The baby lies quietly, largely unimpressed with the shade-dappled idyll of Cleveland Park on a breezy, sunny Wednesday morning. His parents coo and grin and make noises only infants find amusing. They’re trying to take pictures of him smiling in his pearl-white onesie. Were his first words what the?!, it would hardly be a surprise.
I intrude upon this happy moment to ask the parents if they are concerned about the cluster of measles cases in Spartanburg. At the time I ask, 12 of the 16 confirmed cases of measles in South Carolina were in Spartanburg County.
The young mom, who didn’t give her name, responded: “I don’t know what [measles] is.” The father, and another woman who also didn’t give her name, said they had not heard of measles either.
Just down the road from Cleveland Park, the emergency room and medical buildings that make up the Spartanburg Regional Healthcare System’s medical complex are largely quiet. Few visitors or workers are masked and none of the patients pay much attention to the sandwich board signs posted at all public entrances.
“Stop,” it says. “Do you have symptoms of measles?” From there it lists the symptoms that could mean you have contracted the virus – cough, runny nose, red eyes, and rash.
A couple with a little girl leave the outpatient wing of the hospital. She holds her father’s hand and can’t take her eyes off her reflection in the sliding glass door. She was not there about measles; her parents also expressed no concern.
In Spartanburg Regional’s pediatric wing, I wait to meet Dr. Jack Cleland. Before he finds me, I chat with an SRHS employee about why I’m here. His wife, the employee says, does not keep up with news or social media. She also didn’t know that measles had even broken out.
And while it’s not wise to extrapolate how an entire county feels about measles based on a few interactions, it is safe to say that there are no significant signs of concern in or near Spartanburg Regional Medical Center.
“Not a lot of people are panicking,” Dr. Cleland says. He’s getting a lot of questions about measles, he says, but Dr. Cleland had yet to see a measles case himself by Wednesday afternoon.
He attributes the lack of panic, and his lack of exposure to measles cases, to the fact that vaccination against the disease was so successful that it effectively took concern off the table for Americans.
“As a pediatrician, it's scary to say, there's a lot of things that I've vaccinated against I've never seen,” he says. “So you’re really having to polish up your book knowledge because you certainly don't have the street knowledge of it right now. Most physicians in our world haven't seen a lot of these diseases.”
Measles certainly qualifies. The disease was considered eradicated in the U.S., and nearly every adult has either been exposed to the virus or been inoculated with an MMR – measle, mumps, rubella – vaccine since childhood. Spartanburg, like the rest of the state, “has herd immunity,” he says.
The outbreak, then, while concerning to Dr. Cleland, is not leading to a medical crisis among the vaccinated.
“The group of people that we really are the most concerned with are the unvaccinated and the kids that are under a year old,” he says.
That number could certainly grow.
The percentage of school-age children who are vaccinated with required immunizations to attend public schools in South Carolina is lowest in the Upstate. For the 2024-25 school year, the state Department of Public Health reported that 92.8% of students in the Upstate received required immunizations. That number dropped from 96.2% in the 2020-21 school year.
All four regions have seen a drop in vaccinated students since 2021, but the falloff for Upstate students is the largest. Spartanburg County reported that 90% of students were immunized for last school year. That’s the third-lowest rate among counties in the state behind Fairfield (89,4%) and Jasper (82.5%).
Spartanburg County also has the highest current rate and highest total number of students in the state who are unvaccinated because of religious exemption – 4,783 students, making up 8.2% of the county’s school-age population.
The county’s measles outbreak has so far concentrated in two schools – Global Academy of South Carolina, a charter school, and Fairforest Elementary School, which is part of Spartanburg County School District 6.
Cynthia Robinson, chief communications officer for the school district, confirmed Wednesday that four of the 12 cases confirmed in the Upstate happened at Fairforest. She said the school district has followed DPH protocols for deep cleaning, adding: “We do want parents to know that there are no other confirmed cases of the measles at any of our other District 6 schools at this time.”
Representatives from Global Academy did not respond to a request for comment before this story published.
As of Thursday, more than 150 unvaccinated children were being quarantined in the county.
This is not like Covid
While measles is highly contagious – it is airborne and droplets can hover for two hours – the outbreak happening across the U.S. is not like Covid, Dr. Cleland says. It will not shut down businesses and transportation systems. And even as it spreads – as state health officials expect it will – Dr. Cleland doesn’t expect things to get out of control.
“We've learned a lot of lessons after Covid about how fearful to be with these things and how to handle these things,” he says. “We certainly don't want to scare everybody into the point of running out of toilet paper everywhere again.”
And it’s hard for him to say exactly how to avoid measles exposure because, unlike Covid, it doesn’t take any kind of physical contact to contract measles.
But again, he says, high MMR vaccination rates and existing natural immunity among those born before the mid-1950s, will contain any future measles cases almost entirely among the relatively small unvaccinated population.
DPH is hosting mobile MMR vaccination clinics in Spartanburg from Oct. 16 until Oct. 23. For a schedule, click HERE.
“One vaccination, believe it or not, for about 90% of the population is all they really, truly need for their whole life,” Dr. Cleland says. “We do that second booster to catch that other 10% or so that might need it.”
MMR vaccinations are typically started at age 1, but under the current outbreak, children can get a vaccination at 6 months.
“The caveat is, it doesn't count towards your two-dose series for kindergarten,” Dr. Cleland says.
If you do contract measles, the telltale symptom is a rash on the face. Dr. Cleland says that nervous parents worried about a rash need not worry that it means measles unless it starts on the face. Mostly, he says, anyone who contracts measles will have what feels like a bad cold.
But that leaves physicians having to assume that it’s not a cold until measles can be ruled out, he says.
The danger of measles, however, is that it can cause encephalitis in some people.
“That dreaded complication where it can attack your brain is what's the most fearful part,” Dr. Cleland says. “That's the main reason for that vaccination.”
If you're unvaccinated and catch measles, he says, “sometimes even upwards of a year later, you can actually also develop almost like an autoimmune reaction against your brain. Even five to seven years later, after you've gotten it and you had a normal life.”
The future could be scarier, but not because of measles
Of more concern to Dr. Cleland than measles is what else an increasing number of children are not vaccinated against.
“We were talking about other diseases like polio that we vaccinate against,” he says. “Measles, thank goodness, for the most part, it's a viral course. It will run its course and you'll be fine afterwards. But there are other diseases that[like] polio that aren't quite so forgiving. And, and you'll see a lot more long-term problems from those. And so that's my big fear.”
Measles, Dr. Clelend says, can be “very scary. It's very contagious. But there's some other ones that we vaccinate [against] and, in my opinion, [are] a little scarier.
