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Three more confirmed measles deaths were reported in the 24 hours till 8:00am yesterday, taking the total to 42 since March 15. Four more suspected deaths were recorded during the period, raising the toll to 198, according to the Directorate General of Health Services.

A total of 172 confirmed cases were reported in the same period, bringing the number to 4,231. Another 1,215 suspected cases pushed the toll to 29,549.

In its Disease Outbreak News on Thursday, WHO said Bangladesh’s National International Health Regulations (IHR) Focal Point notified it on April 4 of a nationwide surge in measles cases, affecting 58 of 64 districts across all eight divisions.

The highest cumulative burden of suspected cases since March 15, 2026, has been reported in Dhaka (8,263 cases), Rajshahi (3,747), Chattogram (2,514), and Khulna (1,568).

In Dhaka, cases are concentrated in densely populated informal settlements, including Demra, Jatrabari, Kamrangirchar, Korail, Mirpur, and Tejgaon industrial and slum clusters.

Children under five account for 79 percent of reported cases, including those under two (66 percent) and infants under nine months (33 percent).

A total of 166 suspected deaths has been reported, mainly among unvaccinated children under two, it said.

WHY THE OUTBREAK?

According to the WHO risk assessment, the current outbreak is occurring in the context of suboptimal population immunity.

WHO said that, before the outbreak, Bangladesh had made substantial progress towards measles elimination, with first-dose coverage rising significantly between 2000 and 2016 and second-dose coverage improving after its nationwide introduction in 2012 through 2024.

Confirmed cases declined sharply during this period.

However, recent declines in MR1 and MR2 coverage due to a nationwide stockout of measles-rubella vaccines between 2024 and 2025, combined with routine immunisation gaps and the absence of nationwide supplementary campaigns since 2020, have increased the number of susceptible children and contributed to the outbreak.

In addition, some children were infected before reaching the age of eligibility for vaccination at 9 months.

RISK ASSESSMENT

WHO said the concentration of cases among unvaccinated and under-vaccinated children, including infants, raises concern over continued transmission and severe outcomes.

It also warned of considerable risk of cross-border spread due to population movement.

Major urban centres such as Dhaka, Chattogram, Sylhet and Cox’s Bazar serve as key international travel and transit hubs, increasing the likelihood of both national and cross-border spread, particularly among unvaccinated or inadequately vaccinated travellers.

Measles remains endemic across the South-East Asia region, and the regional risk is assessed as high.

In Myanmar, a large number of children remain unvaccinated or zero-dose, while ongoing conflict and humanitarian crises have weakened surveillance and response capacity.

India, despite high vaccination coverage, has reported a rise in cases over the past six months. Border areas such as Jashore and Chapainawabganj -- identified as hotspots -- have busy land crossings with India, increasing the risk of cross-border transmission.

RECOMMENDATIONS

WHO recommended strengthening epidemiological surveillance in high-traffic border areas to enable rapid detection and response to suspected cases.

It stressed the need for continued coordination across national, divisional and local levels once rapid response teams are activated, supported by clear and continuous communication channels.

During outbreaks, hospitals should implement measures to prevent nosocomial transmission, including isolating patients and minimising contact in waiting and hospital areas.

WHO also recommended maintaining stocks of measles, mumps and rubella vaccines, along with syringes and related supplies, to respond to imported cases.

However, it does not recommend any restrictions on travel or trade based on the current outbreak.