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South Carolina Measles Outbreak Hits 973 Cases as Hospital Data Remains Hidden

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Outbreak reaches record size in early 2026 By February 21, 2026 South Carolina recorded 973 measles cases, the largest U.S. outbreak since the disease was declared eliminated 25 years ago, according to state health officials [1]. The surge began in late 2025 and has accelerated despite public‑health advisories urging vaccination.

Hospital admissions vastly underreported State hospitals have logged only 20 measles‑related admissions, roughly 2 % of total cases, far below CDC estimates that about 20 % of infections require hospitalization [1]. South Carolina law does not compel hospitals to report measles admissions, forcing clinicians to rely on informal networks and limited state agency data. This reporting gap hampers real‑time assessment of severe outcomes.

Physicians warn complications are hidden Pediatricians argue the 2 % hospitalization figure is “ludicrous,” citing likely undercounts of pneumonia, dehydration, and encephalitis among patients [1]. They stress that delayed or missed hospital data obscures the true burden of severe complications, which can lead to long‑term disability or death.

Legislative move could limit provider advocacy Lawmakers are considering a bill that would bar health providers from questioning or interfering with a patient’s right to refuse vaccines, echoing broader GOP “medical freedom” rhetoric [1]. Critics say the measure would further erode clinicians’ ability to counsel families during the outbreak.

Hospital reporting varies across the state Spartanburg Regional Healthcare System voluntarily disclosed four measles admissions as of mid‑February, while Prisma Health declined to release numbers, stating it reports only required data [1]. The uneven reporting underscores the absence of a standardized statewide reporting mechanism.

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Timeline

2000 – The United States declares measles eliminated after a 25‑year stretch without endemic transmission, setting a benchmark that later public‑health officials cite when assessing current outbreaks [4].

1992 – The last year the U.S. records more than 2,000 measles cases, a figure not surpassed until 2025, underscoring how historic vaccination policies (two‑dose MMR) curbed incidence [16].

2024‑25 school year – National kindergarten MMR coverage falls to 92.5 percent, below the 95 percent herd‑immunity threshold needed to prevent sustained spread [21].

Oct 2025 – South Carolina health officials declare a measles outbreak after the first cases appear in the fall; over 200 infections emerge in the Spartanburg area within weeks [9].

Jan 20, 2025 – The first West Texas measles case develops a rash, later seeding a 762‑case outbreak that produces two child deaths [12].

Aug 2025 – Texas health authorities declare the West Texas outbreak over after hundreds of cases, but the episode highlights gaps in vaccination and reporting [5].

Dec 30, 2025 – The CDC confirms 2,065 measles cases across 43 states in 2025, the highest annual total since 1992, and documents 49 separate outbreaks [10][21].

Dec 2025 – In Texas, the Seminole Independent School District sees a 41 percent rise in student absences and a 71 percent surge among preschool‑to‑first‑grade students, linked to 141 confirmed cases and a kindergarten vaccination rate of 77 percent [13].

Dec 2025 – Nationwide, 84 new measles cases are reported in a single week, the highest weekly count since April, driven by multiple regional clusters [11].

Dec 11, 2025 – South Carolina reports 27 new cases in Spartanburg County, pushing the state total to 111 and placing 250 people in quarantine, many of them students [14].

Jan 8, 2026 – Spartanburg County’s measles cases exceed 200; vaccination coverage among schoolchildren has slipped from 95 percent to 90 percent over five years, fueling transmission [9].

Jan 9, 2026 – Federal officials argue the U.S. can retain measles‑elimination status because current clusters are not linked to the Texas outbreak, emphasizing the WHO’s 12‑month “no local transmission” rule [8].

Jan 10, 2026 – A South Carolina family visiting Washington spreads measles to eight sites across three cities; health officials issue exposure alerts and stress that “measles is highly contagious” [20].

Jan 15, 2026 – The United States records 171 measles cases in the first weeks of 2026, driven by upstate South Carolina and the Utah‑Arizona border corridors, prompting warnings that “tracking exposures is increasingly difficult” [7].

Jan 16, 2026 – Snohomish County, Washington confirms three new measles cases linked to the visiting South Carolina family, raising the county total to six and prompting officials to urge vaccination checks [19].

Jan 20, 2026 – South Carolina’s upstate outbreak reaches 646 confirmed cases, with more than 500 people in quarantine and exposures at multiple universities [2].

Jan 20, 2026 – The Pan American Health Organization schedules an April 13 meeting to decide whether the U.S. retains measles‑elimination status, a decision that hinges on a single transmission chain persisting for 12 months [12].

Jan 20, 2026 – Analysts warn that data gaps and declining public‑health funding hinder outbreak tracing, while the national vaccination rate sits at 92.5 percent, below herd‑immunity levels [15].

Jan 20, 2026 – The West Texas outbreak’s 762 cases and two child deaths keep the U.S. at risk of losing elimination status at the upcoming PAHO review [18].

Jan 21, 2026 – CDC Principal Deputy Director Dr. Ralph Abraham says losing elimination “is not a grave development” and stresses that vaccination remains “the most effective way to prevent measles” [6].

Jan 27, 2026 – South Carolina tops 789 measles cases, overtaking the 2025 Texas surge; 18 hospitalizations and 557 quarantines underscore severity, and the federal government pledges $1.4 million in aid [4].

Jan 29, 2026 – Snohomish County reports three additional cases, bringing its total to six; officials note the latest case attended a church service on Jan 18 and advise residents to verify immunizations [17].

Jan 30, 2026 – Spartanburg County records 847 measles infections, the largest U.S. outbreak since the 2000 elimination, with pediatrician Dr. Stuart Simko describing patients as “very sick” with uncontrolled high fevers [1].

Feb 21, 2026 – South Carolina’s outbreak swells to 973 cases, now the nation’s biggest; hospitals report only 20 admissions, a figure physicians call “ludicrous” and argue severely undercounts complications [3].

Future (April 13, 2026) – PAHO convenes to determine if the U.S. has maintained measles‑elimination status, a decision that could be symbolic but may affect funding and public‑health policy [12].

Future (2026 legislative session) – A pending South Carolina bill would bar doctors from questioning vaccine refusals, reflecting broader “medical‑freedom” rhetoric and potentially limiting public‑health interventions [3].

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