Measles behind all deaths, not just suspected cases

Children are dying from measles. Experts have said that if measles symptoms are present, such deaths can also be considered measles-related.

Confusion has arisen among the public over deaths from measles and deaths with measles symptoms. This confusion has been created by the Directorate General of Health Services (DGHS), which has described some deaths as “suspected measles” in its press releases.

Since mid-March, various media outlets, including Prothom Alo, have been reporting the number of child deaths from measles. The Bangladesh Shishu Hospital and Institute in Sher-e-Bangla Nagar and the Infectious Diseases Hospital in Mohakhali initially provided figures on measles deaths.

However, at one point, the Directorate General of Health Services introduced a distinction. Its Integrated Control Centre began categorising some deaths as confirmed measles deaths and others as suspected measles deaths. Experts say that if symptoms of measles are present, all such deaths should be considered measles deaths.

This view was expressed at a joint meeting of the National Immunization Technical Advisory Group (NITAG) and the National Verification Committee (NVC) held on 12 April. NITAG is the highest national technical body advising the government on vaccination, while NVC evaluates the quality and capacity of disease detection systems in the country.

The meeting, chaired by noted scientist Firdausi Qadri, was attended by NVC chairperson and former director of the Institute of Epidemiology, Disease Control and Research (IEDCR), Professor Mahmudur Rahman, along with senior officials from the Ministry of Health, the Directorate General of Health Services, and representatives from UNICEF and the World Health Organization (WHO).

In the third week of last month, the Infectious Diseases Hospital told Prothom Alo that 22 people had died of measles. On 19 April, it reported 32 suspected measles deaths and two confirmed deaths. In this case, information published in the media may give rise to confusion among readers.

For cases where samples from deceased children could be tested, the directorate reports confirmed deaths. However, it has not been able to test samples from all affected children. In those cases, the deaths are classified as suspected measles deaths.

Data from the directorate’s Integrated Control Centre released yesterday, Thursday, show that this year there have been 194 suspected measles deaths and 39 confirmed measles deaths. In reality, 233 children have died from measles this year.

Professor Fowara Tasmim, additional director general (development) of the Directorate General of Health Services, told Prothom Alo, "It can be assumed that all those who have died were infected with measles."

"However, without laboratory tests, it should not be stated that all of them died of measles. Out of 100 cases, perhaps one death may not have been due to measles. Just because it could not be tested, that one case should not be classified as a measles death," she added.

However, a public health expert who attended the joint NITAG–NVC meeting told Prothom Alo that those showing symptoms of measles or admitted to hospital with such symptoms are measles patients, and their deaths are caused indeed from measles.

Public health expert and former chief scientific officer of IEDCR, Mushtuq Husain, said that anyone with measles symptoms is a measles patient. Describing deaths as “suspected measles” creates doubt among the public.

People may think the government is underreporting deaths. Providing accurate information is essential to tackling an outbreak, and confusion only worsens the situation, he added.