Scotland County had a measles scare in January.
A patient at a local urgent care had symptoms that are common with the infectious disease, which can include a high fever, red eyes, and a rash. Medical providers then contacted Amanda Holland, director of the Scotland County Department of Health and Human Services.
The patient ultimately didn’t have measles. But health officials had reason to be worried: North Carolina has seen 24 measles cases since the start of December, according to the N.C. Department of Health and Human Services.
Most of the cases have been in Buncombe and Polk counties in western North Carolina. But Scotland County borders South Carolina, which is experiencing the largest measles outbreak in the United States. The state had 997 cases as of March 17, mostly in Spartanburg County in the northwestern corner of the state, according to the South Carolina Department of Public Health.
“We were concerned,” Holland told the county health and human services department’s advisory board members on March 19. “We’re kind of situated between that.”
Holland and her team decided to focus on increasing measles vaccination rates among Scotland County children. The Centers for Disease Control and Prevention says the two-dose measles, mumps, and rubella (MMR) vaccine is the best way to protect against the highly contagious disease, which is caused by a virus and infects a person’s respiratory tract.
When theBorder Belt Independent asked the Scotland County Health and Human Services Department about measles vaccination rates in schools in January, officials identified two schools that fell below the 95% vaccination threshold the CDC says is necessary to protect against a measles outbreak. In the 2024-2025 school year, Sycamore Lane Primary School had a vaccination rate of 87.5%, and Wagram Elementary School had a 92.7% rate.
Health officials reached out to Nicole Monroe, a school nurse supervisor, to get more of the schools’ students vaccinated. Thanks to Monroe’s efforts, Sycamore Lane now has a vaccination rate “well above” the 95% threshold, said Clerissa Butler, lead immunization, communicable disease, and tuberculosis nurse at the county health department.
“I’m hoping the same for Wagram,” said Butler, adding that the health department is waiting for parents’ approval to vaccinate students there.
County health officials plan to encourage families to vaccinate their children against measles during back-to-school efforts this summer, Butler told the advisory board. North Carolina requires all public school students to have both doses of the MMR vaccine by kindergarten.
The state offers medical and religious exemptions. Non-medical exemptions are on the rise; the percentage of students with a non-medical exemption for one or more vaccines more than doubled between the 2020-2021 and the 2024-2025 school years, according to the CDC. Butler reported that one student at Sycamore Lane Primary School had a religious exemption to the MMR vaccine.
North Carolina has not seen any new cases of measles since the end of February. But one of the most recent exposure notices came from nearby Cumberland County on March 19. Officials there told residents that an individual who tested positive for measles visited a country club in Fayetteville on March 13.
The Scotland County Health and Human Services Department now screens residents for measles symptoms at its registration desks. Butler said any patient who has measles will receive the MMR vaccine, which is the CDC’s recommended treatment. If a measles patient is pregnant or the MMR vaccine poses risks to their health, they will be given immunoglobulin, which is made from donated human blood plasma that contains antibodies to help fight the disease.
Measles was first considered eliminated in the United States in 2000, but it is at risk of losing that status if cases continue to rise. Last year, the country saw its highest number of measles cases since 1991, according to the CDC, and there have been 14 new outbreaks in 2026.