The measles outbreak in South Carolina now stands at 664 cases, more than doubling in a few weeks, officials said this week.The highly contagious virus has also spread onward to North Carolina, Ohio and Washington state, and similar outbreaks are unfurling in arizona and Utah as well.
The outbreak, which first began in Texas a year ago this week, has spread to most US states – and as the US passes the one-year mark, its measles-elimination status will probably end, a symbol indicating an expected wave of year-round preventable disease. The outbreak has been plagued by misinformation, with Robert F Kennedy Jr, secretary of the US Department of Health and Human Services and longtime vaccine critic, framing measles vaccination as a personal choice and promoting unproven treatments.
The vast majority of those infected are children, and most of them did not receive the measles, mumps, and rubella (MMR vaccine). last year, there were 2,242 confirmed cases of measles across 44 states, according to the US Centers for Disease Control and Prevention (CDC). There have already been 171 measles cases reported in nine states in 2026 – and that number does not include the jump in cases reported by South Carolina on Friday.
“I think it’s just the new normal, unfortunately, that public health departments have to be responding to,” said Katherine Wells, director of public health in Lubbock, who oversaw the city’s response to the west Texas measles cluster.
In 2026, measles will probably percolate in more communities with low vaccination rates and then put pressure on vulnerable children and adults even in highly vaccinated communities, she said. And measles isn’t the onyl fear.
“Measles is the canary in the coalmine,” Wells said. “As we see lower and lower vaccination rates, we could see an outbreak of rubella or polio or some of these other vaccine-preventable diseases.”
Because it is so highly contagious - it can linger in the air in a room for two hours - measles typically spreads more quickly than other infectious diseases. But preventable illnesses like polio, tetanus, diphtheria and whooping cough are not far behind a measles outbreak.
“Measles is a bellwether,” said James Alwine,emeritus professor at the University of Pennsylvania,a virologist,and a member of the coordinating committee of Defend Public health. “It means that your vaccination level is so low that all the other vaccine-preventable diseases will come up with time.”
Vaccination rates are falling throughout the US as exemptions from school mandates increase, according to new data.
Texas Measles Outbreak of 2023-2024
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A measles outbreak originating in Texas during 2023 and 2024 resulted in 762 confirmed cases, 99 hospitalizations, and two deaths, ultimately contributing to the United States losing its measles elimination status.
The Outbreak’s Scope and Timeline
The outbreak was described as “full-blown” by state health officials as early as 2023, with a meaningful number of sick children. The texas Department of State Health Services (DSHS) officially declared the outbreak over in August 2023, after recording 762 confirmed cases, 99 hospitalizations, and tragically, the deaths of two young children. Texas Announces End to West Texas Measles Outbreak,DSHS,August 28,2023.
However, the outbreak’s impact extended beyond Texas, spreading to other states.
Loss of Measles Elimination Status
The Texas outbreak played a role in the United states losing its measles elimination status, a designation achieved in 2000.This signifies that measles is no longer considered endemic in the U.S., meaning it’s no longer continuously transmitted within the country.
According to health officials, the loss of this status signals a shift toward more frequent outbreaks in communities with lower vaccination rates, possibly impacting even highly vaccinated populations.
“We’re now entering an era where we’re going to see outbreaks in these unvaccinated communities, and then I think those outbreaks will start putting pressure on other, more-vaccinated communities,” stated Wells.
Vulnerable Populations
Children under one year of age and those with underlying health conditions are notably vulnerable to measles, even within communities with high vaccination coverage.
This vulnerability is especially concerning in healthcare settings, where these young or immunocompromised children may be exposed.
