Measles claims 25% of child victims under six months old

It started with a small rash on the body of baby Al-Rayhan Rafi. His family rushed from Jashore Sadar Hospital to Dhaka, moving from one hospital to another. Despite visiting four hospitals, enduring long hours of anxiety, and a 15,000-taka ambulance journey, the child could not be saved. After a three-day battle for life in the ICU of Dhaka Children's Hospital, the light of Rafi's tiny life faded at just 3 months and 16 days.

Rafi is not alone. Many more children under six months are losing their lives to the severity of measles. According to data from Bangladesh Children's Hospital and Institute in the capital's Shyamoli (Dhaka Children's Hospital), 49 children have died from measles between March 15 and June 20. A significant number of these children were under six months old.

Analysis of the deceased children's ages reveals that nearly all were under one year old. Of these, 59 percent were under nine months. The most alarming finding is that 25 percent of the deceased children were under six months old. Furthermore, a considerable number had not even completed three months of age.

Even the doctors at the country's largest children's hospital are concerned. Professor Dr. Md. Mahbubul Haque, head of the Critical Care Pediatrics department at the hospital, said they have even seen the death of a one-month-old child from measles.

He said, "These children had very low immunity, and many were suffering from malnutrition. However, he said, he believes that deaths from measles at such a young age due to maternal immunity are not normal."

Maternal immunity is a natural protective system a child is born with. During pregnancy through the mother's blood and after birth through breast milk, some antibodies enter the child's body. These antibodies typically help protect the child against various infectious diseases, including measles, during the first six months of life.

According to the national immunization program, a child receives the first dose of the measles vaccine at nine months of age. However, following the recent outbreak, children aged six months to five years are also being vaccinated under a special program. Yet, the concern remains that children under six months are dying from measles before reaching the vaccination age.

Dr. Mushtuq Husain, former chief scientific officer at the Institute of Epidemiology, Disease Control and Research (IEDCR), said, "The deaths of children under six months from measles are extremely concerning." In his view, to protect these children, at least 95 percent of people over six months of age must be brought under vaccination coverage. This will help create herd immunity in the community. Additionally, ensuring maternal nutrition, healthcare, and prenatal care during pregnancy is crucial.
Why are children under six months dying?

Three-month-old Ayat was brought to Dhaka Children's Hospital from Ramganj in Lakshmipur for treatment. After contracting measles, she began suffering from severe pneumonia. Despite 15 days of treatment and struggle, she could not be saved. Her final days were spent in the hospital's Intensive Care Unit (ICU).

Public health experts say that measles deaths in children under six months are not a normal occurrence. This is because antibodies received from the mother during pregnancy typically provide protection to the child during the first few months of life. Therefore, the occurrence of deaths among such young children has become a particular cause for concern.
According to experts, measles vaccination coverage in the country has steadily increased since 1985, reaching nearly 95 percent. However, the remaining 5 percent—individuals who have never been infected with measles and have never received the vaccine—lack the necessary immunity, preventing the formation of herd immunity. When these women become mothers, their children face a comparatively higher risk of contracting measles.

However, this is not the only factor. Experts believe that the immune systems of both mother and child, their nutritional status, and whether the child received adequate breast milk after birth must also be carefully considered.

Public health expert Dr. Mohammad Iqbal stated, "Deaths from measles in three-month-old children are very rare. The deaths of children under six months require in-depth investigation and analysis. At the same time, maternal nutritional status, health conditions, and the duration of breastfeeding should also be brought under research."

Meanwhile, parents are growing increasingly anxious because children under six months are not covered by the measles vaccine. They are asking how they can protect their children until they reach the vaccination age.

Anamika Saha, mother of one-and-a-half-month-old Rudra Saha, said, "Young children are dying from measles. The number of infections is rising every day. My son still has four and a half months to go before he can get the measles vaccine. I am very worried about him."

Public health expert Lelin Chowdhury suggested that until adequate herd immunity is built in the community, women planning to have children can get themselves tested for the presence of measles antibodies. This would give them an idea of the level of risk. Additionally, he strongly advised placing utmost importance on breastfeeding to boost the newborn's immune system.

Three more children die of measles

In the last 24 hours, three more children have died with measles-like symptoms across the country. This brings the total number of children who have died from confirmed measles and measles-like symptoms to 680.

Following the measles outbreak, the Directorate General of Health Services (DGHS) began collecting new data starting March 15. According to the latest figures, 93 children have been confirmed dead from measles so far. Additionally, 587 more children have died with measles-like symptoms.

In the last 24 hours, 62 new cases of measles have been identified. During the same period, 1,001 individuals sought treatment at various hospitals across the country with symptoms of measles.

According to DGHS data, the highest number of deaths with measles-like symptoms—250—occurred in the Dhaka division. Additionally, 87 deaths were recorded in Rajshahi division, 74 in Sylhet, 53 in Mymensingh, 49 in Chattogram, 39 in Barishal, 27 in Khulna, and 8 in Rangpur division.