Measles outbreak in Bangladesh, 21 children die in March

A measles outbreak has emerged in Bangladesh, spreading widely across at least seven districts. Reports indicate that 21 children have died from measles in the current month alone.

Experts believe the situation has reached this level due to inadequate attention to measles prevention. There is a gap in vaccination coverage among children.

Measles is highly contagious and spreads rapidly; one infected individual can transmit the virus to 15–18 others. Without immediate intervention, the disease may spread further and increase child mortality.

Speaking to Prothom Alo on Saturday, Moinul Ahsan, director (Hospitals and Clinics) at the Directorate General of Health Services, said, “Measles is present across the country to varying degrees. However, we are seeing higher numbers of patients in Dhaka, Mymensingh, Rajshahi, Pabna, Chattogram, Jashore, and Natore.”

However, authorities at the Infectious Diseases Hospital stated that patients from Narayanganj, Narsingdi, Bhola, and Patuakhali are also receiving treatment at the facility in the capital.

Prothom Alo correspondents have further confirmed cases in Chapainawabganj district.

Information gathered from relevant hospitals shows that, so far, 12 children have died while undergoing treatment at Rajshahi Medical College Hospital, three at Mymensingh Medical College Hospital, three at the Infectious Diseases Hospital in the capital, and three at Chapainawabganj District Hospital.

Nizam Uddin Ahmed, chair of the Steering Committee of Gavi, the Vaccine Alliance, told Prothom Alo, “Recent measles infections in Dhaka and several other districts are deeply concerning for the public health system. If the infection spreads extensively, it may become difficult to control. In this situation, rapid vaccination, strengthened surveillance, ensured supply and enhanced field-level monitoring can help bring the situation under control.”

A visit to the Infectious Diseases Hospital in the capital on Saturday afternoon revealed overcrowding and long queues, with many parents holding young children.

Conversations with several attendants indicated that some had come to confirm whether their children had measles, while others sought to determine whether they had chickenpox.

The 100-bed hospital provides treatment for measles, chickenpox, HIV/AIDS, tetanus, black fever and rabies.

On the second floor, only eight beds are allocated for measles patients; however, as of Saturday afternoon, 117 patients—either confirmed or suspected cases—had been admitted.

Mothers were seen lying with their children in corridors and on floors across different levels of the hospital.

Munni Akhter, who travelled from Baghata village in Narsingdi, was seen staying in a fourth-floor corridor with her one-year-old son, Ahmadullah.

She told Prothom Alo, “My son developed a fever 15 days ago, followed by a rash. We first consulted a local private clinic, which later advised us that he had measles and referred us to this hospital.”

A woman from the Basila area of Dhaka said that staying in the corridor with her one-year-old son was extremely difficult. Despite repeated attempts, she could not secure a bed in any ward.

ARM Sakhawat Hossain, consultant (Child Health) at the hospital, told Prothom Alo, “From 1 January this year until yesterday (Saturday), 450 patients have been admitted with suspected measles. Among them, 70 per cent have been confirmed. Of the 117 patients admitted yesterday (Saturday), around 70 per cent have measles. Three children have died this March. We are receiving a higher number of patients from Mohammadpur and Azimpur.” He added that many infected children had not received vaccination.

Incidentally, 69 measles patients received treatment at this hospital last year.

Hospital authorities are struggling to manage the surge in measles cases. Acting Superintendent Tanzina Jahan told Prothom Alo, “As there are no black fever patients at present, we are using that ward for measles patients. Some AIDS patients have been discharged, and the remaining space is being used for measles cases.”

She also noted the emergence of a new challenge, stating, “It is currently the season for chickenpox. Yesterday (Saturday), 10 patients with chickenpox were admitted. If the number increases, we will face further difficulties, as chickenpox is also contagious.”

The hospital currently has 22 physicians on duty. In response to the rising number of measles patients, the government has deployed an additional six physicians to the facility.

With support from the World Health Organization, authorities tested samples from 153 suspected patients in Rajshahi Division on 18 March. The tests confirmed 44 cases.

As of yesterday (Saturday), 70 patients were admitted to Rajshahi Medical College Hospital.

In Chapainawabganj District Hospital, 70 patients were admitted as of Saturday afternoon, while Pabna Sadar Hospital had 26 patients.

This year, 12 children have died at Rajshahi Medical College Hospital and three in Chapainawabganj.

At Mymensingh Medical College Hospital, 105 measles patients were admitted over the past 11 days. As of Saturday afternoon, 69 patients remained admitted. So far, three children have died at the hospital.

A source from donor agencies stated that the first measles case this year was identified on 4 January in a Rohingya camp in Cox’s Bazar.

Authorities issued an alert in the camp area on 10 January. At the same time, measles cases began increasing in slum areas of the capital.

Bangladesh is not a measles-free country. However, vaccination programmes had previously reduced the prevalence of the disease.

Public health experts believe that many children are not receiving routine vaccinations. The country has also not conducted measles–rubella vaccination campaigns for several years.

Relevant sources stated that children receive the first dose of the measles vaccine at nine months and the second dose at 15 months.

During campaigns, all children aged between nine months and 10 years receive vaccination.

The most recent national campaign took place in 2020, when authorities planned to vaccinate 34 million (3.4 crore) children. The previous campaign was conducted in 2014.

It was not possible to contact Professor Pravath Chandra Biswas, director general of the Directorate General of Health Services, regarding the vaccination situation. He did not respond to phone calls or messages.

However, an official from the Expanded Programme on Immunisation (EPI), speaking on condition of anonymity, told Prothom Alo, “The central warehouse currently has no stock of measles–rubella vaccines. I do not know which districts or upazilas have already run out of supply.”

Several government officials and public health experts told Prothom Alo that not all children are receiving vaccinations on time.

In some areas, there is a shortage of field-level health workers, while in others, vaccine supplies are inadequate.

Professor Mahmudur Rahman, a public health expert and chairman of the National Verification Committee for Measles and Rubella Elimination, said that vaccine supply shortages and, in some cases, insufficient manpower have left many children unvaccinated, contributing to the outbreak.

Physicians at the Infectious Diseases Hospital reported that children under nine months of age are also contracting measles, even though vaccination begins at nine months.

When asked about this, Professor Mahmudur Rahman said, “We have already observed this issue. Its scientific causes need to be investigated. We informed the ministry about the matter one and a half years ago.”

Physicians stated that measles primarily affects children. It typically begins with fever, which gradually becomes severe. A rash then appears on the face before spreading across the body.

During this period, children may develop complications such as pneumonia and diarrhoea. Caregivers should seek medical advice or admit children to hospital if these symptoms appear.

Moinul Ahsan, director (Hospitals and Clinics) at the Directorate General of Health Services, told Prothom Alo, “All government medical college hospitals and district hospitals across the country have been prepared to treat measles patients. In the capital, special arrangements have been made at the Children’s Hospital, the Infectious Diseases Hospital, and the Dhaka North City Corporation Market Hospital to treat affected children.”

Experts have also recommended mass vaccination campaigns in areas where measles has spread widely. However, there is currently an insufficient supply of vaccines to support such campaigns.

[This report was prepared with contributions from Abul Kalam Azad in Rajshahi and Mostafizur Rahman in Mymensingh.]