South Carolina’s Measles Crisis Deepens: Children Face Life-Threatening Brain Swelling
The ongoing measles outbreak in South Carolina has taken a grave turn, with state epidemiologist Linda Bell confirming that several affected children have developed encephalitis, a severe and potentially fatal swelling of the brain. This alarming development underscores the critical public health threat posed by the resurgent disease.
What began as a handful of infections in October has spiraled into a full-blown crisis. As of February 3rd, the state has reported 876 measles cases, with a staggering 700 emerging since the start of the new year. This surge mirrors a troubling national trend, with the United States recording over 2,267 cases in 2025—the highest in three decades. Experts attribute this resurgence primarily to declining vaccination rates across the country.
Encephalitis: A Devastating Complication
Encephalitis is a rare but profoundly serious complication of measles, capable of causing convulsions, deafness, or intellectual disability in children. It typically manifests within 30 days of the initial measles infection, resulting either from the virus directly infecting the brain or an immune system overreaction causing inflammation. Tragically, 10 to 15 percent of children who develop measles encephalitis do not survive.
While state law mandates reporting of measles cases, specific data on hospitalizations and complications, such as encephalitis, are not publicly disclosed. “We don’t comment on the outcomes of individuals, but we do know that inflammation of the brain, or encephalitis, is a known complication of measles,” Bell stated during a recent media briefing. “Anytime you have inflammation of the brain, there can be long-term consequences, things like developmental delay and impacts on the neurologic system that can be irreversible.”
Beyond Brain Swelling: Other Serious Threats
The South Carolina Department of Public Health is aware of 19 measles-related hospitalizations. Beyond encephalitis, other severe complications include pneumonia, which affects approximately one in 20 children with measles and stands as the leading cause of death for pediatric patients. Furthermore, several pregnant women exposed to the virus have required immune globulin administration, a measure to provide temporary protection, as measles during pregnancy can lead to preterm birth or miscarriage.
The Lingering Danger: Subacute Sclerosing Panencephalitis (SSPE)
A particularly insidious and rare form of brain swelling, subacute sclerosing panencephalitis (SSPE), can emerge years after an initial measles infection. Last September, Los Angeles County reported the tragic death of a school-age child due to SSPE. This child had contracted measles as an infant, before reaching the recommended age for the first dose of the MMR vaccine (12 to 15 months). After an apparent recovery from the initial illness, the measles virus remained dormant in the brain, only to later trigger a destructive inflammatory response. SSPE typically appears seven to ten years post-infection and is estimated to affect two in every 10,000 measles patients, slowly destroying brain tissue over time.
The Shield: MMR Vaccine is Key
Amidst these alarming developments, the message from health officials is clear and urgent: the measles, mumps, and rubella (MMR) vaccine remains the most effective defense against measles and its devastating complications. Encouragingly, South Carolina has seen a significant uptake in vaccination efforts. This January alone, over 7,000 more MMR doses were administered statewide compared to January 2025, marking a 72 percent increase. In Spartanburg County, the epicenter of the outbreak, the increase was even more dramatic, with over 1,000 additional doses given—a 162 percent jump. According to Bell, January has been the most successful month for measles vaccination during the current outbreak, offering a glimmer of hope in an otherwise concerning situation.
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