Now that measles are in the Rock Hill region, here’s what to expect next

At the onset of a South Carolina measles outbreak in Spartanburg County last fall, State Epidemiologist Linda Bell warned that the entire state should be concerned. Now that the Rock Hill region has its first confirmed case, that message hasn’t changed.

“The virus doesn’t observe any of these geographic borders,” Bell said Wednesday. “It doesn’t care where you live.”

The South Carolina Department of Public Health confirmed a Lancaster County measles case on Tuesday. The state is still investigating it and hasn’t determined where the person contracted the virus, or if there were any public exposures to measles in South Carolina related to the case.

The state referenced public exposures in North Carolina when announcing the Lancaster County case on Tuesday but didn’t state a clear connection between the two. The Lancaster County case had exposures in North Carolina, Bell said Wednesday. There are no known spots in South Carolina where public exposures happened from the Lancaster County case, she said.

Mecklenburg and Union counties, which both border Lancaster County on the state line, have reported a combined four measles cases.

Mecklenburg County also has three Charlotte sites where the public may have been exposed to measles in January, according to the North Carolina Division of Public Health. Vista Auction and Sardis Presbyterian Church on Sardis Road are listed, as is a Lidl grocery store on Monroe Road.

Union County has four potential exposure sites listed. American Family Urgent Care, a QuikTrip gas station and an Atrium Health Primary Care family medicine office are all in Indian Trail. Shining Light Baptist Academy is in Monroe.

One other site with a Charlotte address is listed, at the Atrium Health Harrisburg Emergency Department in Cabarrus County.

So far, no measles cases or public exposures have been announced for York or Chester counties.

In a country where measles cases were eliminated two decades ago, it’s unfortunate that cases continue to spread, Bell said.

”It tells us that we have a great deal more work to do to stop this outbreak that should not be happening,” she said.

Are measles cases increasing in SC?

While new to Lancaster County, measles cases statewide seem to be decreasing. The state saw fewer than 40 cases per week last year. Then, the first week of January brought 188 cases. Measles cases spiked the following week at 200. They’ve dropped each week since so far, to 68 cases last week.

Yet Bell cautions against reading too much into recent decreases. The virus is also impacting a broader area. More than 95% of cases are in Spartanburg County, but Lancaster County makes six counties to have reported a measles case.

“We are not sure yet if we are really seeing a slowing,” Bell said. “So this is really not the time for anyone to let their guard down and say this is over with.”

Surveillance, from medical sites reporting cases to wastewater testing, doesn’t give a strong signal that there’s rampant measles infections in communities, Bell said. The cases with unidentified sources of infections, like in Lancaster County, are still concerning.

“That does tell us that there may be some element of unidentified, unrecognized, low-level circulation of measles in our communities,” Bell said.

What to expect from measles

Vaccination is the main prevention for measles, Bell said. More than 92% of cases in South Carolina during this outbreak have been people who were unvaccinated. Only 2.7% of cases involved someone known to be fully vaccinated. More than 70% of cases involve some under the age of 12.

In York County, 93.7% of school students are fully vaccinated. Those numbers are 94.4% in Lancaster County and 92.1% in Chester County. Spartanburg is the lowest in the state, at 88.9%. Rock Hill region counties have lower vaccination rates today, like the rest of the state, compared to four years ago.

Whether cases decrease or begin to pop up in other places is highly dependent on community-level immunity from vaccination or immunity from prior infections, Bell said. Unlike the flu and some other viruses, measles aren’t expected to increase or decrease in certain seasons of the year.

“It is the most effective virus in finding susceptible people,” Bell said. “There’s no seasonality.”

Part of the uncertainty with what comes next is that South Carolina hasn’t faced this type of outbreak. Higher vaccination rates in the recent past meant the state never had more than half a dozen cases per year, typically confined to one family or imported from international travel, Bell said.

“This is not normal,” she said. “This is unprecedented.”

This story was originally published February 12, 2026 at 5:00 AM.