Measles outbreak continues despite vaccination

Three more children died with measles symptoms in the 24 hours until Tuesday, while 904 new measles and measles-symptom cases were reported during the same period, according to government data.

Overall, 828 children with measles and measles symptoms have died between 15 March and 28 July, underscoring the severity of the outbreak despite an extensive vaccination campaign.

Public health experts say the continued spread of the disease reflects a combination of factors rather than a failure of vaccination alone. They identified gaps in vaccination coverage, childhood malnutrition, high population density, delayed hospital visits and late diagnosis as the principal reasons the outbreak remains out of control.

They argued that while the government has focused primarily on immunisation, other essential public health interventions-including early case detection, isolation of infected children, public awareness campaigns, infection prevention, improved hospital management and strengthened surveillance in high-risk areas-have not received adequate attention. As a result, they say, the chain of transmission has not been broken.

There is also no clear indication of when the outbreak will come under control.

Public health expert Dr Zakia Ferdous Khanam said measles is an extremely contagious viral disease that can spread rapidly from one infected person to many others.

"Ensuring high vaccination coverage is therefore essential to prevent transmission," she said.

According to the Health Services Division, the latest MR campaign targeted 18,015,064 children aged between six months and 59 months. More than 18,480,000 children were eventually vaccinated, exceeding the official target by around three per cent.

However, government figures reveal a significant discrepancy between two major child health programmes. While the MR campaign targeted around 1.80 crore children, the National Vitamin A Campaign for the same age group set a target of 2.26 crore children-a difference of nearly 46 lakh children.

Public health expert Dr Be-Nazir Ahmed, former director of the Disease Control Unit at the Directorate General of Health Services (DGHS), said the failure to vaccinate all eligible children is one of the main reasons the outbreak remains uncontrolled.

"A discrepancy of 46 lakh children is enormous. The entire matter deserves a thorough investigation," he said.

Dr Mushtaq Hossain, public health specialist and former adviser to the Institute of Epidemiology, Disease Control and Research (IEDCR), said the government's target population may not have included all eligible children. He added that limited preparation time before the campaign could have left many children out of the microplanning process.

Physician Dr Abul Hayat Manik said malnutrition could reduce the effectiveness of vaccination, as undernourished children may fail to develop adequate protective antibodies. He stressed the importance of nutritious food and breastfeeding to strengthen children's immune systems.

Dr Ayesha Akhter, Deputy Director of the 250-Bed TB Hospital, said many parents initially mistake fever, cough and skin rashes for common viral illnesses, delaying medical treatment. Such delays not only worsen patients' conditions but also increase the risk of transmission.

She added that delayed diagnosis and reporting weaken surveillance, contact tracing and emergency vaccination efforts, making outbreaks more difficult to contain.

Public health experts said the most effective strategy is to ensure every eligible child receives two doses of the measles vaccine on schedule, while simultaneously tackling childhood malnutrition, strengthening early case detection, improving public awareness and ensuring timely treatment.

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