South Carolina’s ongoing measles epidemic has taken a harrowing turn. State health officials confirmed Wednesday that children infected in the recent outbreak are now developing encephalitis—a severe and occasionally fatal inflammatory brain disorder.
The complication, characterized by brain swelling, can manifest in devastating ways, including convulsions, permanent intellectual disabilities, and death. While the exact number of pediatric encephalitis cases remains unspecified, South Carolina’s state epidemiologist, Dr. Linda Bell, warned reporters of the grim prognosis for those affected.
“There can be long-term consequences, things like developmental delay and impacts on the neurologic system that can be irreversible,” Bell said, emphasizing the state’s goal to prevent this potential complication in all patients.
A Pediatric Crisis by the Numbers
Data released Tuesday by the South Carolina Department of Public Health underscores that the burden of this outbreak is falling almost entirely on minors. Of the state’s 876 confirmed cases:
- 233 cases are in children under the age of five.
- 555 cases are in those between the ages of five and seventeen.
Encephalitis typically manifests within 30 days of the initial measles infection. The stakes for these children are high; historically, and as noted by Wired, roughly 10 to 15 percent of children who develop measles encephalitis do not survive.
Beyond Brain Swelling: Hospitalizations and Pneumonia
Encephalitis is only one facet of the clinical damage officials are tracking. Since the epidemic began in October, South Carolina has recorded 19 hospitalizations for measles-related complications. This includes several instances of pneumonia—a secondary infection that remains one of the leading causes of child mortality globally.
“Increasing vaccination coverage protects those who cannot be vaccinated, such as young infants, pregnant women, and those with weakened immune systems,” Bell stated. “These are complications we hope to prevent.”
The data highlights a clear driver for the current crisis: a staggering 95 percent of cases occurred in unvaccinated individuals. While several outbreaks have surfaced across the U.S. since last year, South Carolina’s current surge has now surpassed the massive West Texas outbreak to become the largest in decades.
The Toll of Misinformation
Measles was technically eliminated in the U.S. in 2000, thanks to the high efficacy of the measles-mumps-rubella (MMR) vaccine. Two doses provide 97 percent of recipients with lifetime immunity. However, that public health achievement is being dismantled by vaccine hesitancy and the spread of false information.
Dr. Sruti Nadimpalli of Stanford Medicine noted that a dangerous “misconception” persists regarding the virus’s severity.
“There’s also a misconception that measles is just a routine childhood infection, that it’s not consequential,” Nadimpalli said in a statement. “In actuality, it weakens the immune system and has very serious side effects, such as severe debility and death.”
A Shift in the Palmetto State
Despite the rising case counts, there are indications of a shift in public behavior. Bell reported that last month saw the most significant spike in immunizations in South Carolina since the start of the COVID-19 pandemic.
While the surge in vaccine uptake is a positive metric for herd immunity, Bell reminded the public of the vaccine’s limitations in an environment with high viral circulation. “The MMR vaccine is one of the most effective vaccines in preventing infection, but no vaccine offers 100% protection against infection,” she concluded.