More than 150 unvaccinated students across two schools in Spartanburg County, South Carolina, have been placed under a 21-day quarantine due to exposure to a measles outbreak. This measure, announced by state health officials, follows a rise in measles cases in the region, with at least eight confirmed cases in the current outbreak and a total of 11 reported in South Carolina this year as of Wednesday, October 9, 2025.

The affected schools are Global Academy of South Carolina, a public charter school, and Fairforest Elementary, a public school within Spartanburg School District 6. All unvaccinated students exposed at these institutions have been excluded from in-person instruction and will continue their learning virtually. The South Carolina Department of Public Health (DPH) is actively investigating the outbreak, with some cases having no identified source, suggesting community transmission.

Global and Local Context of Measles Resurgence

This situation in the United States mirrors broader global challenges in controlling measles, a highly contagious viral disease. The Centers for Disease Control and Prevention (CDC) reported a total of 1,563 measles cases in the US in 2025, the highest annual number in over three decades. Globally, the World Health Organization (WHO) noted continued measles outbreaks in 2025 across various regions, including Africa.

In Kenya, measles remains an endemic disease, with recent outbreaks raising concerns among health officials. As of May 2025, over 3,000 cases and 18 deaths were reported in 11 counties across Kenya over the past year. Malindi Sub-County, for instance, reported a measles outbreak in August 2025, with officials citing low childhood immunisation coverage as a significant concern. Turkana County also experienced a protracted measles outbreak due to low immunisation coverage and cross-border transmission.

Policy and Governance in Kenya

The Kenyan Ministry of Health (MoH) has been actively working to combat vaccine-preventable diseases. In July 2025, the MoH launched a nationwide integrated Measles-Rubella (MR) and Typhoid Conjugate Vaccine (TCV) campaign. This 10-day campaign, running from July 5 to July 14, 2025, aimed to vaccinate over 7.5 million children aged 9 months to 5 years with the MR vaccine, targeting 95% coverage. The TCV component targeted 21.5 million children aged 9 months to 14 years, aiming for at least 80% coverage.

Despite these efforts, Kenya's immunisation coverage for the first MR dose stands at 83%, and only 60% for the second dose, falling short of the 95% threshold required to interrupt transmission and prevent outbreaks. The Kenya National Immunization Policy Guidelines, developed in line with the Constitution of Kenya 2010 and Vision 2030, outline strategies for measles control, including providing the first dose of measles-containing vaccines at 9 months and a second dose at 18 months.

Stakeholder Perspectives and Data

Health experts in Kenya emphasize that gaps in immunisation are the weakest link in the fight against measles, particularly with funding cuts impacting vaccine availability. Dr. Linda Bell, South Carolina's state epidemiologist, stressed the importance of vaccination, noting that the MMR vaccine is about 97% effective after two doses and offers lifelong immunity.

The DPH in South Carolina indicated that about 90% of Upstate residents are vaccinated against measles, which is below the 93% threshold for herd immunity. In Kenya, the measles immunisation rate for children aged 12-23 months was 90% in 2022, an increase from 89% in 2021, according to TheGlobalEconomy.com. However, this figure represents the first dose, and the uptake of the second dose remains a challenge.

Risks and Implications

The highly contagious nature of measles poses a significant risk, especially in communities with low immunisation rates. Measles can cause severe complications such as pneumonia, diarrhoea, and encephalitis, and can be fatal, particularly in malnourished young children or those with weakened immune systems. The current outbreaks, both internationally and within Kenya, highlight the potential for rapid spread and the strain on healthcare systems if vaccination rates are not maintained or improved.

Unanswered Questions and Controversies

The unknown source of some measles cases in the South Carolina outbreak suggests undetected community spread, raising concerns about the extent of the virus's circulation. Similarly, in Kenya, despite vaccination campaigns, a significant number of children have not received the recommended two doses of the measles-rubella vaccine, contributing to ongoing outbreaks.

Timeline and Next Steps

In South Carolina, the quarantined students will remain out of school for 21 days from their last exposure. Health officials are considering setting up mobile vaccination sites to increase coverage.

In Kenya, the Ministry of Health continues to integrate measles-rubella and typhoid conjugate vaccines into routine immunisation schedules. Ongoing community sensitisation and stakeholder involvement are crucial to addressing vaccine hesitancy and improving coverage.

What to Watch

The effectiveness of quarantine measures and accelerated vaccination efforts in South Carolina will be critical in containing the current outbreak. In Kenya, monitoring the impact of recent vaccination campaigns and addressing the funding gaps for immunisation will be key to preventing further measles resurgence. The global trend of increasing measles cases underscores the ongoing need for robust public health interventions and sustained vaccination efforts worldwide.