A view outside Clemson Memorial Stadium on the campus of
Clemson University joins growing list of South Carolina institutions affected by measles outbreak that has spread beyond Spartanburg County epicenter to neighboring states and now higher education.

Clemson University confirmed Saturday that an individual affiliated with the institution has tested positive for measles, marking the outbreak's arrival on a major college campus as South Carolina grapples with the nation's worst measles crisis in decades.

The South Carolina Department of Public Health informed Clemson officials of the confirmed case, which comes amid an explosive surge in infections centered around neighboring Spartanburg County. The infected individual has been isolated per health department requirements, and contact tracing is underway for anyone who may have been exposed, according to a university press release.

The confirmation arrives at a critical moment in South Carolina's escalating public health emergency. State health officials reported 558 total measles cases as of Friday, with 124 new infections diagnosed in just three days, representing a nearly 30 percent surge and bringing case numbers that have doubled in the past week alone.

A Campus Largely Protected, But Vulnerable Pockets Remain

According to the most recent data from Clemson's Student Health Services, nearly 98 percent of main campus students have provided proof of immunity. This vaccination rate exceeds the 95 percent threshold epidemiologists consider necessary to achieve herd immunity and prevent outbreaks from gaining traction.

However, that two percent gap represents hundreds of potentially vulnerable individuals on Clemson's main campus, which enrolls approximately 20,000 undergraduate students. In a highly contagious disease like measles, where a single infected person can transmit the virus to up to 18 others in unvaccinated populations, even small immunity gaps can enable transmission chains.

The university has not disclosed whether the infected individual is a student, faculty member, staff member, or visitor, citing privacy considerations during the public health investigation.

Isolation and Quarantine Protocols in Effect

A person infected with measles is contagious four days before and after a rash begins, creating an extended window during which transmission can occur before an individual even knows they are infected. This pre-symptomatic contagiousness makes measles particularly difficult to contain.

Isolation of an actively infectious case lasts until four full days have passed after the onset of the rash, with dates determined by the Department of Public Health. Meanwhile, quarantine for measles is reserved for exposed individuals without documented immunity and lasts for 21 days after the last exposure per DPH guidelines.

If a person without documented immunity receives a dose of the MMR vaccine within 72 hours after the last exposure, they do not have to quarantine, providing a narrow window for post-exposure prophylaxis that can prevent both infection and the disruption of extended quarantine.

The number of Clemson community members potentially subject to quarantine has not been disclosed, though contact tracing efforts are actively identifying anyone who may have been exposed during the infectious period.

The Broader South Carolina Crisis

The Clemson case emerges from what has become a cascading public health emergency across South Carolina's Upstate region. "Over the last seven to nine days, we've had upwards of over 200 new cases. That's doubled just in the last week," Dr. Johnathon Elkes, an emergency medicine physician at Prisma Health in Greenville, South Carolina, said during a media briefing Friday. "We feel like we're really kind of staring over the edge, knowing that this is about to get a lot worse."

The outbreak remains centered around Spartanburg County, with most cases located there. As of the latest update, 531 people are in quarantine and 85 are in isolation statewide, with the expected end date for quarantine extending to February 16.

Of the 558 confirmed cases, 134 involve children under age 5, 372 involve children ages 5 to 17, 39 involve adults 18 and older, and 13 cases have an unknown age. The concentration among school-age children reflects both the outbreak's epicenter in schools with lower vaccination rates and the heightened vulnerability of unvaccinated pediatric populations.

Eight people, including adults and children, have required hospitalization for complications of the disease since the start of the outbreak, though current hospitalization numbers were not disclosed.

Vaccination Rates Below Critical Threshold

The vaccination rate among students in Spartanburg County is 90 percent overall, which is lower than the 95 percent threshold needed to prevent measles. In neighboring Greenville County, the MMR vaccination rate was 90.5 percent for the 2024-25 school year.

However, these county-level statistics mask significant variation at individual schools. State epidemiologist Linda Bell said one school has a vaccination rate as low as 20 percent, creating what epidemiologists call "immunity pockets" where disease can circulate freely.

Spartanburg County has a relatively high number of nonmedical exemptions from vaccines, with about 8 percent of students having such an exemption, a jump from just 3 percent in 2020, according to data published in the Journal of the American Medical Association. These represent parents opting out of required school vaccines for personal or religious reasons.

Low Uptake of Free Vaccinations Despite Crisis

Despite the escalating outbreak and availability of free vaccines, public response has been disappointing. On Wednesday and Thursday, the South Carolina Department of Public Health deployed mobile health units to Spartanburg offering free measles vaccinations. Just 18 people showed up to get the shots: nine adults and nine kids, state health officials reported.

This reluctance to vaccinate persists even as the outbreak spreads to new locations and public exposure sites multiply. Infected individuals visited multiple public locations during their infectious periods, including Walmart on Cedar Springs Road in Spartanburg on Saturday, January 3 from 5 to 8 p.m., Wash Depot on South Pine Street in Spartanburg later that night from 9 p.m. until 1 a.m. on Sunday, January 4, and Bintime Spartanburg on South Blackstock Road on Wednesday, January 7 from 4 to 7:15 p.m.

