South Carolina Faces Largest Measles Outbreak Since 2000

In South Carolina, a significant resurgence of measles has emerged, marking the largest outbreak since the United States declared the disease eliminated in 2000. Over the past two months, pediatrician Stuart Simko has encountered six cases of measles firsthand, a stark contrast to his prior experience, which consisted solely of historical case studies. The children he treated were severely ill, suffering from high fevers and other complications.

Simko, affiliated with Prisma Health, expressed his concerns regarding the severity of the disease. “It’s a terrible, terrible disease that can cause mortality,” he stated, emphasizing the importance of vaccination to prevent such illnesses. In total, South Carolina has reported 789 infections, predominantly among unvaccinated children, highlighting a troubling trend in public health.

The outbreak has raised alarms as the U.S. faces potential loss of its measles elimination status, following similar declines in the United Kingdom and Canada. Last year, two school-aged children died during a measles outbreak in Texas, further underscoring the dangers associated with declining vaccination rates.

Community Response and Vaccination Rates

In Spartanburg County, a region comprising several former mill towns with a population of approximately 370,000, the vaccination rate for school-aged children stands at about 90%. However, some schools report significantly lower rates, often due to religious exemptions. The Centers for Disease Control and Prevention (CDC) recommends two doses of the measles, mumps, and rubella (MMR) vaccine for children aged between one and six, as it is 97% effective in preventing measles. To achieve herd immunity, around 95% of the population needs to be vaccinated.

Local residents have begun to acknowledge the seriousness of the outbreak, with many knowing someone affected. Yet, public awareness remains limited. Unlike the response in Texas, where public warnings were prominent, Spartanburg’s only visible sign of concern was an urgent care office advising symptomatic individuals to wait in their vehicles. “It’s really bad here,” said community member Kate Martin, who has children in local schools. “But the average person just doesn’t think it’s a big deal.”

Political and Public Health Implications

State Senator Josh Kimbrell initially refrained from commenting on the outbreak, despite being critical of the government’s pandemic response. His perspective shifted after hearing from a constituent whose vaccinated wife ended up in the ICU due to measles. This prompted Kimbrell to advocate for public health measures, including restrictions on unvaccinated individuals’ activities. His statements received mixed reactions, with some applauding his stance while others accused him of infringing on personal rights.

Local health officials have noted that the outbreak has disproportionately affected Russian and Ukrainian immigrants. The recent resettlement of hundreds of Ukrainian refugees and an influx of Slavic immigrants in Spartanburg have contributed to the situation. Some community members have voiced opposition to vaccines based on misinformation, including debunked claims that the MMR vaccine contains fetal cells.

In contrast, individuals like Inna, a member of the Ukrainian community, have chosen not to vaccinate their children due to concerns about vaccine contents and misconceptions regarding autism. Although her family has thus far avoided infection, Inna remains unconcerned about the measles risk, stating, “We’re more worried about what’s in the vaccine.”

Public health experts are increasingly alarmed by the changing landscape of vaccination attitudes. Jennifer Grier, an associate professor of immunology at the University of South Carolina School of Medicine Greenville, pointed out that the perceived risk of measles is no longer low. “Unfortunately, now that situation of getting measles is not low risk anymore,” she remarked.

As the outbreak unfolds, significant challenges remain in addressing vaccine hesitancy and misinformation. The South Carolina Department of Public Health (DHS) has made some progress, with mobile clinics administering vaccines to 62 individuals since October. Yet, experts contend that efforts have been hampered by recent changes in federal vaccine policy under the leadership of Robert F. Kennedy Jr., who has expressed mixed views on the MMR vaccine.

Kennedy’s influence appears to resonate within the community, as residents attribute some vaccine hesitancy to his prominent stance on vaccine skepticism. In a recent statement, the Department of Health and Human Services reiterated that vaccination is the most effective means to prevent measles.

As the outbreak continues, concerns persist regarding the long-term implications of decreased vaccination rates. Experts warn that if the current trend persists, the U.S. may witness a significant public health crisis, potentially resulting in preventable deaths among children. Grier concluded, “Because we have the means to stop the infections, we know the risk of the infections, and it still was able to come back to our community.”