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South Carolina health officials say there have now been more than 550 cases since the outbreak began in October, mostly among unvaccinated children.
North Carolina has up to eight cases of measles in counties near the state line.
Most of North Carolina's cases have confirmed links to its sister state.
The South Carolina Department of Public Health is still tracking down exposure locations with varying degrees of success.
One school district reported its first case of measles Thursday after checking in on a student who hadn't attended school for about a week.
The school district's chief information officer says they hadn't been informed of the case.
For NPR News, I'm Luis Alfredo Garcia in Columbia, South Carolina.
State health officials say the count of in-state cases related to the outbreak is up to 311.
South Carolina had just topped 200 cases Tuesday.
Now it has the top spot in total measles cases of any state with an active outbreak.
The other outbreaks are in Arizona and Utah.
A county that borders North Carolina is still the epicenter of the outbreak, but it's spreading.
Cases are now confirmed in Greenville, South Carolina, where more than 70,000 people live.
State epidemiologist Dr. Linda Bell says there are likely hundreds of people exposed to measles who have no idea they should be in quarantine and that tracking down exposure sources has become more difficult.
For NPR News, I'm Luis Alfredo Garcia in Columbia, South Carolina.
State health officials say the count of in-state cases related to the outbreak is up to 185, and it's in a county that borders North Carolina.
The county has the lowest school vaccination rate of any county in South Carolina.
Exposure spreads throughout households and schools for the most part, but it is affecting kids at a higher rate than cases in other states with current outbreaks.
South Carolina's Department of Public Health reports about 90% of its 2025 measles cases were in children.
Cases in the outbreak along the Arizona-Utah border are not as child-heavy.