Measles surge raises WHO alarm

The World Health Organization (WHO) has raised serious concern over the evolving measles outbreak in Bangladesh, assessing the national risk as “high” amid widespread transmission, rising child deaths, and significant immunisation gaps.

In an assessment report released on Thursday (23 April 2026), WHO said the situation reflects sustained domestic transmission of Measles across most of the country.

The warning is based on rapid geographical spread, a high number of affected children, and reduced vaccine protection following recent immunisation disruptions.

According to the report, Bangladesh notified WHO on 4 April 2026 of a marked increase in measles cases.

Since January 2026, infections have risen sharply, driven by ongoing local transmission.

Between 15 March and 14 April 2026 alone, the country recorded 19,161 suspected cases and 2,897 laboratory-confirmed cases.

During the same period, there were 166 measles-related deaths, with a case fatality rate reported at around 0.9 per cent.

WHO also noted 30 confirmed deaths linked directly to measles, with a slightly higher case fatality rate of 1.1 per cent in confirmed cases.

Health system pressure has also increased, with 12,318 hospital admissions and 9,772 discharges recorded over the same period.

Seven children died from measles and measles-like symptoms from 8am yesterday to 8am today (24 April), according to the Directorate General of Health Services (DGHS).

During the same 24-hour period, 1,215 patients with measles-like symptoms were admitted to hospitals nationwide.

Of these, 172 cases were laboratory-confirmed as measles. So far this year, at least 42 children have died from confirmed measles infections in Bangladesh.

In addition, 198 children have died with symptoms consistent with measles.

DGHS data shows that between 15 March and 24 April, a total of 4,231measles cases were confirmed through laboratory testing.

According to the latest health bulletin, 29,549 suspected measles cases have been identified nationwide.

Of these, 16,527 patients have already been discharged after receiving treatment.

WHO said cases have been reported across all eight divisions of Bangladesh, affecting 58 of 64 districts — around 91 per cent of the country.

The highest cumulative burden has been observed in Dhaka (8,263 cases), followed by Rajshahi (3,747), Chattogram (2,514), and Khulna (1,568).

In Dhaka, infections are heavily concentrated in densely populated informal settlements, including Demra, Jatrabari, Kamrangirchar, Korail, Mirpur, and Tejgaon — areas characterised by overcrowding and limited access to health services.

Data from Bangladesh’s Expanded Programme on Immunization (EPI) indicates that measles has now spread across 61 districts, underscoring the scale of national transmission.

Children under five account for the majority of infections, representing around 79 per cent of all reported cases.

Within this group, 66 per cent are under two years old, while 33 per cent are infants below nine months.

Overall, 91 per cent of cases occur in children aged between one and 14 years, highlighting significant immunity gaps across childhood age groups.

WHO also reported that most measles-related deaths have occurred among unvaccinated children under two years old.

The agency said the outbreak is taking place against a backdrop of suboptimal population immunity.

Many infected children were either unvaccinated or had received only a single dose of measles-containing vaccine. Some infants were also infected before reaching the eligible vaccination age of nine months.

WHO noted that Bangladesh had previously made strong progress towards measles elimination.

First-dose vaccine coverage rose significantly from 89 per cent in 2000 to more than 100 per cent by 2016, while second-dose coverage improved following its introduction in 2012.

However, recent setbacks — including vaccine stockouts between 2024 and 2025 and the absence of nationwide supplementary immunisation campaigns since 2020—have contributed to a growing number of susceptible children.

These disruptions, combined with routine immunisation gaps, are considered key drivers of the current outbreak.

Measles is a highly contagious viral infection spread through airborne droplets. It typically begins with fever, cough, runny nose, and inflamed eyes, followed by a characteristic rash.

The virus can remain infectious from four days before to four days after rash onset.

While many patients recover within two to three weeks, complications can be severe, including pneumonia, diarrhoea, encephalitis, blindness, and death.

WHO estimates that one in every 1,000 cases may develop encephalitis, and two to three deaths may occur per 1,000 cases.

In response, Bangladesh has launched a nationwide measles-rubella vaccination campaign targeting children aged 6–59 months, with expanded coverage for younger infants.

The campaign began in selected high-risk areas on 5 April and expanded nationwide on 20 April, following approval by the National Immunization Technical Advisory Group (NITAG).

Rapid response teams have been deployed, vaccine procurement has been accelerated, and hospital preparedness has been strengthened. Vitamin A supplementation is also being provided as part of case management.

Surveillance systems have been reinforced, with improved case detection, weekly reporting, and healthcare worker training ongoing.

WHO highlighted the risk of cross-border spread due to population movement, particularly through major transit hubs such as Dhaka and Chattogram.

Bangladesh shares porous borders with India and Myanmar, where vaccination gaps and ongoing public health challenges could facilitate further transmission.

While the regional risk is assessed as high and the global risk as moderate, WHO does not recommend any restrictions on travel or trade.

WHO has urged Bangladesh to achieve and sustain at least 95 per cent coverage for both doses of measles-containing vaccine nationwide.

It also recommends strengthening surveillance systems, improving outbreak response capacity, and ensuring rapid vaccination of at-risk groups, including healthcare workers, travellers, and border populations.

Post-exposure measures such as vaccination within three days or immunoglobulin within six days for vulnerable contacts are also advised.

WHO emphasised that urgent action is needed to close immunity gaps and prevent further spread, warning that without sustained intervention, continued transmission is likely.