Measles Outbreak: Average of 1056 Infected, Seven Die Daily
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Measles, a preventable disease, continues to pose a serious public health concern in Bangladesh. An average of 1,056 people are contracting the disease each day, while seven die daily on average. Most of those infected and deceased are children. The trend has remained largely unchanged since March, although the death toll has declined somewhat.
The Directorate General of Health Services (DGHS) began maintaining fresh data on the measles situation on March 15. An analysis of those figures reveals the current pattern of infections and deaths.
Public health experts say the country is still facing a measles emergency. They argue that herd immunity has not been achieved because vaccination coverage remains below the required level. As a result, infections and deaths continue. Owing to population density and geographic factors, fatalities are higher in Dhaka and Sylhet.
According to DGHS data, seven more children died with measles symptoms across the country in the past 24 hours. During the same period, 1,031 new measles cases were reported. Between March 15 and July 5, a total of 738 people died from measles or measles-like symptoms, while nearly 118,250 people were infected.
Mushtaq Hossain, former chief scientific officer of the Institute of Epidemiology, Disease Control and Research and a public health expert, said the measles situation has not improved even after the vaccination campaign ended. He attributed the decline in deaths to greater public awareness rather than a reduction in transmission.
Herd Immunity Yet to Be Achieved
When more than 95 percent of a population is covered by vaccination, herd immunity is usually established within four weeks, leading to a decline in measles transmission. However, nearly seven weeks have passed since the measles vaccination campaign ended. While deaths have decreased somewhat, the infection rate has remained largely unchanged.
Public health experts say authorities initially underestimated vaccination targets because of the emergency situation, making it difficult to accurately calculate the number of children who needed vaccines. As a result, the outbreak remains uncontrolled. They argue that the government should acknowledge this reality and revise its vaccination targets accordingly.
According to government figures, the measles vaccination campaign targeted 18,015,064 children aged between six months and five years. Authorities administered vaccines to 18,477,914 children.
Although the number of vaccinated children exceeded the official target, a result the government has highlighted as a success, the infection rate has remained virtually unchanged more than four months into the outbreak. More than 30,000 people have contracted measles each month over the past three months, while the number of deaths remains a cause for concern.
Asked about the situation, DGHS Disease Control Director Md. Halimur Rashid told Agamir Somoy, “The government has done everything it could. Now we are waiting to see what happens.”
Questions about gaps in vaccination coverage resurfaced during the recent Vitamin A campaign. Children in the same age group targeted during the measles outbreak also received Vitamin A capsules. However, the number of children covered by the two programs differed by more than 3.8 million.
Public health expert Mushtaq Hossain said, “The government set the vaccination target too low. As a result, even though the target was achieved, the desired number of children did not come under measles vaccination coverage. The government must acknowledge this reality. It must identify and vaccinate those who were left out; otherwise, the outbreak will not stop.”
Deaths Higher in Dhaka and Sylhet
Of the seven patients who died in the past 24 hours, four were from Dhaka and one was from Sylhet. An analysis of DGHS data shows that these two divisions have recorded the highest number of measles-related deaths in recent months.
Public health specialists say outbreaks are often difficult to control in slum communities and hard-to-reach areas. The same may be true for the current measles outbreak. Measles is highly contagious, and one infected person can transmit the disease to between 12 and 18 others.
Dhaka is densely populated and home to a significant number of slums. Sylhet, meanwhile, contains extensive haor wetlands where transportation remains difficult. Many areas can only be reached by boat, and the region also includes tea gardens. Public health experts say these geographic challenges make it difficult to bring all children under vaccination coverage. While measles vaccination coverage exceeded 103 percent in other divisions, it reached only 99 percent in Sylhet.
Public health expert Mohammad Iqbal said, “Managing outbreaks in remote areas is naturally more difficult. These areas must be identified quickly and brought under vaccination coverage. In this regard, the commitment of healthcare workers is just as important as government efforts.”
Dr. Ziauddin Haider, special assistant to the prime minister on health affairs with the rank of state minister, said many children in both Dhaka and Sylhet suffer from malnutrition, which could be contributing to measles-related deaths. He also said further research is needed to confirm whether children who died with measles symptoms were actually infected with measles.
