By Ruma Paul
DHAKA, Sept 9 (Reuters) – Bangladesh, which once came close to eliminating measles, is facing its worst outbreak on record, with 999 suspected and confirmed measles-related deaths reported since March as hospitals struggle with overcrowding, shortages and a continuing influx of sick children.
The prolonged outbreak, despite a nationwide emergency vaccination campaign launched in April, follows disruption to routine immunisation in 2024 and 2025, experts said, when the country was going through political turmoil after a deadly uprising against then prime minister Sheikh Hasina.
Bangladesh is currently experiencing the biggest measles outbreak in the world, according to a list on the United States Centers for Disease Control and Prevention website.
Health officials and experts said missed vaccinations and vaccine supply problems as a result of the political upheaval had left children vulnerable, particularly infants under nine months who are too young to get routine vaccinations, helping fuel transmission across age groups.
Since the outbreak emerged in March, Bangladesh has recorded more than 166,000 suspected measles cases, including 19,835 laboratory-confirmed infections, according to Health Ministry data. The outbreak has been linked to 999 deaths, including 100 confirmed measles fatalities, while more than 146,000 suspected patients have been hospitalised.
IMMUNITY GAPS
Experts blamed the outbreak on weak programme oversight, insufficient monitoring and procurement policy changes under the interim government that replaced Hasina, disrupting vaccine availability and leaving many children unprotected against the highly infectious disease.
Health Minister Sardar Md. Sakhawat Husain told parliament on Monday the procurement changes triggered a vaccine shortage, while the 2024 postponement of a vaccination programme and the cancellation of a nationwide measles-rubella campaign the following year left more children vulnerable to infection.
The World Health Organization, UNICEF and other health agencies have also pointed to the disruption to immunisation schedules. Under-fives accounted for about 80% of cases during the early stages of the disease’s spread.
The outbreak follows years of progress towards measles elimination. Bangladesh maintained high measles vaccination coverage for much of the past decade, with rates staying at or above the 95% level recommended by the WHO for most of the period, apart from a dip during the COVID-19 pandemic.
“Bangladesh missed its measles elimination target because of vaccination gaps in 2024 and 2025,” said Professor Mahmudur Rahman, an epidemiologist and former director of the Institute of Epidemiology, Disease Control and Research.
“To my knowledge, Bangladesh has never witnessed so many children dying from measles. Nor have we ever seen such a high number of patients in a single year. This is a truly terrible situation, and the saddest part is that the victims are children,” he said.
Rahman said closing immunity gaps, increasing vaccination coverage and stepping up public awareness were immediate priorities to contain the outbreak.
HOSPITALS UNDER STRAIN
Hospitals are struggling to cope with the surge in measles cases at a time when growing numbers of dengue patients are putting additional pressure on an already overstretched healthcare system.
More than 45,000 people have been admitted to hospital for dengue this year, according to health ministry data. On Tuesday, dengue deaths rose to nine, while admissions climbed to 1,571, both daily highs for the year.
“Patients are pouring in, and it is very difficult to accommodate everyone,” said Dr. Nanda Dulal Saha, acting director of the state-run Shaheed Suhrawardy Medical College Hospital in Dhaka, adding the hospital currently had 60 beds for measles patients, but many were being treated on the floor.
Saha said a shortage of paediatric saline, which can help alleviate the symptoms of measles, was complicating the situation.
The hospital, designed for 1,350 patients, is currently caring for more than 2,350, he said.
For families, the outbreak has meant weeks of uncertainty, repeated hospital visits and mounting costs.
Nasima Begum, 35, a house help, said her 13-month-old son contracted measles nearly two months ago. After failing to secure a bed at four hospitals, he was finally admitted and discharged 10 days later, but continues to suffer recurring fever and has yet to fully recover.
Begum said her son missed his vaccination because he was sick. When they returned to the vaccination centre later, they were told the vaccine was unavailable. Unlike her youngest son, her four older children had received their routine vaccinations.
Mohammad Ripon, a factory worker, said his eight-month-old daughter developed a rash and other measles-like symptoms days after being discharged from hospital, forcing the family to seek treatment at multiple facilities before turning to a dedicated measles hospital for answers.
“We are just hopping around from one hospital to another,” Ripon said. “We are not getting the correct information at all.”
Bangladesh’s emergency measles-rubella vaccination campaign targeted about 18 million children aged six months to under five years. More than 19.7 million children have since been vaccinated, according to health ministry data, but experts said stronger routine immunisation and catch-up campaigns were still needed.
The twin health crises of measles and mosquito-borne dengue, a debilitating illness linked to warmer temperatures and urbanisation, underscore the challenge facing Bangladesh’s health system in maintaining routine services while responding to preventable infectious diseases.
Although measles is one of the world’s most contagious diseases and typically causes fever and a tell-tale rash, it can be prevented with two doses of vaccine.
“We are poor and cannot afford treatment. I only pray that my son recovers,” Begum said. “I don’t want any other mother to see her child suffer or die from this disease.”
(Reporting by Ruma Paul, additional reporting by Jennifer Rigby and Sam Jahan; Editing by Krishna N. Das and Kate Mayberry)
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