A sharp surge in measles cases has gripped at least seven districts – Dhaka, Mymensingh, Rajshahi, Pabna, Chattogram, Jashore, and Natore – exposing a critical gap in Bangladesh’s public health surveillance.

While the Ministry of Health has hurriedly allocated Tk604 crore for emergency vaccinations, the true scale of the outbreak remains obscured by a lack of comprehensive data and a multi-year breakdown in the national immunisation calendar.

Despite the escalating crisis, the government appears to be operating with a fragmented understanding of the outbreak.

Dr Abu Ahammad Al Mamun, Director (MIS) of the Directorate General of Health Services (DGHS), admitted to the Daily Sun that official records are significantly limited.
“According to reports available until 29 March, around 70 patients and 14 deaths were reported in government hospitals this month. However, there is no report from
private and autonomous hospitals available,” Dr Mamun stated.

DGHS officials further conceded that the health authority has yet to implement any special measures to centralise or record the admission and casualty rates of measles patients nationwide. This data vacuum suggests that the official death toll – which has already crossed 20 across state-run facilities – likely represents only a fraction of the actual fatalities.

Field reports indicate 12 deaths at Rajshahi Medical College Hospital, three at Mymensingh Medical College Hospital, and three at the capital’s Infectious Diseases Hospital (IDH), alongside three more in Chapainawabganj.

Immunisation stagnation

The current vulnerability of the nation’s children is being traced back to a sustained pause in mass immunisation efforts.  Public health experts noted that while regular vaccination programs had previously kept measles under control, the absence of nationwide campaigns for several years has left a generation of children unprotected.

Mohammad Shahariar Sajjad, deputy director (EPI) of the DGHS, revealed that political instability and administrative hurdles have derailed the Measles-Rubella (MR) schedule.  “The MR campaign is scheduled every four years. It was conducted in 2016 and 2020, but the third cycle, due in 2024, was not held,” he said.
This four-year stagnation has created a demographic “immunity gap.”

Current analysis by the EPI suggests that 30% to 35% of affected children are under nine months old – younger than the standard age for the first vaccine dose. Consequently, the government is now forced to consider a policy shift to reduce the eligible age for the MR vaccine to stem the tide of infections.

Hospitals under siege

In the absence of a coordinated national response, frontline hospitals are struggling to manage the surge.

Dr Ariful Bashar, in-charge of the IDH in Mohakhali, described a facility under immense pressure, with 100 to 150 patients seeking admission daily. Long queues of parents, many carrying symptomatic infants, have become a common sight at outpatient departments.

In a bid to catch up, the DGHS has directed ten government medical colleges to set up “measles corners” and opened a 10-bed ICU unit at the IDH for severe cases.

Other facilities, including the Shishu Hospital, ICMH Matuail, and the DNCC hospital, have also been repurposed to handle the influx.

Four deaths reported in 10 days in Chattogram, 24 hospitalised

The outbreak has taken a particularly deadly turn in Chattogram, where at least four children have died over the last ten days.

Data from both public and private facilities reveal that as of Sunday, 24 patients were hospitalised, with six in critical condition in Intensive Care Units (ICUs).

The Chattogram Maa-O-Shishu Hospital has emerged as a focal point for severe cases, treating 15 patients in its ICU over the past ten days. Of these, three children succumbed to the virus.

Dr Mishu Talukdar, assistant professor of pediatrics, noted that infected children are presenting with life-threatening symptoms, including respiratory distress and seizures.

“The condition of some patients is deteriorating very rapidly,” he warned.

A fourth death was reported at the Chattogram International Medical College Hospital (CIMCH), where Principal Dr Muslim Uddin Sabuj highlighted that malnourished children from low-income families are at the highest risk.

In response to the influx, the Chattogram Medical College Hospital (CMCH) has converted its existing ‘Dengue Corner’ into a dedicated ‘Measles Corner’.

The facility was treating 12 children on Sunday, most of whom arrived from the Cox’s Bazar region.
Dr Mohammad Musa Miah, Head of Pediatrics at CMCH, confirmed that several patients are under six months old.

While Chattogram Civil Surgeon Dr Jahangir Alam assured that regular vaccination continues and supplies are adequate, the severity of cases at the Bangladesh Institute of Tropical and Infectious Diseases (BITID) suggests the virus is becoming increasingly difficult to manage.

Prof Dr Mamunur Rashid of BITID emphasised that while measles is generally treatable, the current surge requires immediate medical intervention to prevent further fatalities.

The government’s response

Speaking on Sunday at the 17th Asia Pharma Expo, Health and Family Welfare Minister Sardar Md Sakhawat Hossain acknowledged the rising prevalence of the disease over the last fortnight.

“The government has made a special allocation of Tk604 crore to bring children who have not yet received the vaccine under a new campaign,” the Minister said.

He added that a nationwide special drive is being considered once vaccine procurement – supported potentially by Gavi, the Vaccine Alliance – is complete. However, until a comprehensive recording system for casualties and admissions is established, health experts warn that the government remains “in the dark,” fighting an outbreak whose boundaries and severity are yet to be fully mapped.

According to the World Health Organisation (WHO), measles is a highly contagious viral disease that spreads through respiratory droplets. It remains a leading cause of death among young children globally, though it is entirely preventable through timely vaccination.