The Shadow
RICHMOND, Va. (VR)- A fast-growing measles outbreak in South Carolina, now the nation’s largest since the disease was declared eliminated in the United States more than two decades ago is prompting fresh concern among Virginia health officials, who warn that the highly contagious virus could spread north across state lines if the right protocols aren’t followed.
South Carolina has reported 789 measles cases as of this week, surpassing the size of last year’s massive Texas outbreak, which peaked at 762 cases before it was contained.
At least eighteen people, both adults and children in South Carolina have been hospitalized, while 557 more are under quarantine after potential exposure. No deaths have been reported thus far, but exposures have been identified at dozens of schools, and quarantines have been expanded to new campuses as cases continue to rise.
Virginia has not been spared entirely. The Virginia Department of Health confirmed four measles cases this year as of Jan.30, including a case involving an out-of-state resident who traveled through Washington Dulles International Airport on Saturday, January 24.
Health officials are coordinating to identify and notify individuals who may have been exposed, including passengers from specific flights. Potential exposure locations and timeframes include Concourse B, the route to the international arrivals building, and the baggage claim area between 5:00 a.m. and 9:00 a.m., as well as the Dulles shuttle bus to the rental car facilities between 7:00 a.m. and 9:30 a.m. on the same day.
The numbers underscore how quickly measles can return in communities where immunity has waned. Public health experts say that roughly 95% vaccination coverage is needed to prevent sustained transmission because measles is among the most contagious viruses known. One infected person can, on average, transmit the virus to 12 to 18 others in an unprotected population, according to epidemiologists. By comparison, diseases such as Ebola spread far less readily because they require direct contact and do not linger in the air the way measles can.
The measles, mumps and rubella (MMR) vaccine is highly effective with about 93% protection after one dose and 97% after two doses and confers lifelong immunity. Yet vaccination rates have slipped in recent years in the United States and globally, a trend amplified by misinformation and pandemic-era disruptions. In the 2023–24 school year, about 92.7% of American kindergartners received two MMR doses, below the level
considered necessary to halt outbreaks. Global coverage for at least one measles-containing dose fell to 83% in 2023, contributing to rising case counts worldwide.
South Carolina’s ongoing surge, centered in Spartanburg County, illustrates the risks when community coverage dips. State data cited by local physicians show some schools reporting much lower immunization rates than the 95% threshold typically required to block transmission. Mobile clinics have been deployed to increase vaccine access as health leaders plead with families to catch up on missed shots. “We have this amazing vaccine that would help protect us all from getting the measles, and we are just seeing that people aren’t as excited about getting that vaccine anymore,” a South
Carolina pediatric infectious disease specialist said this week, noting that most cases have occurred in unvaccinated children.
Measles was declared eliminated in the U.S. in 2000, meaning there was no continuous domestic transmission for at least a year. But the nation experienced more than 2,200 confirmed cases in 2025, the highest annual total since elimination, and at least 416 by early 2026 before South Carolina’s latest surge was tallied. Federal officials have warned that if outbreaks continue, the U.S. could lose its elimination status, a
designation the World Health Organization has already revoked for some countries in recent years amid falling vaccination rates.
For Virginians, proximity to South Carolina adds urgency. Travel, sports tournaments, family visits and commerce routinely carry people across state lines, and the virus can spread through airborne particles that linger for up to two hours in indoor spaces. With clusters identified in other states linked to South Carolina’s outbreak, health departments emphasize that an outbreak anywhere can threaten communities everywhere, especially where immunization gaps exist.
Clinicians are also being warned to refresh themselves on the measles virus. Many younger providers have never seen a case firsthand. Classic symptoms typically appear 7 to 14 days after exposure, with High fever, cough, runny nose, and irritated, red eyes being common. A telltale rash often begins at the hairline and spreads downward across the body. Small white “Koplik spots” may appear inside the mouth early but can be missed. Laboratory confirmation relies on PCR testing of respiratory samples, ideally within three days of rash onset, with serologic testing as a backup. Because patients are infectious from four days before to four days after the rash appears, immediate masking, isolation and airborne precautions are critical in clinics and hospitals to prevent further spread.
Complications are not rare. More than half of pediatric patients can develop pulmonary issues such as primary viral pneumonia or secondary bacterial infections. Other complications include ear infections, diarrhea, myocarditis and, in rare cases, brain inflammation and blindness. Globally, measles caused an estimated 100,000 deaths in 2023, with the greatest risk for infants, pregnant women, and those with weakened immune systems. In the United States, mortality has been estimated at roughly 1 to 3 deaths per 1,000 infections, with higher risk in crowded conditions or where malnutrition
is prevalent.
Public health guidance in Virginia remains straightforward, check your vaccination status, ensure children receive two doses of MMR the first at 12–15 months and again at 4–6 years. If you think you’ve been exposed or develop symptoms, isolate and call a healthcare provider before arriving in person. Adults who lack documentation may need vaccination, particularly if they work in healthcare, attend postsecondary institutions or plan to travel internationally. The Virginia Department of Health reports that approximately 95% of kindergartners in the Commonwealth are fully vaccinated, which helps keep overall risk low, but gaps in coverage can still allow the virus to find footholds, especially during regional surges like the one unfolding to the south.
State and federal agencies are supporting outbreak response with funding, coordination, and public information campaigns. While some national debates have centered on alternative treatments, leading health authorities continue to emphasize that vaccination is the most effective means of prevention. Vitamin A supplementation can reduce severe complications in infected children, but it is not a substitute for immunization, and timely isolation remains crucial to protect schools, healthcare settings, and vulnerable populations.
As Virginia monitors exposures and prepares for potential spillover, experts say the path to preventing wider spread is well known, restore and maintain high vaccination coverage, rapidly identify and isolate suspected cases, and communicate clearly with the public about risks and protections. In a region where state borders are open and daily life crosses them, the stakes are shared.
For more information about potential exposure sites and vaccination guidance, residents can consult the Virginia Department of Health and contact local health departments for assistance.
