South Carolina measles outbreak is largest in US since measles was declared eliminated

The United States is confronting its largest measles outbreak in over two decades, centered in South Carolina. As of Tuesday, 789 cases have been reported in the state, surpassing a significant outbreak in Texas last year, which saw 762 cases and tragically, two deaths.

A Resurgence of a Declared Eliminated Disease

Measles was declared eliminated in the US in 2000, defined as the absence of continuous transmission for more than a year. However, recent years have seen a concerning rise in cases. Before 2025, the US averaged approximately 180 measles cases annually following elimination. In 2025 alone, that number surged to over 2,200 confirmed cases – the highest total since the year 2000.

The current outbreak in South Carolina began in October and has rapidly expanded, with over 600 cases reported in 2026 alone. As of Tuesday, at least 18 individuals – both adults and children – have been hospitalized due to measles complications, though no fatalities have been reported within the state.

Did You Know? The measles vaccine was first licensed in 1963, and the combination measles-mumps-rubella (MMR) vaccine became widely available in the 1970s.

Spreading Beyond South Carolina

The outbreak isn’t confined to South Carolina. Cases have been linked to outbreaks in North Carolina, Washington, and California. Currently, 557 individuals in South Carolina are under quarantine, potentially exposed to the virus and lacking immunity through prior vaccination or infection. Exposures have been reported at three additional schools, adding to existing quarantines at 20 others.

The Centers for Disease Control and Prevention (CDC) reported 416 confirmed measles cases nationally as of Friday, though this data predates the latest figures from South Carolina. At least 14 states have reported confirmed cases this year, alongside a growing outbreak along the Arizona-Utah border.

Federal Response and Shifting Perspectives

The US Department of Health and Human Services is providing $1.4 million in aid to support the measles response in South Carolina. The CDC is working with state health officials to track transmission patterns and coordinate efforts. However, the federal government’s approach to measles has evolved under the leadership of HHS Secretary Robert F. Kennedy Jr., a long-standing vaccine skeptic.

While the department maintains that vaccination remains the most effective preventative measure, Kennedy has also explored unconventional treatments, including vitamin A, a steroid, and an antibiotic. CDC Principal Deputy Director Dr. Ralph Abraham has also questioned the link between the Texas and South Carolina outbreaks, and downplayed the significance of potentially losing the country’s “elimination status.”

Expert Insight: The statements from HHS Secretary Kennedy Jr. and Dr. Abraham represent a departure from the traditionally strong public health messaging emphasizing vaccination as the primary defense against measles, potentially complicating efforts to contain the outbreak.

The vast majority of cases in South Carolina are occurring among children who are not fully vaccinated. Over 700 of the 789 reported cases as of Tuesday involved individuals who had not received the two recommended doses of the MMR vaccine.

Looking Ahead

If vaccination rates remain low, the outbreak could continue to expand, potentially leading to further hospitalizations and the spread of the virus to additional states. The Pan American Health Organization is scheduled to meet in April to determine whether the US will retain its measles elimination status. Losing this status could have implications for international travel and trade, and could signal a broader decline in public health infrastructure. State health officials are actively encouraging vaccination through mobile health unit events.

Frequently Asked Questions

What is measles elimination status?

Measles elimination status means there has not been continuous transmission of the disease for more than a year at a time. The US achieved this status in 2000, but the recent outbreaks put that status at risk.

How many doses of the MMR vaccine are recommended?

The CDC recommends two doses of the MMR vaccine for full protection against measles.

What is the current situation with quarantines in South Carolina?

As of Tuesday, 557 people in South Carolina are in quarantine due to potential exposure to measles, and exposures have been reported at 23 schools.

Given the current surge in measles cases and the complexities surrounding public health responses, what role do you believe community education and access to vaccination play in safeguarding public health?