With a measles outbreak confirmed in the Upstate of South Carolina, third-year biology student Leah Chandler said it’s becoming more nerve-wracking as cases continue to spread.
As of Feb. 6, confirmed cases have risen to 920 in the Upstate, and the outbreak is centered around Spartanburg County, where Chandler is from.
“Spartanburg is a very tight community,” Chandler said. “Seeing it spread so rapidly ... it makes you not want to go out to stores or out in public just because if someone there has it, you’re kind of screwed."
Third-year political science and cello performance student John Koontz said he’s become more aware of the outbreak when he visits back home to Spartanburg.
“There’s definitely been growing concerns, I would say, for me,” Koontz said.
South Carolina’s first measles case was reported in the Upstate on July 9, 2025. An outbreak was confirmed by the South Carolina Department of Public Health, or DPH, on Oct. 2, with eight cases reported then.
Outbreak in the state
The July 9 case was the first confirmed case in the state since September 2024, according to The Post and Courier.
Before then, the state had six confirmed cases in 2018, and the last detection before that was in 1997. In 2000, measles was declared eliminated in the United States because there had been no continuous spread for over 12 months, according to the Centers for Disease Control and Prevention.
On Feb. 3, a case in Sumter County was confirmed. According to a press release from DPH, it is unclear whether this case is linked to the Upstate outbreak.
An Oct. 2 press release from the DPH said that an outbreak is defined as three or more cases that are epidemiologically linked, meaning there was some kind of connection between the cases.
Spartanburg is the South Carolina county with the largest number of people who are either unvaccinated or under-vaccinated, according to Dr. Melissa Nolan, an epidemiology and biostatistics professor at the Arnold School of Public Health, whose research focuses on infectious diseases.
According to a Feb. 6 press release from the DPH, 277 people are currently in quarantine, and eight are in isolation. The end date for those in quarantine is March 2.
Isolation is for individuals who suspect they may have symptoms, are already experiencing symptoms or those who have been confirmed to have measles. Individuals in quarantine have been exposed to measles. Both of these are meant to slow the spread of measles or prevent it, according to Public Health Communications.
Since the outbreak in October, 18 people have been hospitalized due to complications relating to measles, Dr. Linda Bell, South Carolina’s state epidemiologist, said in a media briefing on Jan. 28. There has been a mix of children and adults hospitalized, Bell said. A Jan. 30 press release from DPH stated one more person was hospitalized due to complications of the disease.
As of Feb. 5, there have been 733 confirmed cases of measles in the U.S. since 2026 began, and a total of six cases were reported among international visitors as well.
While this outbreak has mostly been centered around the Spartanburg area, it has also now also spread to adjacent counties, Bell said. Cases have been reported in Greenville, Anderson and Cherokee counties.
Clemson University confirmed a case of measles on Jan. 17 in an individual affiliated with the main campus, the university reported.
What is measles?
Measles is a highly contagious disease that is spread when an infected person breathes, coughs or sneezes, according to DPH. Initial symptoms include fever, coughing, a runny nose and red eyes. After two to four days, these symptoms will then turn into a rash that lasts five to six days. The rash starts on the face and then spreads to the remainder of the body.
However, symptoms can also begin anywhere from seven to 12 days, and even up to three weeks after exposure.
Measles is contagious four days before and after the rash begins. Someone can spread measles before they know they are infected, according to the DPH.
The measles virus can also linger in the air for two hours even if the infected person has already left the area. It can also stay alive on surfaces for two hours, according to the DPH.
“It literally hangs out in this kind of cloud of air, and so anyone that's walking through can become infected with it that way,” Nolan said.
Measles is still common in other parts of the world, including Asia, Europe and Africa, and can be brought back into the U.S. by international travelers, the DPH reported.
The majority of the cases are close contact known cases, or cases contracted by people within the same air space as an infected individual, leading them to be exposed to measles. Public exposure sites around the Spartanburg area serve as an indicator that measles is circulating in the community, according to DPH. This circulation increases the risk of exposure and infection for those not immune due to not receiving the vaccination.
The DPH has listed public exposure sites with dates and times of potential measles exposure on its website. If someone was at a location where measles was exposed, symptoms should be monitored, especially if unvaccinated, according the DPH.
According to a 2025 report by the CDC, 97% of people who contracted measles were unvaccinated. Nolan said 2% of cases are from those who are fully vaccinated. These are called breakthrough cases.
