South Carolina's Measles Outbreak Reaches 646 Cases, Vaccination Falls Short and Risks US Elimination Status

South Carolina is facing a serious measles outbreak, as the number already reached 646, due to the lack of vaccination and misinformation, with the US at high risk of losing its measles eradication status.

Measles infections have drastically increased since the end of January, with at least 88 cases being reported in the last seven days. The outbreak being discussed has its epicentre in Spartanburg, a city with a population of about 39,000 people, and has spread to the surrounding areas.

More than 500 residents, 15 schools of which have students, have been quarantined.

Even higher education institutions have not been spared, as recent cases have been reported first in Clemson University, then Anderson University, where dozens of students are currently quarantined.

'We feel like we're really kind of staring over the edge, knowing that this is about to get a lot worse,' Dr Johnathon Elkes at Prisma Health in Greenville, South Carolina, told NBC News.

This has resulted in 646 cases in the state since October, and health officials have warned that this may get worse without a step up in containment efforts.

'We have right now the largest outbreak in the US, and it's going to get worse before it gets better,' Dr Helmut Albrecht, an infectious disease specialist, told the public to get vaccinated.

Sudden spike in South Carolina cases

The extent of the outbreak goes outside its epicentre.

North Carolina has seven cases that are directly associated with the cluster. Measles cases of children were already documented in Ohio and Washington state, and it was also observed that Arizona and Utah had outbreaks with 217 and 210 cases, respectively.

The transmissibility of the virus is high, and hence it spreads rapidly via airborne particles, particularly in communities with gaps in vaccinations.

According to Clemson News, in a statement, 'A person infected with measles is contagious four days before and after a rash begins. Isolation of an actively infectious case lasts until four full days have passed after the onset of the rash, and dates of isolation are determined by DPH.'

'Quarantine for measles is reserved for exposed individuals without documented immunity and lasts for 21 days after last exposure per DPH guidelines. If a person without documented immunity receives a dose of MMR vaccine within 72 hours after last exposure, they do not have to quarantine,' they continued.

The rate of vaccination and problems of public health

In spite of the existence of a safe and effective vaccine, a good number of children are not vaccinated. Spartanburg County has reached approximately 90% of the school-aged children in terms of vaccination coverage, which is short of the 95% mark to reach herd immunity.

According to experts, declining vaccination rates driven by misinformation and vaccine scepticism provide good grounds to trigger outbreaks.

There is a decrease in the national vaccination rates and exemptions to school-based vaccination are on the rise, which creates the susceptibility even in areas with high immunisation rates in the past.

Robert F. Kennedy Jr, one of the leading vaccine critics and an official in the US Department of Health and Human Services, has publicly expressed doubts about vaccines.

His words have served to increase vaccine scepticism, which has complicated the work of public health officials.

Kennedy Jr and his growing anti-vaccine jabs serve to 'denigrating vaccines in general, specifically the MMR vaccine, trying to link it with autism when there's no link', Dr Rob Davidson, executive director of the Committee to Protect Health Care in Michigan said.

He also said that Kennedy Jr has 'the largest megaphone of public health in the country, maybe in the world.'

These experts report that such misinformation will reduce the trust in vaccines, which will make parents delay or reject immunisations, particularly in regions with already low coverage.

Losing elimination status consequences

In 2000, the US was declared measles-free. But recent epidemics argue this status. The current wave has already caused more than 2,000 cases in the country in 2025, the highest number in decades, with the past few months recording several hundred new cases.

The World Health Organisation (WHO) and the Pan American Health Organisation (PAHO) are keeping a watch on the situation and it may reevaluate the status of the US as measles-eliminated. This is an indicator of effective disease control and its loss is an indicator of an outbreak of a preventable disease.

Strains in the healthcare system and populations at a disadvantage

Infants below the age of one year and immunocompromised individuals are vulnerable population groups to the outbreak.

There are higher admissions recorded in the affected hospitals, some children are even admitted in hospitals with severe complications of measles like pneumonia and encephalitis.

Medical experts caution that the pressure on the system might become worse in case the outbreaks keep increasing. Health authorities emphasise the use of vaccination efforts and interaction with the community to avoid the spread further.