The South Carolina Department of Public Health (DPH) today confirmed 54 new measles cases in just three days, raising the size of its outbreak, which DPH first reported in October, to 700 cases.

The news comes as the Centers for Disease Control and Prevention (CDC) confirmed 416 total US cases so far this month—an increase of 245 infections in the past week—and as US health officials downplay the burgeoning outbreak and the key role that vaccines play in preventing illness.

The United States, meanwhile, will likely lose its elimination status in the coming months as measles cases spike. It had gained that status in 2000. Last year the CDC confirmed 2,255 cases nationwide, the most since 1991. The agency also confirmed three deaths last year, two involving children.

New cases in South & North Carolina, Idaho

The 700 South Carolina cases are all part of an Upstate outbreak centered in Spartanburg County, home to 668 (95%) of those infections.

“The majority of cases are close contacts of known cases,” the DPH said. “However, the number of public exposure sites indicates that measles is circulating in the community increasing the risk of exposure and the risk of infection for those who are not immune due to vaccination or natural infection.”

Officials said 485 South Carolinians are in quarantine and 10 in isolation. The DPH identified new public exposures at five elementary schools, and 15 other schools already had students in quarantine. The agency also highlighted public exposures at stores, a fitness center, and a post office in Boiling Springs, Greer, Duncan, and Gaffney.

“Vaccination continues to be the best way to prevent measles and stop this outbreak,” the DPH said. It doesn’t break down cases into 2025 and 2026 totals.

In addition, health officials in Mecklenburg County, North Carolina, reported two new cases, one involving an adult who had contact with a traveler, and one involving a child who had contact with a child from Spartanburg, South Carolina, the county seat.

So far this year North Carolina officials have confirmed 12 measles cases, 13 since the middle of December, the state health department said in an update today. One of the 2026 cases was confirmed this week.

Also this week, the Idaho Division of Public Health reported two cases for 2026, following 14 in 2025.

Lead US officials downplay measles, vaccination

Of the 416 cases that the CDC noted today, 86% are in children and young adults 19 years and younger, and 25% are in children younger than 5 years. Among all patients, 94% were unvaccinated or have an unknown vaccination status.

South Carolina accounts for 338 of the 2026 cases, the CDC said, or 81% of the total. Utah is a distant second, with 32.

Last year the CDC tallied 49 separate measles outbreaks, defined as three or more related cases. So far, all cases this year are either tied to one of those outbreaks or not part of an outbreak. In 2024, the nation saw just 16 outbreaks.

Despite the expansion of the US outbreak, key federal officials continue to downplay the role of vaccination, show a lack of concern over rising cases, and appear to misunderstand what elimination status means.

Earlier this week, Ralph Abraham, MD, principal deputy director of the CDC, said that the United States losing its measles elimination status is the “cost of doing business.” He suggested the loss will be due to cases imported via international travel, when in fact elimination status depends on local spread only, not on travel-related infections. And less than 2% of US cases last year were imported, with only three (less than 1%) imported so far this year.

He added, “We have these communities that choose to be unvaccinated. That’s their personal freedom.”

A Wall Street Journal editorial yesterday countered his approach. “The problem with this line is that unvaccinated children can sicken infants and immuno-compromised children who can’t be inoculated, leaving some disabled or worse,” the editors wrote. “In a better Administration, government leaders would explain this to parents rather than brush aside serious illness as inconsequential.”

They added, “Outbreaks happen when vaccination rates fall below the levels needed to maintain herd immunity, which is about 95%. The kindergarten vaccination rate in South Carolina was 91% during the 2024-2025 school year.” It is much lower in the Upstate area.

In addition, as noted in the New York Times today, Kirk Milhoan, MD, PhD, chair of the CDC’s Advisory Committee on Immunization Practices (ACIP), expressed concern that some children might die of measles or become paralyzed with polio after their parents choose not to have them vaccinated. But he added, “I also am saddened when people die of alcoholic diseases,” adding, “Freedom of choice and bad health outcomes.”

He made the comments on a “Why Should I Trust You?” podcast yesterday. He also said, when asked about the role of ACIP, “What we are doing is returning individual autonomy to the first order—not public health but individual autonomy to the first order.”

The Pan American Health Organization said this week it has formally invited the United States and Mexico to a virtual meeting on April 13 to review their measles elimination status.