On Friday, South Carolina reported 124 additional measles cases over a span of three days, raising the total to 558 in what’s becoming a rapidly escalating outbreak. This surge has seen cases nearly double in just the past week.
“Currently, we have the largest outbreak in the United States, and it’s likely to worsen before we see any improvements,” said Dr. Helmut Albrecht, an infectious disease physician associated with Prisma Health and the University of South Carolina School of Medicine, during a press briefing. He also mentioned that many individuals across the state are already under quarantine or in isolation.
The outbreak is centered in Spartanburg County, located in the northwestern part of the state. Interestingly, this area has witnessed a rise in students with nonmedical exemptions from mandatory school vaccinations since the pandemic began. Recent research published in JAMA indicates these exemptions are increasing nationwide, leaving communities more vulnerable to outbreaks.
Worryingly, infections have already expanded beyond our borders, with six cases in neighboring North Carolina linked to the Spartanburg outbreak. “We’ve lost our capacity to contain this due to insufficient immunity,” Albrecht cautioned, urging the public to get vaccinated.
While the overall vaccination rate among students in Spartanburg County sits at 90%, it’s still below the critical 95% needed to effectively prevent measles outbreaks. Measles is renowned for its contagiousness; just one case can infect up to 18 other individuals, on average.
The outbreak kicked off in October and has significantly intensified in recent weeks, with 248 new cases reported this week alone. The majority of those affected are unvaccinated children and teens. Hundreds of youngsters have been quarantined since the outbreak commenced, with exposures occurring in various public venues, as noted by state epidemiologist Linda Bell in a recent media briefing.
“Potential public exposure settings identified over the last week include churches, businesses, and numerous healthcare facilities,” Bell explained. She warned that individuals who are unvaccinated face a higher risk of infection.
Digging into the numbers, while 90% of students in Spartanburg County comply with vaccination mandates, certain schools report alarmingly low rates—one noted a mere 20% vaccination compliance. Moreover, Spartanburg boasts a relatively high rate of nonmedical exemptions, approximately 8%, a jump from just 3% in 2020, based on recently published data.
Tim Smith, whose wife is an assistant teacher in the county, shared that even after being vaccinated, she contracted measles from a student and needed hospitalization due to severe dehydration. Smith voiced his concerns during a school board meeting, asserting that exemptions in Spartanburg have reached an untenable level.
“It’s absolute insanity,” he declared. “There are laws mandating vaccinations, yet some people have found loopholes such as religious exemptions that anyone can apply for.” It’s not just religious exemptions; most states allow parents to opt out of vaccination requirements for various personal reasons.
The trend of rising nonmedical exemptions appears to be a nationwide issue, with a recent JAMA study revealing that these exemptions have steadily increased across many U.S. counties, a trend that has accelerated post-pandemic. Researchers evaluated exemption data from over 3,000 U.S. counties and jurisdictions across 45 states and Washington, D.C., from 2010 to 2024.
In many states, pockets of under-vaccination persist even when overall vaccination rates are high, warns Dr. Nathan Lo, a physician-scientist at Stanford University and co-author of the study. “Infectious disease outbreaks can be triggered by just a small cluster of unvaccinated individuals,” he notes, underscoring the pressing threat posed by these community vulnerabilities.
Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, concurs. He emphasizes that with rising exemptions comes a declining vaccination rate, suggesting that many communities are sitting on a powder keg. “There are numerous South Carolinas waiting to happen,” he states.
