Buncombe County Hospitals, Inexperienced Clinicians Confront Growing Measles Cluster

Buncombe County public‑health officials and state investigators have tracked a measles cluster that produced six confirmed local cases by late January and was reported at seven cases by mid‑February, while a Centers for Medicare & Medicaid Services survey tied a Jan. 4 emergency department exposure at Mission Hospital in Asheville to at least 26 additional infections. CMS investigators found the two patients who arrived Jan. 4 were not isolated for more than two hours and said that failure violated the facility’s infection control policy.

County records show Buncombe County issued an exposure warning about the Jan. 4 emergency department event on Jan. 6 and released another exposure report tied to Mission on Jan. 16. Local reporting noted a new child case reported Jan. 20 that brought Buncombe’s total to six cases since December 2025, and state reporting as of Jan. 28 listed 14 confirmed cases across North Carolina with 83 people asked to quarantine.

Federal surveyors’ findings outlined more granular concerns inside Mission Hospital: patients at the Jan. 4 event were separated from others only by plastic partitions, the Jan. 4 incident occurred despite training that CMS said had taken place seven months earlier, and CMS designated the situation an Immediate Threat or Immediate Jeopardy. Citizen‑Times and union leaders have linked those infection control breakdowns to staffing shortages and resource strains at Mission since HCA Healthcare purchased the system in 2019; CMS records cited at least the fourth Immediate Jeopardy citation since the 2019 sale. Mission spokesperson Nancy Lindell said, “Our hospital has been working with state and federal health officials on proactive preparedness, and we are following guidance provided by the CDC.”

Buncombe County’s public exposure notices list two clinic events with precise locations and watch windows: Novant Health – GoHealth Urgent Care, 349 New Leicester Highway in Asheville, Feb. 4 from noon to 3:45 p.m., symptoms to be watched through Feb. 25; and MAHEC Family Health Center, 123 Hendersonville Road in Asheville, Feb. 6 from 2:45 p.m. to 7:30 p.m., watch through Feb. 27. The county advises anyone who was at those sites and has not been contacted to call the N.C. Public Health Outreach Team at 844‑628‑7223. Buncombe Public Health Director Dr. Ellis Matheson urged callers to call ahead before visiting providers: “To help stop the spread of this highly contagious disease, please call ahead and let them know your symptoms.”

Clinicians in North Carolina and nationally are facing diagnostic and experience gaps: reporting cited clinicians who have never seen measles, and a clinical explainer used the term morbiliform, noting, “There is the word morbiliform - it means a rash similar to measles, and there are many viruses that can cause a rash in children.” Theresa Flinn, president of the North Carolina Pediatric Society, said, “In my 30 years in health care, I have never seen a measles case like this.” CNN reporting noted a local private school quarantined about 100 students after an exposure and that state data showed only 41 percent of students at that school were immunized.

Public‑health agencies are following CDC infection control guidance that advises immediate placement of suspected measles patients in negative‑airflow isolation rooms and warns the virus can linger in the air for up to two hours and that a person is contagious four days before and four days after a visible rash. State epidemiology briefings in mid‑February warned more cases were likely and raised concern that Buncombe could follow the trajectory of the large Upstate South Carolina outbreak, which media reports cited as approaching 800 cases or exceeding 847 in Spartanburg County over four months. Community clinicians and advocates such as Stinchfield criticized federal messaging and resources, saying the lack of stronger federal action is harming children and burdening local health care.

Counts and attributions have evolved—WLOS reported six Buncombe cases as of late January while mid‑February state statements identified seven cases—and source reports differ on the state epidemiologist’s given name (listed as Zack Moore in one source and Jack Moore in another). Buncombe officials including pediatrician Fogleman and Health Department Director Jennifer Mullendore have used county livestreams to urge vaccination and debunk misinformation as contact tracing, quarantine orders and exposure notifications continue.