A significant proportion of measles deaths and infections in Bangladesh have been reported among infants below nine months of age, the age at which the first dose of the measles vaccine is administered, as the number of cases and deaths continues to rise across the country.

Data from the Institute of Public Health showed that 514 people tested positive for measles in March after 952 samples collected from different districts were examined.

Several hundred children, mostly under two years of age, are currently undergoing treatment at healthcare facilities across the country with measles symptoms, while at least 48 suspected measles deaths have been reported from at least 10 districts, including Dhaka, Rajshahi and Chattogram.

The data showed that the measles test positivity rate reached 54 per cent in March, significantly higher than the usual rate of below 4 per cent in previous years.

In January, 51 positive cases were detected. The number rose to 157 in February and surged to 514 in March, accompanied by higher positivity rates.

At the Infectious Diseases Hospital in Dhaka and Rajshahi Medical College Hospital, around 70 per cent of measles patients were found to be under nine months of age.

According to Rajshahi Medical College Hospital data, 57 per cent of confirmed measles cases involved infants under six months, while seven patients were below three months of age.

An Infectious Diseases Hospital physician, Sribash Paul, said that all 20 measles patients currently undergoing treatment on one floor of  the hospital were under nine months of age.

In the past 24 hours, another child died of measles at the hospital, raising the total death toll there to 23.

Virologists and public health experts described the situation as alarming and called for immediate action.

Director of the disease control wing at the Directorate General of Health Services, Professor Md Halimur Rashid, said that the government was planning a nationwide measles vaccination campaign in June.

‘We are planning to vaccinate children from six months of age during the campaign, considering the outbreak,’ he told New Age on Monday.

Globally, the World Health Organization recommends measles vaccination at nine months of age in high-transmission countries. However, early vaccination from six months is allowed during outbreaks or high-risk situations, though it is considered a supplementary dose and must be followed by routine doses later.

Former vice-chancellor of Bangladesh Medical University Professor Nazrul Islam said that the nine-month vaccination schedule was scientifically determined based on the assumption that infants inherit immunity from their mothers.

‘Now it appears that infants are not receiving sufficient immunity from their mothers, which may explain the earlier infections,’ he said, suggesting maternal immunisation to boost immunity instead of vaccinating infants early.

Former head of the virology department at Dhaka Medical College Professor Sultana Shahana Banu cautioned against early vaccination without proper antibody assessment and stressed the need for maternal vaccination and improved maternal care during pregnancy and breastfeeding.

However, Bangladesh Shishu Hospital and Institute paediatric specialist Md Kamruzzaman said early vaccination could be more effective in the current situation.

Institute of Public Health National Measles Laboratory virologist Kh Mahbuba Jamil said samples from 786 healthcare facilities were being tested following World Health Organization guidelines.

She said that 33 per cent of confirmed cases involved unvaccinated children, while a significant number of vaccinated children were also found infected.

Public health experts blamed disruptions to vaccination activities over the past two years for the surge in infections.

Expanded Programme on Immunization officials said vaccination drives against measles and other preventable diseases had been hampered due to shortages of vaccines, manpower and logistics following the suspension of health sector operational plans in 2024.

Health adviser Sardar Md Sakhawat Husain said the government had allocated Tk 604 crore for vaccine procurement, while Gavi, the Vaccine Alliance, had already donated two crore doses of measles vaccine.

EPI deputy director Md Shahriar Sajjad said vaccines had reached the country, but logistics and field-level preparations were still pending. He added that the government was preparing to launch the vaccination campaign by June.

Bangladesh conducts routine measles vaccination and nationwide campaigns every four years in line with World Health Organization guidelines. The country last conducted a campaign in 2020 and had planned another in 2024, which was not implemented.

Bangladesh initially aimed to eliminate measles by 2020, later extending the target to 2025 and then to 2026. However, the recent surge in infections has raised concerns about achieving that goal.