Copyright Charleston Post and Courier

The measles outbreak in Upstate South Carolina continues to spread, with four new cases confirmed, the Department of Public Health announced Oct. 31. The outbreak has now sickened 34 people, and the state has seen 37 total cases since July. The four new cases were all close contacts of previous cases, the department said. No other information was released about the new cases. The department is working to isolate and quarantine those who have had close contact with known cases in an effort to limit the spread of the highly infectious virus. The outbreak was first identified Oct. 2 in a cluster of cases centered around two schools in Spartanburg County — Fairforest Elementary and Global Academy of South Carolina. A gym in Greenville and an unnamed Spartanburg business were also identified as sites where cases emerged in the outbreak. In eight cases identified earlier in the week, the state emphasized that the new cases had no school contacts. Dr. Linda Bell, the state epidemiologist, said they also were not tied to the Spartanburg business. State officials have said they expect more cases because the virus appears to be circulating in the community. All but one of the previous cases were unvaccinated. One person had received one dose of the measles, mumps and rubella vaccine, which is short of the recommended two doses, public health said. The MMR vaccine is safe and highly effective at preventing infection from measles, offering a 97 percent or greater lifetime protection with two doses, doctors previously told The Post and Courier. DPH has community health workers in Spartanburg County, the epicenter of the outbreak, to do outreach with the public about measles and the vaccine, Bell said. The department is also offering no-cost vaccine through mobile clinics in Spartanburg County and so far 28 people have received doses, 23 adults and five children. More vaccine is available at the following days and times: