TUESDAY MEASLES UPDATE: DPH Reports 20 New Measles Cases in Upstate, Bringing Outbreak total to 176
COLUMBIA ― The South Carolina Department of Public Health (DPH) is reporting 20 new cases of measles in the state since Friday, bringing the total number of cases in South Carolina related to the Upstate outbreak to 176 and the total number reported to DPH this year to 179.
Seven of the new cases were known household exposures, five resulted from a previously reported school exposure, two resulted from an exposure at church, and one resulted from an exposure at either school or church. The sources of four cases are unknown, and one is still being investigated.
There are currently 287 people in quarantine and two in isolation. The latest end of quarantine for these is January 21.
Although complications from measles are not reportable, DPH has learned that three people, including adults and children, with measles required hospitalization for complications of the disease. To protect privacy, DPH does not provide personal details or specifics of the clinical status of cases.
DPH encourages those potentially exposed to notify a health care provider of a possible measles exposure before seeking care to allow arrangements to be made in clinical settings to protect others as clinical sites have also been settings of public exposures.
A person with measles is contagious from four days before the rash appears through four days after its onset, meaning people with mild symptoms can spread measles before they know they have the disease. To help stop the spread of measles, it is very important for those who have even mild illness or are in quarantine to stay home to protect others. We encourage employers to support workers in following DPH recommendations to stay out of work while ill or in quarantine which also protects businesses, other workers and clients.
Vaccination continues to be the best way to prevent measles and stop this outbreak. Vaccines are also available at many primary care provider offices and pharmacies, as well as DPH Health Departments.
Any community partners or organizations interested in scheduling a vaccination event from DPH’s Mobile Health Unit can request a visit to their location by completing a form on our website. DPH will prioritize requests for MMR vaccination events, if received, and will also take steps to increase appointment availability for MMR vaccination in health department locations, should demand dictate.
Outbreak Data Points
Age breakdown of 176 cases:
Under 5: 36
5-17: 119
18+: 15
Minors under 18 (age undisclosed): 6
Vaccination status:
165 unvaccinated, 4 partially vaccinated with one of the recommended two-dose MMR sequence, 1 vaccinated, 4 unknown, and two still being investigated.
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COMMENTARY
Measles Vaccination as a Public Health Investment, Not an Expense
By Joey Mattingly
As of this month, the Centers for Disease Control and Prevention has recorded more than 1,700 measles cases, the most in three decades. These cases stemmed from 45 reported outbreaks, a sharp increase from just 16 in 2024. Over 200 patients have been hospitalized and three have died.
The human toll of these outbreaks is significant -- especially given that measles is entirely preventable when vaccination rates remain near the 95% threshold needed for herd immunity. But beyond the devastating health consequences, the spread of measles creates an economic burden for patients, health insurance companies, and our government. My math suggests that a 1,500-case outbreak costs the United States anywhere from $16 million to $199 million in direct medical expenses, lost productivity, and public health spending.
This financial toll could grow exponentially in the years ahead if vaccination rates continue dropping further below the herd immunity threshold, resulting in more outbreaks. Currently, less than 93% of kindergarteners are vaccinated against the measles. If measles vaccination rates decline by just another 10%, the economic challenges could grow exponentially.
This reality underscores the need to redouble vaccination efforts against the measles and other once-common childhood diseases -- so that Americans don't waste hundreds of millions of dollars responding to infections that could have been prevented for pennies on the dollar with vaccines.
The measles virus is extraordinarily contagious. One infected person spreads the disease to 15 others, on average. Before the first measles vaccine became available in 1963, the disease infected three to four million Americans each year, hospitalizing tens of thousands and killing hundreds. That's why herd immunity is so essential: it's harder for a disease to tear through a community if most people are immune.
The direct costs of any measles outbreaks are relatively easy to measure -- simply add up all the medical bills tied to treating the disease.
Measuring indirect costs is a bit trickier, since the figure must account for lost productivity and lost wages while patients recover and the resources that families devote to caregiving.
Then there's the costs to health departments and state and local governments for expenses related to contact tracing, emergency pop-up clinics, and surge staffing.
Using the midpoint estimates from past measles outbreaks, modeling suggests that a 1,500-case outbreak this year would require about $9 million in direct healthcare spending, would cause productivity losses of $26 million, and necessitate public health spending of $55 million -- for a total cost of $90 million. But that figure could be as low as $16 million or as high as $199 million, depending on variables such as the share of infections that require hospitalization.
Michael Baker of the American Action Forum recently arrived at similar numbers when analyzing this year's largest single outbreak, where 762 people in West Texas fell sick, 99 were hospitalized, and two sadly succumbed to the highly infectious virus.
By his estimate, the Texas outbreak generated an estimated price tag of $35.4 million.
Vaccinating those 762 people, by contrast, would have cost between $40,000 and $115,000 in total.
And that's just for the measles.
Simply put, government spending on immunization programs offers taxpayers a staggering return on their investment by preventing exponentially greater expenses in the future. Reversing the decline in vaccination rates won't just save lives. It'll save our economy too.
Joey Mattingly, PharmD, MBA, PhD, is an associate professor and vice chair of research in the Department of Pharmacotherapy at The University of Utah College of Pharmacy. This article originally appeared in RealClearHealth.
