The US Is In For Another Bad Year of Measles Cases

Cases of measles in the United States reached its highest level in more than 30 years in 2025, with 2,242 confirmed infections. A particularly severe outbreak in West Texas, which began in January of last year, was a significant factor in these cases. Now, a measles surge in South Carolina is poised to surpass the West Texas outbreak, which could mean another year of high measles cases.

“I’m worried,” says Susan Kline, an infectious disease doctor and professor of medicine at the University of Minnesota. “Given the scale of the current outbreak in South Carolina, I don’t think this bodes poorly for the current year.”

Across the country, state vaccination levels have steadily declined in recent years. Combine this with the Trump administration’s hostility toward vaccines, and the United States will likely experience more measles outbreaks in the months and years to come.

The outbreak in South Carolina began last fall, when the state health department reported the first eight cases of measles on October 2. An outbreak is defined as three or more cases linked to a common exposure. This number increased to 176 by the end of the year. As of Jan. 20, the state had confirmed 646 cases, most in the “upstate” region, the northwest part of the state.

The measles outbreak in West Texas resulted in 762 confirmed cases, 99 hospitalizations and two deaths among school-aged children, both unvaccinated. The outbreak was officially declared over in August, seven months after it began.

“We really feel like we’re looking over the edge, knowing that the situation is about to get worse,” Johnathon Elkes, an emergency medicine physician at Prisma Health in Greenville, South Carolina, said on a Jan. 16 call with reporters.

Measles is highly contagious and the virus can linger in the air for hours after a person coughs or sneezes. The first symptoms usually include a high fever, cough and runny nose. The characteristic rash does not appear until several days later. Although most people recover from measles, the disease can be dangerous, especially for babies and young children. The virus can damage the lungs and severely weaken the immune system, leaving people vulnerable to pneumonia and other infections for several weeks or even months. Pneumonia is the most common cause of measles-related death in children.

So far, 10 people in South Carolina have required hospitalization since the outbreak began. This includes both adults and children. Cases have been identified on two college campuses, Clemson University and Anderson University, and the number of public exposure locations continues to increase week by week. In addition to the 646 confirmed cases, another 538 people in the state have been potentially exposed to measles and have been asked to quarantine at home while they wait to see if they develop symptoms.

Right now, the state is seeing double-digit new cases every day, South Carolina State Epidemiologist Linda Bell said during a Jan. 21 briefing.

“We could be in this situation for weeks or even months if we don’t see a change in protective behaviors,” she said.

There are no antiviral medications to treat measles. The best protection against the disease is vaccination against measles, mumps and rubella (MMR). Among the 646 cases in South Carolina, 563 are unvaccinated, 12 have received one of two doses of the MMR vaccine, 13 are vaccinated and 58 have unknown vaccination status. The vaccine may not provide adequate protection for people with weakened immune systems.