Bangladesh battles deadly measles outbreak as investigation highlights vaccination gaps

A measles outbreak in Bangladesh has killed 1,147 people and infected more than 202,000 others since it began in March 2026, with an investigation by Reuters linking the crisis to declining vaccination coverage, weak health data and difficulties reaching children.

The Reuters investigation, published on Saturday, found that Bangladesh’s routine measles vaccination programme faltered in 2025, with first-dose coverage falling to 90 per cent and second-dose coverage to 86 per cent.

The figures were below the 95 per cent coverage level the World Health Organisation (WHO) says is needed to prevent measles outbreaks.

The investigation was based on a review of WHO documents and interviews with more than a dozen scientists, health workers and officials. Reuters also examined previously unreported documents from meetings between the Bangladeshi government, WHO and other health partners.

“Until recently, Bangladesh had been a vaccination success story,” Reuters noted. WHO and UNICEF estimated that the country achieved 96 per cent coverage for the first measles vaccine dose and 93 per cent for the second dose in 2024.

However, Reuters reports that political turmoil following 2024 protests disrupted health services.

“But that same year, protests erupted that ended 15 years of rule by Prime Minister Sheikh Hasina. In the ensuing political turmoil, health workers went on strike, vaccine orders were delayed, and follow-up vaccinations that usually accompany routine programmes were disrupted,” it noted.

Emergency campaign

As the outbreak worsened, Bangladesh launched an emergency vaccination campaign that reached almost 20 million children in April and May.

The government said the campaign had covered every child in the target age group of six months to five years.

However, Reuters found evidence that millions of children may have been missed. A separate routine health intervention conducted in June had a target list containing four million more children than the measles emergency campaign, despite covering the same age group.

The discrepancy raised questions about how complete the emergency campaign was and the data used to determine how many children needed vaccination.

By August, Reuters reviewed documents showing that gaps persisted. Meeting minutes described the proportion of children with confirmed measles who had not been vaccinated as virtually unchanged after the emergency campaign.

At the end of September, the government launched another campaign targeting 3.4 million children it said had previously been missed.

Mark Jit, a WHO vaccine adviser, described Bangladesh’s experience as “a real warning to every country”, saying preventing an outbreak through vaccination was easier, cheaper and safer than responding after transmission had intensified.

Nigeria’s situation

The development comes as measles also remains a public health concern in Nigeria, where thousands of cases and more than 100 deaths were recorded in the first seven months of 2026.

According to the Nigeria Centre for Disease Control and Prevention (NCDC), 9,308 suspected measles cases were recorded across the 36 states and the Federal Capital Territory between January and July.

Of these, 7,713 were confirmed, while 522 were discarded and 1,073 remained pending. The NCDC recorded 109 deaths during the period, giving a case fatality ratio of 1.41 per cent.

The burden was reported nationwide, with all 36 states and the FCT recording at least one suspected case. A total of 611 local government areas reported at least one suspected case, while measles outbreaks were recorded in 71 LGAs across 14 states.

The NCDC said children aged nine to 59 months accounted for 58.67 per cent of confirmed measles cases recorded in 2026 during the period covered by the report.

Borno recorded the most suspected cases, with 2,673, followed by Zamfara with 1,157 and Yobe with 792. The three states accounted for more than half of the suspected cases recorded during the period.

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Surveillance challenges

The NCDC has also identified surveillance and data reporting as challenges in Nigeria’s response.

Its reports have highlighted the need to harmonise surveillance and laboratory data from states and laboratories, provide timely reporting and strengthen follow-up with states experiencing outbreaks.

As of the end of July, the agency was conducting outbreak-response activities, including surveillance engagement, developing supplementary immunisation plans for measles and rubella, and testing samples through reference laboratories.