Bangladesh at high risk of measles due to vaccine shortage: WHO

The World Health Organization (WHO) has expressed concern over the measles situation in Bangladesh, assessing it as a nationally “high-risk” condition due to vaccine shortages.

The assessment was published in a report released on Thursday (April 23).

According to the WHO report, a total of 19,161 suspected measles cases were recorded in the country between March 15 and April 14. During the same period, 2,897 cases were confirmed through laboratory testing.

The report further states that 2,973 laboratory-confirmed measles cases were identified overall, while 166 suspected deaths were linked to measles, with a case fatality rate of 0.9 percent. In addition, 30 laboratory-confirmed measles-related deaths were reported, with a fatality rate of 1.1 percent.

The organization said cases have been detected in all eight divisions of Bangladesh, and in 58 out of 64 districts—about 91 percent of the country. This indicates widespread national transmission.

The WHO noted that most patients are children under five years of age, accounting for 79 percent of cases. Among them, 66 percent are under two years old, and 33 percent are under nine months. The majority of deaths have also occurred among unvaccinated children under two.

The report highlights that a large proportion of children are either unvaccinated or have received only one dose of the vaccine. Some children were infected before reaching the eligible age for vaccination at nine months. Overall, 91 percent of cases are in children aged 1–14, indicating significant immunity gaps in this age group.

According to WHO, Bangladesh had previously made notable progress toward measles elimination. Coverage for the first dose of measles-rubella (MR) vaccine increased from 89 percent in 2000 to 118 percent in 2016, while second-dose coverage rose from 22 percent in 2012 to 121 percent in 2024. However, a national shortage of MR vaccines in 2024–25, combined with gaps in routine immunization and the absence of nationwide supplementary immunization campaigns since 2020, has increased the number of susceptible children, leading to the current outbreak.

The WHO has classified the national risk level as “high,” citing ongoing transmission across multiple divisions, a large vulnerable child population, documented immunity gaps, and measles-related deaths.

It warned that unvaccinated and partially vaccinated children remain at highest risk, along with infants too young to be vaccinated, contributing to sustained transmission and severe illness.

The report further states that Bangladesh’s earlier progress in measles control has been reversed, increasing vulnerability to sustained outbreaks. Without urgent action, transmission may continue to spread.

The WHO urged strengthened surveillance, rapid case detection, and improved vaccination coverage to close immunity gaps. It also emphasized maintaining at least 95 percent coverage for both MR vaccine doses in all municipalities.

Special attention was recommended for border and transit areas, including major cities such as Dhaka, Chattogram, Sylhet, and Cox’s Bazar, due to high population movement and international travel, which increases cross-border transmission risks.

The organization also advised vaccinating high-risk groups, including healthcare workers, transport and tourism workers, airport and border staff, and international travelers. It recommended post-exposure vaccination within three days and immunoglobulin treatment within six days for those who cannot be vaccinated in time, especially infants, pregnant women, and immunocompromised individuals.

Finally, WHO stressed the importance of maintaining adequate stocks of vaccines, syringes, and essential supplies, and ensuring coordination between national and local health authorities to prevent further spread.