South Carolina has reported 211 measles cases as of Tuesday, health officials said, making it the second-highest total in the country after Texas, which has reported more than 800 cases in 2025.
The South Carolina Department of Health and Environmental Control said four of the state’s cases required hospitalization. State epidemiologist Dr. Linda Bell declined to release further information citing patient privacy.
The outbreak has extended into North Carolina, where four children tested positive after visiting Spartanburg County, according to North Carolina’s health department.
“It is clear the virus is circulating in the community,” Bell said. “The question is who in the community, who is susceptible, will get infected.”
Bell said the spread is unlikely to stop soon and emphasized that the measles, mumps, and rubella (MMR) vaccine remains the most effective way to prevent infection. According to the state, at least 93% of South Carolina cases were among unvaccinated individuals.
As of Wednesday, 144 people were in quarantine due to exposure without previous immunity. This included nine students from Sugar Ridge Elementary and Boiling Springs Elementary schools in Spartanburg County.
Possible exposures have also been linked to in-person gatherings at Tabernacle of Salvation Church, Slavic Pentecostal Church of Spartanburg, Ark of Salvation Church — all located in Inman — and Unitarian Universalist Church of Spartanburg. The state health department has partnered with church leaders and interpreters to share vaccination guidance with their communities.
Enclosed settings such as churches and schools can contribute to transmission, Bell said, and individuals unaware of their exposure may continue to interact with others in public. Measles symptoms, including fever and rash, typically appear one to three weeks after exposure.
Those exposed may avoid the 21-day quarantine by receiving a first vaccine dose within 72 hours, Bell said, though relatively few have done so. She did not release specific figures.
The United States could lose its measles elimination status this month if the virus continues to circulate nationally. The country achieved the designation in 2000, nearly three decades after the vaccine became available.
Most people receive two doses of the MMR vaccine in childhood, providing about 97% protection. Unvaccinated adults can also begin the two-dose series.
South Carolina is also seeing high levels of flu activity. Since September, the state has recorded 15,589 influenza cases, more than twice last year’s total but still below the 45,000 cases reported during the 2023–2024 season.
This season, 26 people in South Carolina have died of flu-related complications, the health department said. All but one were at least 50 years old. One death was a child from the Upstate region; no further details were provided.
“To prevent complications and deaths, it’s critical that everyone in South Carolina get their flu shots as well as updated vaccines for respiratory illnesses, including COVID and respiratory syncytial virus, or RSV,” Bell said in a statement.
