Dhaka: Bangladesh is battling a severe measles outbreak that has claimed 1,186 lives, including 104 confirmed measles deaths, as gaps in childhood vaccination and weaknesses in the health system leave thousands of children vulnerable to the highly contagious disease.
The country's Directorate General of Health Services reported 211,040 suspected measles cases and 22,972 laboratory confirmed cases between March 15 and October 16. The combined death toll includes 1,082 deaths among suspected measles cases and 104 confirmed deaths. The figures highlight the scale of the public health emergency, which has continued despite a nationwide emergency vaccination campaign.
Children have been among the worst affected. Earlier figures reported by the World Health Organization indicated that children under five accounted for 94 per cent of reported deaths. Health experts have warned that the outbreak exposes serious weaknesses in routine immunisation and the ability of authorities to reach every child.
Measles is a highly contagious viral disease that can cause serious complications, particularly among young children and people who have not developed immunity. Vaccination remains the most effective way to prevent infection and limit its spread. Public health experts generally recommend achieving at least 95 per cent coverage with two doses of the measles vaccine to prevent outbreaks.
However, vaccination coverage in Bangladesh declined in recent years. Estimates from the World Health Organization and the United Nations Children's Fund indicate that first dose coverage fell from 96 per cent in 2024 to 90 per cent in 2025. Coverage for the second dose dropped from 93 per cent to 86 per cent over the same period.
The decline left more children vulnerable to infection and contributed to conditions that allowed the virus to spread. Health experts have linked the deterioration to several problems, including shortages of measles and rubella vaccines during 2024 and 2025, interruptions to routine immunisation, delays in vaccination activities and weaknesses in local health services.
Bangladesh launched an emergency measles and rubella vaccination campaign on April 5, initially concentrating on high risk areas before expanding the programme. Nearly 20 million children reportedly received vaccinations during the campaign, with support from the government, WHO, UNICEF and Gavi, the international vaccine alliance.
Despite the large number of vaccinations, the outbreak continued to spread. An investigation by Reuters found that the campaign had failed to reach all eligible children. Differences in child population estimates and weaknesses in vaccination records raised questions about whether health authorities had accurately identified all children who needed protection.
In late September, the government launched another campaign targeting 3.4 million children who had previously been missed. However, the available figures do not establish how many of these children have since been vaccinated or how many remain unprotected.
The difficulties have been particularly serious in remote communities, where access to healthcare can be limited. The Reuters investigation described families in the northeastern region of Sylhet whose children died without vaccination. Some parents said health workers had not visited their villages until after their children had died.
The investigation also highlighted problems with child registration and staffing shortages. Estimates cited in the report suggest that as many as 40 per cent of children may not be registered, while government data indicated that around one third of health worker positions were vacant.
These problems make it harder for authorities to identify children who need vaccines, organise outreach programmes and ensure that no community is overlooked. However, the number of unregistered children should not be treated as the number of unvaccinated children, as the two groups are not necessarily the same.
Hospitals have also faced considerable pressure. During a visit to Shahid Shamsuddin Ahmed Hospital in Sylhet in September, Reuters reported that the facility, which has 100 beds, had 178 patients admitted. Bangladesh was also dealing with a dengue outbreak, placing additional demands on healthcare services.
Another concern is the number of cases among older children. WHO figures cited in its outbreak assessment indicated that 91 per cent of cases occurred among children aged one to 14 years. The findings point to substantial gaps in immunity across this age group, including among children who had not received the recommended doses of vaccine.
Researchers are also examining infections among infants who are too young to receive routine measles vaccination. WHO has noted that some children became infected before reaching the eligible age. This highlights the importance of maintaining high vaccination coverage among older children to reduce the spread of infection within communities and protect those who are not yet eligible for vaccination.
The outbreak has prompted an independent review of Bangladesh's national immunisation programme. The government began the review on October 4 with support from WHO and other national and international partners. The review examined vaccine supplies, staffing, vaccination coverage, data quality, disease surveillance and outbreak preparedness.
Findings presented on October 14 identified gaps in childhood immunisation, depleted stocks of measles and rubella vaccines in 2025, delays in the special vaccination campaign and weaknesses in local planning and staffing. The review team warned that other vaccine preventable diseases, including whooping cough and diphtheria, could also pose risks unless urgent action is taken.
The experts recommended addressing shortages in the health workforce, improving local vaccination planning and ensuring a reliable supply of vaccines. The findings have added to calls for stronger routine immunisation services and better systems for identifying children who have missed vaccinations.
For Bangladesh, the immediate challenge is to contain the outbreak and protect children who remain vulnerable. The longer term task is to strengthen healthcare services, improve vaccination records and maintain high immunisation coverage across all communities.
The crisis also carries an important warning for other countries. Emergency vaccination campaigns can protect millions of children, but they cannot replace reliable routine immunisation. Without consistent vaccine supplies, adequate staffing and accurate records, gaps in protection can remain hidden until a serious outbreak exposes them.