By Erica Cerutti

Medical experts believe measles-related hospitalizations in South Carolina are significantly higher than reported, since the state does not require hospitals to report admissions for the virus.

South Carolina is experiencing the nation’s largest measles outbreak since the virus was declared eliminated in 2000. More than 970 cases have been confirmed in the state since late October, the majority of which have occurred among unvaccinated individuals, according to data from the state’s health department.

Hospitals in the state have reported 20 measles-related admissions since the outbreak began in the fall, indicating a 2% hospitalization rate. That is likely a significant undercount, with only a handful of hospitals in regions affected by the outbreak having reported hospitalizations, experts told the news outlet.

“A hospitalization rate at 2% is ludicrous,” said Paul Offit, MD, an infectious disease physician and director of the Vaccine Education Center at Children’s Hospital of Philadelphia. “It’s vast underreporting,” he said. “Measles makes you sick.”

Officials with the state health department are urging hospitals to report all measles-related admissions, though cannot force them to do so. The Department of Public Health said it has not added hospitalizations as a reporting requirement for infectious diseases since the primary purpose of public health surveillance is to understand transmission patterns, rather than track complications.

However, physicians say not having an accurate picture of hospitalizations and complications can make the outbreak appear less severe than it is and hinder efforts to clearly communicate the risks to the public, particularly for young children and unvaccinated individuals.

“It’s a very big disservice to the public not reporting complications we are seeing in hospitals or even ERs,” said Leigh Bragg, MD, a pediatrician in South Carolina.

Three more updates on measles outbreaks in the US:

1. Less than two months into the year, case counts are already nearing 1,000. As of Feb. 19, there have been at least 982 confirmed cases of measles in the U.S., according to the latest CDC data. At the current pace, 2026 could far outpace 2025, when 2,280 cases were reported nationwide for the full year.

2. South Carolina has been the hardest hit, with 632 cases confirmed so far this year, according to CDC data. Overall, 26 states have reported measles cases in 2026. Outbreaks are also growing in Utah, Florida and Arizona.

3. As measles outbreaks expand, more hospitals are grappling with exposure incidents, triggering infection prevention protocols and public health notifications. In recent weeks, facilities in Oregon, North Carolina, the District of Columbia, New Jersey, Utah and South Carolina have been identified by state and local health departments as potential exposure sites.