A shocking reality is unfolding in South Carolina, where a rapidly spreading measles outbreak has become the largest in the United States since the disease was declared eliminated over two decades ago. With a staggering 789 cases reported as of Tuesday, this outbreak surpasses even the massive one in Texas, which ended in August last year with 762 cases and sadly, two child fatalities.
South Carolina's battle with measles began in October, and since then, the state has seen a surge of more than 600 cases in 2026 alone. At least 18 individuals, including both adults and children, have been hospitalized due to complications from measles, according to the state health department. While no deaths have been reported yet, the situation remains critical.
The impact extends beyond South Carolina's borders, with additional cases in North Carolina and Washington linked to this outbreak. The US declared measles eliminated in 2000, meaning there had been no continuous transmission for over a year. However, the past few years have seen a significant rise in measles cases, with an average of about 180 cases reported annually since elimination, according to the US Centers for Disease Control and Prevention (CDC). In 2025, the US reported over 2,200 confirmed measles cases, a stark increase from previous years.
The CDC's latest update on Friday reported 416 confirmed measles cases in the US so far in 2026, but this data is up until Thursday, before South Carolina's latest numbers were released. At least 14 states have already reported confirmed cases this year, and another large outbreak is ongoing along the Arizona-Utah border. This surge in measles cases puts the US at risk of losing its elimination status, which the Pan American Health Organization may reconsider when they meet in April.
The CDC previously hailed measles elimination as a historic public health achievement, largely attributed to vaccination. The measles vaccine was licensed in 1963, and the combination measles-mumps-rubella (MMR) vaccine became widely available in the US in the 1970s. The country's elimination status was previously threatened in 2019 due to large outbreaks in New York, particularly in Orthodox Jewish communities in Brooklyn and Rockland County.
Under the leadership of Robert F. Kennedy Jr., a long-time vaccine skeptic, the federal government's stance on measles has shifted. Dr. Ralph Abraham, the Principal Deputy Director of the CDC and a former Louisiana surgeon general, has expressed skepticism about the ongoing transmission of measles from the Texas outbreak, which began in January 2025. Despite this, Abraham downplayed the potential loss of elimination status, stating it would "not really" be significant, attributing it to the "cost of doing business with our borders."
Abraham emphasized that "vaccination remains the most effective way to prevent measles" and that the CDC is committed to helping, but they are open to discussing alternatives for treatment and prevention. The vast majority of cases in the South Carolina outbreak are among children, nearly all of whom were not fully vaccinated with the recommended two doses of the MMR vaccine. Of the 789 cases reported as of Tuesday, more than 700 individuals were either not vaccinated or had not received the two recommended MMR doses, according to the health department.
State health officials have been actively promoting vaccination, including through mobile health unit vaccination events, in an effort to contain the outbreak. Spartanburg County, the epicenter of the outbreak, had one of the lowest vaccination rates in the state during the 2024-25 school year, with only 90% of students receiving required immunizations. Public health experts emphasize that a 95% vaccination rate is typically needed to prevent the spread of measles in a community due to its highly contagious nature.
The MMR vaccine is widely accessible at doctors' offices, pharmacies, and health departments, and is often free for many families through the Vaccines for Children program or health insurance. State Epidemiologist Dr. Linda Bell urged the public to take advantage of vaccination opportunities, stating, "As we continue to watch this daily surge in cases, [the Department of Public Health] strongly encourages those who are not protected to get protected against unexpected exposures and illnesses now to help us stop this outbreak and protect our communities." This outbreak serves as a stark reminder of the importance of vaccination and the potential consequences of vaccine hesitancy.
