Why Bangladesh has lost 1,000 lives to measles despite record vaccine drive

Dhaka, Bangladesh – One-year-old Saif Hasan died within minutes of being taken into intensive care at Dhaka’s Infectious Diseases Hospital (IDH) on August 27.

The child from the southern Bangladesh district of Shariatpur had developed a fever and rashes days after receiving his first measles-rubella vaccine. His family wondered whether the vaccine had made him ill.

But Saif, who had been receiving treatment for a pre-existing respiratory illness, was likely infected with measles before the vaccine had time to protect him, Shrebash Paul, a junior consultant at the hospital, said. “The infection then aggravated his underlying condition.”

Saif’s death points to the challenge Bangladesh faces in containing a measles epidemic that is now believed to have killed more than 1,000 people since March 15 this year. Last year, Bangladesh recorded 132 measles cases in total, with zero deaths.

The deaths come despite an emergency campaign that has administered nearly 20 million vaccine doses over this period.

By September 9, health authorities had recorded 1,009 deaths – 100 among laboratory-confirmed measles patients and 909 classified as suspected measles deaths. Yet the same official data shows 19.75 million children vaccinated since the emergency campaign began in April against the target of 18 million.

But public health experts say that apparently extraordinary figure helps expose one of the problems Bangladesh has faced in controlling the epidemic: On the one hand, the original estimate of the children needing vaccines was too low, while on the other, national coverage figures can obscure pockets where large numbers of susceptible children remain.

Bangladesh’s vulnerability to measles did not emerge overnight.