South Carolina Faces Largest Measles Outbreak in Decades

Lack of mandatory reporting hinders state's ability to track hospitalizations and severity of outbreak

Published on Feb. 22, 2026

Got story updates? Submit your updates here. ›

South Carolina is experiencing its largest measles outbreak in decades, with 973 confirmed cases as of February 22, 2026. However, the state's data shows only 20 measles-related hospitalizations, which is dramatically lower than the CDC's estimate that about 20% of measles cases typically require hospitalization. The lack of mandatory reporting requirements for hospitals to report measles admissions is hindering the state's ability to fully understand the scope and severity of the outbreak.

Why it matters

The underreporting of measles hospitalizations in South Carolina raises concerns about the accuracy of the public health data and the state's ability to effectively respond to the outbreak. Without a clear picture of the number of severe cases, doctors and public health officials are limited in their ability to communicate the risks to the public and make informed decisions about resource allocation and containment efforts.

The details

South Carolina does not require hospitals to report admissions for measles, leaving doctors to rely on fragmented information and professional networks to understand the true scope of the outbreak. The state's Department of Public Health is urging hospitals to voluntarily report admissions, but only seven have done so. This lack of mandatory reporting is not unique to South Carolina, as most states in the South do not require hospitals to report measles-related admissions. The absence of real-time hospitalization data hinders doctors' ability to advise patients, particularly those hesitant about vaccination, and makes it difficult to communicate the severity of the illness.

  • The measles outbreak in South Carolina was first confirmed on October 2, 2025.
  • As of February 22, 2026, the state has reported 973 confirmed measles cases.

The players

Tim Smith

A Spartanburg County resident whose fully vaccinated wife contracted measles after a case appeared in her classroom.

Dr. Leigh Bragg

A pediatrician working in a neighboring county who was unaware of any measles hospitalizations in South Carolina until Tim Smith's story reached her on Facebook.

Dr. Paul Offit

The director of the Vaccine Education Center at Children's Hospital of Philadelphia and a former member of the CDC's immunization advisory committee, who stated that a hospitalization rate of 2% is "ludicrous" and indicative of "vast underreporting".

Linda Bell

The state epidemiologist for the South Carolina Department of Public Health, who acknowledged that the agency lacks the authority to compel hospitals to report measles-related admissions.

Dr. Martha Edwards

The president of the South Carolina chapter of the American Academy of Pediatrics, who noted that the lack of information makes it difficult to communicate the severity of the measles illness.

Got photos? Submit your photos here. ›

What they’re saying

“My wife was throwing up. She had diarrhea. She couldn't breathe. All for what? This is — it's absolute insanity.”

— Tim Smith (Facebook)

“A hospitalization rate at 2% is ludicrous. It's vast underreporting. Measles makes you sick.”

— Dr. Paul Offit, Director of the Vaccine Education Center at Children's Hospital of Philadelphia (ProPublica)

“We don't suppose we are getting an accurate picture at all of how these illnesses are impacting our community.”

— Linda Bell, State Epidemiologist, South Carolina Department of Public Health (ProPublica)

“It's a very big disservice to the public not reporting complications we are seeing in hospitals or even ERs. Measles isn't just a cold.”

— Dr. Leigh Bragg, Pediatrician (ProPublica)

“Transparency here is going to support other states. The more transparent we are about all of our statistics, the better off any other state is going to be in preparing.”

— Dr. Danielle Scheurer, Chief Quality Officer, Medical University of South Carolina (ProPublica)

What’s next

The South Carolina Department of Public Health has activated mobile health units to offer free MMR vaccines to unvaccinated individuals, and is urging hospitals to voluntarily report measles-related admissions. However, the state lacks the authority to compel reporting, which could hinder its ability to fully understand the scope and severity of the outbreak.

The takeaway

The underreporting of measles hospitalizations in South Carolina highlights the need for mandatory reporting requirements to ensure public health officials have accurate data to respond effectively to disease outbreaks. The lack of transparency and incomplete information makes it difficult for doctors to communicate the risks to patients and the public, and raises concerns about the state's ability to allocate resources and implement appropriate containment measures.