contain the virus’s spread.
Conflicting Messages: The Official Response Under Scrutiny
The federal response to South Carolina’s escalating measles outbreak has drawn attention due to perceived inconsistencies. Initially, in December, when South Carolina already had over 100 cases, the U.S. Department of Health and Human Services (HHS) press secretary Emily Hilliard explicitly downplayed the threat, stating, “CDC is not currently concerned that this will develop into a large, long-running outbreak.” This initial assessment stands in stark contrast to the “enormous” size of the outbreak that subsequently developed.
Despite the initial misjudgment, HHS is now providing $1.4 million in aid to South Carolina, and the CDC is actively collaborating with state officials to understand transmission patterns and coordinate the public health response. However, the messaging from some lead federal officials has been seen as controversial. HHS Secretary Robert F. Kennedy Jr., while his spokespeople affirm that “vaccination is the most effective way to prevent measles,” has previously made remarks questioning the safety of measles vaccines during the height of the Texas outbreak.
Similarly, CDC Principal Deputy Director Ralph Abraham controversially stated that the U.S. losing its measles elimination status, which it achieved in 2000, would be the “cost of doing business.” He further commented, “We have these communities that choose to be unvaccinated. That’s their personal freedom.” This perspective has been challenged, with critics, including a Wall Street Journal editorial, arguing that unvaccinated children pose a significant risk to vulnerable infants and immunocompromised individuals who cannot be vaccinated, potentially leading to severe outcomes. Kirk Milhoan, MD, PhD, chair of the CDC’s Advisory Committee on Immunization Practices (ACIP), also emphasized “individual autonomy” over public health in discussions about vaccine choices. These differing viewpoints highlight the complex challenges in public health communication during an infectious disease outbreak.
National and Global Implications of the Outbreak
The South Carolina measles outbreak is not an isolated event. It contributes significantly to a concerning national trend. So far in 2026, the CDC has confirmed 416 U.S. measles cases, a substantial increase of 245 infections in just one week. South Carolina alone accounts for 338 of these cases, representing a staggering 81% of the national total for the year. Last year, 2025, saw 2,255 measles cases nationwide, the highest total since 1991, accompanied by three confirmed deaths, including two children.
The surge places the United States at a serious risk of losing its measles elimination status, a significant public health achievement. The Pan American Health Organization (PAHO) has even invited the United States and Mexico to a virtual meeting to review their measles elimination status, underscoring the regional concern over rising case numbers. Beyond South Carolina, other states are also reporting new cases. Mecklenburg County, North Carolina, has confirmed two new cases, bringing their 2026 total to 12. Idaho also reported two cases for 2026, following 14 in 2025. These widespread cases signal a broader challenge to maintaining herd immunity across the country. The overwhelming majority of these 2026 cases (94%) are among individuals who are unvaccinated or whose vaccination status is unknown, further reinforcing the critical importance of widespread immunization.
Frequently Asked Questions
What makes the South Carolina measles outbreak so significant?
The South Carolina measles outbreak is significant because it is the largest in the United States since the disease was officially declared eliminated in 2000. With 847 confirmed cases as of late January 2026, it surpasses the previous largest outbreak in Texas in 2025. The high case count, primarily concentrated in Spartanburg County, is largely due to declining vaccination rates below the critical herd immunity threshold of 95%, making it a serious public health concern with national implications, including the risk of the U.S. losing its measles elimination status.
Where have public measles exposures occurred in South Carolina?
Public measles exposures have been identified at several locations in South Carolina. Notably, Lyman Elementary School has been named as a potential exposure site, with students across multiple Upstate schools currently in quarantine. Another specific exposure occurred at the Burger King on U.S. 221 in Roebuck. Individuals who visited this Burger King on Wednesday, January 28, between 11:30 a.m. and 2:30 p.m. and lack immunity are advised to monitor for symptoms through February 18. Health officials also mention other public places like stores, fitness centers, and post offices in various towns.
What actions should I take to protect myself and my family from measles?
To protect yourself and your family from measles, ensure everyone is up-to-date on their MMR (Measles, Mumps, and Rubella) vaccinations. The MMR vaccine is the most effective preventative measure. If you believe you or a family member may have been exposed, or if you develop symptoms such as a high fever, cough, runny nose, red eyes, or a rash, contact a healthcare provider immediately. Be sure to inform them about potential exposure and symptoms. They may advise wearing a mask or isolating yourself to prevent further spread before your evaluation.
A Call for Renewed Vigilance in Public Health
The ongoing measles outbreak in South Carolina serves as a stark reminder of the critical importance of public health initiatives, especially robust vaccination programs. While individual autonomy in health decisions is a deeply held value, the highly contagious nature of measles underscores that such choices have profound community-wide implications. As cases continue to rise both locally and nationally, proactive measures—primarily widespread vaccination—remain the most effective strategy to protect vulnerable populations, restore herd immunity, and prevent further setbacks to the significant public health achievements of the past. Staying informed, following public health guidance, and ensuring up-to-date immunizations are crucial steps for every individual to contribute to the collective health and safety of our communities.
