Dhaka: Bangladesh is battling to contain the world’s worst measles outbreak, exacerbated by weak data, inadequate outreach and vaccination gaps. Experts say the crisis warns other nations of the deadly risks of falling immunisation rates.
Bangladesh, whose routine vaccination programme faltered in 2025, reported 202,000 suspected measles cases between mid-March and October 9, including 22,000 laboratory-confirmed cases, the World Health Organization said. The country has reported more suspected cases than any other this year.
On April 4, 2026, Bangladesh notified the WHO of a nationwide rise in measles cases. Since January, infections have been reported across all eight divisions and 58 of the country’s 64 districts, or 91%.
The outbreak has killed 1,147 people, with children under five accounting for 94% of reported deaths, the WHO said.
In the northeastern Sylhet region, one of the country’s worst-hit areas, access to information and immunisation remains scarce.
Official records show that 180 children have died there. Eight of the 16 families Reuters interviewed in September said they had not seen health workers offering vaccinations. At least six said health workers visited only after a child in their community had died from measles.
“When my son was nine months old, no one visited. The health workers, I mean,” said Rajia Begum, whose two-year-old son contracted measles.
“But when he got measles a few weeks ago, then they came and vaccinated him. Even we didn't know measles could be so dangerous.”
In Chhatak, also in Sylhet, the daughter of 30-year-old carpenter Humayan Rashid died unvaccinated in June at nine months old.
Labiba Akter could have received a vaccine in April, when an emergency programme lowered the vaccination age from nine months to six.
“Not all of us are educated and (we) don't understand what this vaccination is for,” her father said.
Measles usually kills two or three people in every 1,000 cases, the WHO says, but it can be more deadly in poorer countries because of factors such as malnutrition.
The highly contagious viral disease spreads through the air or droplets from the nose, mouth or throat of infected people. Although it is usually mild or moderately severe, complications can include pneumonia, diarrhoea, secondary ear infections, brain inflammation, blindness and death. Post-infectious encephalitis occurs in about one in every 1,000 reported cases, according to the WHO.
In Bangladesh, access to vaccines and awareness remain major hurdles, experts said.
Until recently, the country had been a vaccination success story. WHO and UNICEF estimated that Bangladesh achieved 96% coverage for the first measles vaccine dose and 93% for the second in 2024.
The second dose helps protect the small percentage of children who do not develop immunity after the first.
But protests in 2024 ended Prime Minister Sheikh Hasina’s 15-year rule. In the ensuing political turmoil, health workers went on strike, vaccine orders were delayed and routine follow-up vaccinations were disrupted.
A WHO-UNICEF report published in July estimated that first-dose coverage fell to 90% in 2025, while second-dose coverage dropped to 86% — several percentage points below the 95% needed for herd immunity.
The report also questioned the quality of official vaccination data for measles and other diseases between 2023 and 2025. Preliminary figures sometimes showed more people vaccinated than the number targeted, suggesting errors in counting doses or estimating target populations.
At the end of September, the government launched a campaign targeting 3.4 million children who had previously been missed.
Health experts are also urging the government to extend vaccination to children over five, who account for a third of measles cases, according to the WHO.
Bangladesh’s National Immunization Technical Advisory Group approved a nationwide measles-rubella vaccination campaign on March 30, 2026, the WHO said. The campaign targeted children aged six to 59 months, with expanded coverage for those aged six to eight months.
It began on April 5 in 30 sub-districts across 18 priority districts before expanding nationwide on April 20.
The WHO recommends sustained, uniform coverage of at least 95% for both doses of the measles-containing vaccine in every municipality.
It also calls for stronger integrated measles and rubella surveillance to ensure suspected cases are detected promptly across public, private and social security healthcare facilities.
Prompt medical care is also vital, the WHO says, but remains another challenge as Bangladesh battles a dengue epidemic alongside the measles outbreak.
In September, all wards at Sylhet’s 100-bed Shahid Shamsuddin Ahmed Hospital, which treats measles patients, appeared overwhelmed. On the day Reuters visited, 178 patients were admitted.
(With agency inputs from Reuters)