The nationwide spread of measles continues to claim lives, with grieving parents and relatives struggling to cope as infections surge across Bangladesh.
The first reports of deaths linked to measles and measles-like symptoms emerged from Rajshahi Medical College Hospital (RMCH) in mid-March this year. Since then, infections have spread rapidly to almost every district in the country, with the death toll surpassing 500.
The outbreak has raised questions over how the disease spread so quickly across the country and why authorities failed to contain it in time.
Outbreak traced back to Rohingya camps
Although the first major outbreak in mainland Bangladesh was detected in Rajshahi division in March, health officials say the infection initially emerged in the Rohingya refugee camps in Cox’s Bazar in January.
The first measles case was detected in the camps on January 4. By the second week of March, authorities confirmed widespread transmission in Rajshahi region, with 44 confirmed infections recorded by March 18.
The outbreak later spread to nearly 58 districts.
Why the virus spread rapidly
Health experts blame several factors for the nationwide spread, including low vaccination coverage, overcrowded hospitals, poor hygiene practices and inadequate isolation facilities.
Doctors say the suspension of a nationwide measles-rubella vaccination campaign scheduled for 2025 created a significant immunity gap among children.
Usually, Bangladesh conducts a large-scale measles-rubella vaccination campaign every five years. However, the campaign was not held last year.
According to Unicef, around 20 to 30 million children remain vulnerable because coverage of the first and second doses of the measles vaccine declined in recent years.
A large number of infected children in Rajshahi were between six and nine months old and had not yet reached the age for receiving the first vaccine dose under the regular immunization schedule.
Hospitals became major transmission hubs
Health experts say hospitals played a major role in accelerating the outbreak.
Children admitted to Rajshahi Medical College Hospital and other healthcare facilities for illnesses such as pneumonia and fever became infected after coming into contact with measles patients.
Due to overcrowding and limited isolation facilities, the virus spread rapidly from patient to patient inside hospital wards.
When infected children later returned to their villages after treatment, they unknowingly carried the virus back to their communities, triggering further outbreaks.
Measles is highly contagious and spreads through airborne droplets released by coughing, sneezing or respiratory secretions.
Misdiagnosis, lack of awareness worsened situation
Many parents in rural areas initially mistook measles symptoms for common fever or allergies, delaying treatment and isolation.
As a result, the virus spread quickly among family members, neighbours and schoolchildren.
Public transport and unrestricted movement also contributed to the spread from Rajshahi to Dhaka, Chittagong, Mymensingh and Khulna divisions.
According to the World Health Organization, Dhaka later experienced the highest patient pressure during the outbreak.
Families describe treatment crisis
Families of infected children described severe overcrowding and shortages at hospitals.
Rozina Khatun, who brought her daughter from Natore to RMCH, said: “At first, we thought it was a common fever. Later, red spots appeared on her body and doctors confirmed it was measles. The hospital was overcrowded and doctors were extremely busy.”
Another guardian, Setara Begum from Charghat upazila, said it took a long time to secure a hospital bed because of the huge number of patients.
Claims of hospital-acquired infections
Several guardians alleged that their children contracted measles while receiving treatment for other illnesses at RMCH.
Sazia Akhter from Chapainawabganj said her six-year-old son was admitted with pneumonia before Eid-ul-Fitr but later became infected with measles after sharing a ward with infected patients.
She alleged that many guardians ignored instructions to isolate infected children, worsening the spread.
At RMCH, wards reportedly operated far beyond capacity, with multiple patients sharing single beds and many others lying on floors and verandas.
Health officials acknowledge failures
Rajshahi Divisional Health Director Dr Habibur Rahman admitted that many hospitals and guardians failed to follow instructions to isolate measles patients.
He said measles is extremely contagious and authorities have been working to contain the outbreak since the beginning.
Health experts say the highest number of infections was recorded among patients from Chapainawabganj, Rajshahi and Pabna.
They blamed inadequate isolation systems, poor hygiene and excessive patient pressure for making the outbreak difficult to control.
Hospital authorities unavailable for comment
Attempts to contact RMCH spokesperson Dr Shankar K Biswas for comment were unsuccessful.
On May 22, RMCH Director Brig Gen PKM Masud-ul Islam received a phone call from this correspondent but ended the call after being asked about the nationwide spread of measles from Rajshahi.
According to RMCH sources, four new patients with measles symptoms were admitted to the hospital in the last 24 hours, while 13 were discharged.
Currently, 71 patients with measles symptoms are undergoing treatment at the hospital.
