A sharp rise in measles infections among children in Bangladesh has raised concern among health experts, who warn that declining vaccination coverage and gaps in immunization campaigns are driving a renewed outbreak.
According to the Directorate General of Health Services (DGHS), 209 children were hospitalized with measles this month alone.
Data show a steep increase in infections, with cases rising from 68 in the first three months of last year to 676 during the same period this year.
Experts say the disease, once largely under control, is now re-emerging in what appears to be wider regional pattern.
Vaccination gaps widen
Under Bangladesh’s Expanded Program on Immunization (EPI), children are scheduled to receive two doses of the Measles-Rubella (MR) vaccine at nine and 15 months.
While recent estimates suggest around 88% of children under five have received both doses, a significant portion remains unvaccinated.
Coverage has fluctuated in recent years.
After improving following the Covid-19 pandemic, vaccination rates began declining again.
By 2025, first-dose coverage dropped sharply to 56.5% and second-dose coverage to 57.1%, nearly half of previous levels.
Health and Family Welfare Minister Sardar Md Sakhawat Hossain said the absence of large-scale immunization campaigns in recent years has left many children unprotected.
“Most cases are being reported among those who have not received the vaccine,” he said.
Infants at highest risk
Health officials said most recent infections have been detected among infants younger than nine months, who are not yet eligible for vaccination.
Dr Alpana Jahan, assistant professor at Dr MR Khan Shishu Hospital, said measles is highly contagious, with one infected child capable of spreading the virus to up to 20 others.
“In Bangladesh, children are vaccinated at nine and 15 months, but many are getting infected before reaching that age,” she said, noting that severe complications, including brain infections, have already been reported.
Hospitals are also facing capacity constraints, with measles patients often treated alongside children with pneumonia and diarrhoea, increasing transmission risks.
Supply delays, response challenges
Despite the rising cases, challenges in vaccine rollout persist.
Although measles vaccines supplied by the World Health Organization have arrived in the country, they remain unused at the EPI headquarters due to delays in funding for campaign implementation.
DGHS officials said the central vaccine stockpile has already been depleted, prompting urgent procurement efforts.
The government has approved a Tk604 crore proposal to purchase additional vaccines.
The health ministry said steps are underway to ensure rapid supply, with plans to launch a nationwide vaccination campaign once doses become available.
As part of the immediate response, the government has reopened the ICU at Mohakhali Infectious Disease Hospital and distributed ventilators and other equipment to affected districts.
Rising deaths, systemic concerns
Sources indicate that at least 38 children have died this year from measles and its complications, as hospitals struggle to cope with the surge in patients.
Public health analysts say even small gaps in vaccination can trigger outbreaks.
DGHS estimates that 5–10% of children miss routine immunization each year, creating a pool of vulnerable individuals.
Some experts have attributed the recent decline in coverage to weak long-term planning and disruptions in immunization activities. Opposition figures have also pointed to delays in vaccine procurement.
DGHS Director (Disease Control) Prof Dr Md Halimur Rashid said similar surges have occurred in the past but emphasized that the situation requires close monitoring.
Outlook and risks
Health authorities plan to administer an additional 20 million vaccine doses by June as part of an expanded response.
Experts stress that renewed focus on immunization campaigns, early intervention and sustained investment in public health systems will be critical to containing the outbreak.
They also highlight the need for further research, as infections are now being detected in children as young as four months—well before the scheduled vaccination age.
While urging the public not to panic, officials have called for increased vigilance, warning that measles remains one of the most contagious infectious diseases.
