Although no new confirmed measles deaths were reported in the past 24 hours, the country continues to record a steady rise in suspected measles deaths. During the 24 hours until Wednesday morning, five more children died with suspected measles, while another 1,083 children were either infected with measles or developed measles-like symptoms.
Public health experts said that although confirmed measles deaths have declined, the continued occurrence of suspected deaths suggests the outbreak is still not fully under control.
They attributed the large-scale outbreak to gaps in vaccination coverage, disruptions to the routine immunization programme and low vaccine uptake in some areas.
According to the latest Directorate General of Health Services (DGHS) data, a total of 854 children died from confirmed or suspected measles between March 15 and 8am on August 5. Of them, 758 died from suspected measles and 96 from laboratory-confirmed measles.
During the same period, suspected measles cases reached 129,905, while confirmed cases stood at 16,655.
Death and infection trends
An analysis of DGHS data shows that from the start of the outbreak until July 31, a total of 837 children died from measles or measles-like illness, averaging nearly six deaths a day. During the same period, 128,310 patients were hospitalized, an average of 923 admissions daily.
During the first 30 days of the outbreak, until April 14, 198 children died and 19,361 patients were hospitalized.
By May 14, the death toll had risen to 439, while hospital admissions reached 54,419.
By June 13, deaths had increased to 648 and hospital admissions stood at 84,899.
By July 13, the total death toll had reached 759, while 112,376 patients had been hospitalized.
As of August 5, the total death toll had climbed to 854, while total infections had reached 146,560.
The data show that the daily death rate has not declined significantly since the early stages of the outbreak. Even after the nationwide vaccination campaign ended, hospitals continue to admit more than 900 new patients a day on average.
Senior physician Professor Dr ABM Abdullah said recent disruptions to routine immunization have created a major public health risk.
"We did not see measles deaths 20 to 30 years ago. Although measles is a serious disease, it is easily preventable. The current situation has arisen because many children did not receive vaccines on time. Malnutrition and a lack of breastfeeding are also contributing factors," he said.
He said the government had already completed a nationwide Measles-Rubella (MR) vaccination campaign, while research by icddr,b found no problems with the vaccine's effectiveness. However, it takes one to two months after vaccination for the body to develop immunity.
"That period has already passed, but infections are not declining at the expected rate. Adults are now also becoming infected with measles," he said, adding that those who have not yet been vaccinated should be brought under vaccination as quickly as possible.
Public health and vaccination expert Tajul Islam Bari said there is no separate disease known as "suspected measles."
"Patients whose infection is confirmed through laboratory testing are counted as confirmed measles cases if they die. However, because of shortages of testing kits and other limitations, it is not possible to test every patient. As a result, deaths of patients whose symptoms are consistent with measles are recorded as suspected measles deaths," he said.
He said many children are admitted to hospital with pneumonia, while the initial symptoms of measles include fever, a cold, cough and a sore throat, followed later by a rash. Pneumonia can also develop as a complication of measles.
He said infected children should receive treatment as quickly as possible, be kept in isolation, provided with necessary medicines and nutritious food, and cared for under proper hygiene.
Experts said it takes several weeks after vaccination for the body to develop adequate immunity. Therefore, alongside vaccination, rapid case detection, isolation of infected children and timely treatment remain equally important.
Bangladesh introduced the Measles-Rubella (MR) vaccine under its national immunization programme in 2012. Following a nationwide MR campaign in 2014, infections declined significantly. Although vaccine coverage reached nearly 90% in 2018 and 2019, routine immunization was disrupted during the Covid-19 pandemic, causing many children to miss scheduled vaccinations. Public health experts say the effects of those gaps are now becoming evident on a large scale.
Professor Mahmudur Rahman, chairman of the National Immunization Technical Advisory Group (NITAG), said infections have not declined as quickly as expected since the vaccination campaign ended.
"It is now important to analyse detailed data to determine which age groups are being affected the most. The next strategy can be developed based on those findings," he said.
To contain the outbreak, the government first launched a special MR vaccination campaign in 30 high-risk upazilas and later in four city corporations. It then carried out a nationwide campaign from April 20 to May 20. The DGHS says the campaign vaccinated more children than initially targeted. Health workers are now identifying children who missed vaccination and administering vaccines through door-to-door visits.
DGHS Director General Professor Dr Prabhat Chandra Biswas said there are currently no confirmed measles deaths, but efforts to vaccinate unvaccinated children are continuing.
"We hope that just as confirmed measles deaths have fallen to zero, suspected measles deaths will also gradually decline to zero. To achieve that, we are identifying children who missed vaccination, ensuring they receive vaccines, strengthening disease surveillance and improving treatment services," he said.