Schools across Spartanburg County have been particularly affected. Holly Springs-Motlow Elementary has 53 students in quarantine, Campobello Graming School has 46 students in quarantine, and Crestview Elementary has 22 students in quarantine, among other affected schools.

Community Demographics and Outbreak Origins

Dr. Eliza Varadi, a pediatrician in private practice in South Carolina, said the outbreak is centered around a community largely populated by people who immigrated from Ukraine to Spartanburg County within the past few decades. Immigration patterns and varying vaccination practices in countries of origin can contribute to pockets of vaccine hesitancy and lower immunity levels.

The outbreak officially began in October 2025, with cases initially trickling in before exploding after the holiday season. What started as a handful of cases in the fall has become an exponentially growing crisis, with health officials warning that the peak may still be ahead.

Spread Beyond South Carolina's Borders

The outbreak's reach is no longer contained within South Carolina. There have already been six cases in neighboring North Carolina linked to the Spartanburg outbreak. And three measles cases have been confirmed in Snohomish County, Washington, that are also connected to Spartanburg, demonstrating how modern travel patterns can carry infectious diseases across the country rapidly.

Since the holidays, South Carolina's measles outbreak has exploded into the worst in the United States. Measles also have been reported this year in Arizona, Florida, Georgia, North Carolina, Ohio, Oregon, Utah and Virginia, according to the Centers for Disease Control and Prevention.

National Context: Worst Year Since 1991

Last year was the nation's worst for the spread of measles since 1991, according to the CDC. The United States confirmed 2,144 cases across 44 states. Three people died, all of them unvaccinated.

The resurgence of a disease once declared eliminated from the United States in 2000 reflects declining vaccination rates, increased vaccine hesitancy, and the highly contagious nature of the measles virus. Measles is caused by a highly contagious virus that is airborne and spreads easily when an infected person breathes, sneezes or coughs.

According to CDC data, at least 171 measles cases have been reported in the first two weeks of 2026, nearly matching the average annual total seen in the 25 years since measles was declared eliminated.

Contrasting Responses: Fear and Apathy

While some Spartanburg residents remain hesitant about vaccination despite the outbreak raging around them, families in other parts of the state are desperate for protection. "I've been getting phone calls from families saying, 'I want that vaccine, like, yesterday. I want it early. What can I do?'" said Dr. Laura Greenhouse, a pediatrician in Columbia, about an hour and a half south of Spartanburg.

On Wednesday, health officials said that someone visited the South Carolina State Museum in Columbia on January 2 while they were infectious. NBC affiliate station WIS reported that nearly 1,000 people visited the museum that day, creating potential exposure for hundreds of families.

Tim Smith's wife is an assistant teacher in Spartanburg County who despite being vaccinated, caught measles from one of her students and got so sick she had to go to the hospital. Smith told the district school board this week that exemptions in Spartanburg have gotten out of control. "It's absolute insanity," Smith said. "She was totally dehydrated."

This case illustrates that even vaccinated individuals can sometimes contract measles, though vaccines significantly reduce both infection risk and disease severity. The MMR vaccine is approximately 97 percent effective after two doses.

What Clemson Students Should Know

For Clemson students, faculty, and staff, health officials emphasize several key points. Anyone without documented proof of immunity should consider getting vaccinated immediately. The MMR vaccine is available through Student Health Services, local pharmacies, and health departments.

Measles symptoms to watch for typically begin 7-12 days (but up to 21 days) after exposure, and include cough, runny nose, and red watery eyes, and fever followed by a rash two to three days later that starts on the face then spreads to the rest of the body.

Anyone experiencing these symptoms should isolate immediately and contact healthcare providers by phone before visiting to prevent potential exposure in waiting rooms and clinical settings. Healthcare facilities have specific protocols for evaluating potential measles cases that minimize transmission risk.

Students living in residence halls should be particularly vigilant, as the airborne nature of measles means the virus can linger in rooms and enclosed spaces for up to two hours after an infected person leaves. Adequate ventilation and avoiding shared spaces when symptomatic can help reduce transmission.

Looking Ahead: An Uncertain Timeline

"We have lost our ability to contain this with the immunity that we have," state epidemiologist Linda Bell said, urging people to get vaccinated. Her stark assessment reflects the reality that with vaccination rates below the herd immunity threshold and hundreds already infected, traditional containment strategies may prove insufficient.

The coming weeks will be critical for determining whether the outbreak continues its exponential growth or begins to plateau. Public health officials continue to emphasize that vaccination remains the most effective tool for protecting individuals and communities.

For Clemson University, the challenge will be maintaining normal academic operations while protecting vulnerable community members. With spring semester underway, large lecture halls, dining facilities, and residence halls create numerous opportunities for transmission if additional cases emerge on campus.

The university has encouraged anyone with questions or concerns to contact Student Health Services and to monitor the South Carolina Department of Public Health's outbreak webpage, which is updated regularly with new exposure locations and guidance.

As South Carolina confronts its worst measles outbreak in decades, the appearance of the disease on a major university campus underscores that no community remains insulated from the consequences of declining vaccination rates and the resurgence of vaccine-preventable diseases.

Originally published on University Herald