Measles thrives on vaccination, nutrition, awareness gaps

Bangladesh, which was once regarded as a regional success story in measles control through its Expanded Programme on Immunisation (EPI), is witnessing an alarming rise in measles infections and deaths linked to the disease and its symptoms. 

Public health experts says gaps in routine immunisation, childhood malnutrition, rapid transmission in densely populated areas, delays in seeking treatment, and late disease detection and reporting are driving the worsening outbreak.

According to the Directorate General of Health Services (DGHS), one person died with measles symptoms in the past 24 hours. As of Friday, the cumulative death toll from measles and suspected measles cases since March 15 this year had reached 780.

During the same period, 1,013 new measles and suspected measles cases were reported in the last 24 hours, raising the total number of infections to 130,255 between March 15 and Friday.

Health experts describe measles as one of the world's most contagious viral diseases. A single infected child can transmit the virus to nearly everyone nearby who lacks immunity through vaccination or previous infection. They warn that even a slight decline in vaccination coverage can quickly trigger large-scale outbreaks.

Public health specialists note that measles immunisation drives were conducted in 2006, 2010 and 2014 across the nation, with another special campaign carried out during the COVID-19 pandemic.

However, routine immunisation coverage dropped sharply in 2025, reaching only 59 per cent of eligible children. Although this year's nationwide Measles-Rubella (MR) campaign increased coverage to around 81 per cent, it remained well below the 95 per cent threshold required for herd immunity, leaving nearly 39 lakh children unvaccinated.

Questions have also emerged over inconsistencies in the target population. While the MR campaign targeted 1.8 crore children, the nationwide Vitamin A campaign set a targets of 2.26 crore children in the same age group, creating a discrepancy of about 46 lakh children.

Public health expert Dr Be-Nazir Ahmed, who is former director of the DGHS Disease Control Unit, said that the failure to vaccinate all eligible children is one of the main reasons measles remains uncontrolled. "A discrepancy of 46 lakh children is enormous. The entire matter deserves a thorough investigation," he said.

Public health expert Dr Mushtaq Hossain said that the government's target population may not have included all children. He added that limited preparation time may have resulted in many children being left out of the campaign's micro-plans.

Experts also warn that every year, newly born children join those who previously missed vaccination, creating a growing pool of susceptible children that increases the risk of nationwide transmission.

Doctors say malnutrition is another major factor behind severe measles complications. Malnourished children have weaker immune systems and face a higher risk of pneumonia, diarrhoea and other life-threatening complications. Paediatrician Dr Abid Hossain Molla said measles tends to cause more severe complications among malnourished children.

Physician Dr Abul Hayat Manik said that even vaccinated children may fail to develop sufficient protective antibodies because of malnutrition. He stressed the importance of nutritious food and breastfeeding to strengthen children's immunity.

Experts also identified overcrowding in Dhaka and other major cities, delayed treatment, and slow disease surveillance and reporting as key obstacles to containing the outbreak.

Public health expert Zakia Khanam Mithila said many parents initially mistake fever, cough or skin rash for common viral illnesses and delay seeking medical care. "Such delays not only worsen the patient's condition but also increase the risk of spreading the virus. She noted that delayed diagnosis and reporting further slow surveillance, contact tracing and emergency vaccination efforts, making outbreaks more difficult to contain," she said.

Experts emphasised that ensuring two doses of the measles vaccine on time, providing prompt treatment to infected children, and maintaining proper infection prevention measures remain the most effective ways to control the disease.

Health Minister Sardar Md. Sakhawat Husain has said at various events that the government has undertaken all necessary measures to combat the outbreak and achieved its vaccination campaign targets. He added that children who have not yet received the vaccine can still be vaccinated and stressed the importance of improving child nutrition.