Why an upstate SC measles outbreak should concern the Rock Hill area, and beyond
AI-generated summary reviewed by our newsroom.
- South Carolina reports an Upstate measles outbreak: eight cases, five linked.
- All identified cases involved unvaccinated people; investigators expect more.
- Health officials urge vaccination drives and contact tracing to limit spread.
A measles outbreak in South Carolina isn’t centered in the Rock Hill region, but there’s still cause for concern in this area, according to the state health department. In fact, the state’s top expert on disease spread through communities said Friday, there should be concern in any region.
“At this time our concern level is for the entire state,” said State Epidemiologist Linda Bell with the South Carolina Department of Public Health.
The health department released information Thursday on a measles outbreak in the Upstate area. An outbreak involves three or more cases that are linked, according to the state. As of Wednesday, eight measles cases had been reported in the Upstate. Five of them in the past month warranted an outbreak listing.
Here are five things to know about the recent outbreak:
Where is the outbreak happening?
For privacy reasons, the health department doesn’t give exact locations or even counties where measles cases occur. The outbreak is within the Upstate area, one of four regions the health department uses to break down the state’s 46 counties.
There are 11 Upstate counties, with Greenville and Spartanburg the largest by population. Greenville County has the most residents of any county statewide, at more than 520,000 people at the 2020 Census. It has nearly twice the population of York County.
Cherokee and Union counties are in the Upstate region. Both border York County, and Union County also borders Chester County. All three Rock Hill region counties — York, Lancaster, Chester — are part of the health department’s 12-county Midlands region.
Along with international or domestic travel to places with higher virus transmission rates or pockets of outbreaks, there’s the threat of measles spread from in-state travel between the Upstate and other areas.
“We just want people to recognize how highly transmissible this virus is, and that it doesn’t matter what region you live in,” Bell said. “We are seeing unrecognized spread in the state.”
Why is the measles outbreak happening?
Two measles cases in July and one in early September, all in the Upstate region, were a result of international travel, Bell said. One case involved transmission from an infected person here to a close contact.
The five most recent cases came in a little more than a week. There’s no known source for two of the cases, Bell said.
“We actually expect more cases to be identified,” she said.
There is one common thread among the cases.
“The people involved, all the cases that have been identified, are unvaccinated,” Bell said. “Nor did they have immunity from a previous measles infection or natural immunity.”
As one of the most highly contagious known viruses, measles will infect about 90% of people who are exposed to it and have no immunity through vaccines or prior infections, Bell said. One infected person can spread measles to between eight and 20 people on average, she said.
“This is the greatest concern, that we’re going to see ongoing transmission in this community if we don’t get our vaccination rate up more quickly,” Bell said.
A population needs to have 95% vaccination or immunity to prevent virus transmission and outbreaks, Bell said. South Carolina has about 90% coverage. There’s been a slow but steady decline in vaccination coverage for the past few years, she said, as evidenced by indicators like the number of students being exempt from vaccinations to start school.
“There’s an urgent need to increase vaccination coverage to prevent spread in South Carolina,” Bell said.
What else do we know about the outbreak?
The ongoing investigation of the five most recent cases involves one school, Bell said. Multiple cases in that school, which Bell would not name, are being investigated. A couple of cases have unknown sources, so it’s unclear if they were spread at that or any other school.
The health department is interviewing people who contracted the measles virus, along with close contacts, to determine how the virus was transmitted and how widespread it may be. The health department communicated with the school and encouraged it to use school communications to let parents know what is happening, Bell said.
The health department doesn’t close schools, Bell said. Local schools and districts make those decisions. The health department also doesn’t follow up after cases are reported with details like whether the measles infections led to hospitalizations, Bell said.
Who is most at risk for getting measles?
Pregnant women, young children and people with compromised immune systems are most at risk for infection. Complications like pneomonia and encephalitis can become life-threatening. Typically, measles symptoms start with a high fever, cough, runny nose and red eyes. In about four days, a red rash tends to form on the face and begin spreading to the rest of the body.
Often the people most susceptible to the measles infection, like pregnant women or people with autoimmune disease, are unable to get vaccines to prevent it.
“Getting our coverage rate in our state also protects those who cannot be vaccinated,” Bell said.
Anyone, though, without immunity should take the virus seriously, she said.
“The virus easily finds any susceptible people, any non-immune person in the population,” Bell said.
What should people do to avoid getting measles?
The familiar health department suggestions from the COVID era can help reduce infections, Bell said, like good hygiene and staying home if sick. But by far the most effective defense is a measles vaccine.
One vaccine dose is 93% effective in creating lifelong immunity, Bell said. The recommended two doses increases that immunity to 97%, she said. Even vaccination within 72 hours of contact with the infection often can prevent it, Bell said.
That’s the concern for the state, that more cases will come and spread will outgrow the health department’s ability to identify cases and vaccinate contacts quickly enough.
Bell suggests talking with a healthcare provider. Vaccines are available at pharmacies, doctor offices and health department or other clinics. They often are no cost for children.
Anyone experiencing symptoms of the measles virus should notify a healthcare facility before visiting it, to allow for precautions to prevent other people from contracting measles in that setting.