"I know I'm vaccinated, so I should be, in theory, all right," Chandler said. "But it is kind of always on your mind."
Vaccination rates
South Carolina measles vaccination coverage for kindergarteners falls short of the target 95%, with only 91% of the state's population vaccinated, according to Johns Hopkins University.
A chart from the DPH also shows that 840 of the cases are from unvaccinated individuals. Twenty of the cases have been from individuals who were partially vaccinated, and 24 have been fully vaccinated. There are 36 cases where the vaccination status is unknown, according to the chart.
A lower proportion of kindergarteners completed the measles, mumps and rubella vaccine in South Carolina in 2024 than the previous year, according to Johns Hopkins. Only 91% of kindergarteners got the vaccine from 2024-25, down from 92% in 2023-24.
Out of the 920 confirmed cases in South Carolina, the highest number of cases has been ages 5 to 11 with 412 cases, according to the DPH chart. Cases among children ages zero to 4 total 240. Ages 12- 17 have totaled 172 cases as well.
Approximately 286,000 kindergarteners were at risk of becoming infected with measles during the 2024-25 school year because the vaccination coverage nationwide amongst this age group decreased by 2.7% since the 2019-20 school year, according to the CDC.
“If an unvaccinated student is exposed to the measles, they must quarantine for 21 days,” Bell said. “That's a lot of time to miss from school activities and time away from friends.”
These lower vaccination rates among children are a result of rising anti-vaccine sentiments among U.S. citizens and those in South Carolina, Nolan said. She said the movement has been growing over the past 10 years.
“There’s been more and more education that's been put out there and propagated through social media, educating parents on how they can circumnavigate those requirements,” Nolan said.
The growth of the anti-vaccination movement has been a concern for Koontz as both a USC student and a resident of Spartanburg.
“I think just anti-vax sentiment growing and becoming so popular has been pretty scary,” Koontz said. “You don’t know who could be unvaxxed, who could potentially be contaminating you.”
According to the CDC, it is recommended that children receive two doses of the MMR vaccine. The first dose is administered between 12 and 15 months, and the second dose between 4 and 6 years old.
“An interesting trend that we’ve seen over the last couple of years is that we’re seeing more and more kids that did not get that second booster,” Nolan said. “So I anticipate, 13 years from now, when we have more college kids that didn’t get that second vaccine, we're going to see more and more.”
Bell said that, while no vaccine is 100 percent effective, the MMR vaccine is one of the most effective when it comes to preventing infection. Those who receive the first dose are 93% protected, according to the DPH. Having the second dose also increases one's protection.
“It’s been shown to provide lifelong protection against measles in about 97% of the people who receive the recommended two dose series,” Bell said.
Columbia
On Jan. 2, an infected individual visited the South Carolina State Museum, making this the first exposure for Columbia, reported by the Post and Courier. The individual did not know they were infected at the time of the visitation, according to a DPH press release.
USC’s Center for Student Health and Well-Being has produced frequently asked questions with general information about measles, immunizations, quarantines and more.
To attend USC, students must provide proof of immunization of two doses of the MMR vaccination after age 1, according to the FAQ. A blood test showing immunity is also accepted. Exemptions for documented medical and religious reasons are made as well.
According to Nolan, if you are exposed to a known case of measles, you must provide documentation that you are fully vaccinated or have antibody protection. If you do not provide these, you are legally required to quarantine for 21 days.
On Jan. 16, USC's human resources department sent an email to all faculty and staff regarding spikes in statewide measles cases. If a faculty or staff member is exposed to measles and is unable to provide proof of immunity through vaccination, they will be instructed by the DPH to quarantine for 21 days, the email said. They were also given instructions on how to submit their immunization records.
Personal impact
Koontz said that back in Spartanburg, his parents are schoolteachers, which worries him, as the elementary age has had a large number of cases.
“I have been a little worried about getting it from them, just because they're interacting with, like, 80 kids a day,” Koontz said.
There are 335 students in quarantine and three more schools identified as public exposures across the 20 K-12 schools in the Upstate as of Jan. 28, according to the briefing.
This has created a sense of unease for Chandler, as her brother is a senior attending Spartanburg High School. She said that one of their rival high schools recently had confirmed cases, leaving her nervous.
Dorman High School, the rival school of Spartanburg High, was one of the schools identified as a new place of public exposure, according to Bell.
“It just seems to be spreading so rapidly,” Chandler said.
Editor’s note: This article was originally published in our February print edition. The most recent information on the outbreak can be found on the DPH website.