JONATHAN M. METSCH, Dr.P.H. – Tracking Emerging Public Health Challenges – October 19, 2026– MEASLES
Bangladesh, whose routine vaccination program faltered in 2025, has reported 202,000 suspected measles cases — 22,000 of them laboratory-confirmed — from the start of the outbreak in mid-March to Oct. 9, the World Health Organization said. That’s more suspected cases than any other country this year.
So far, 1,147 people have died of the highly contagious disease, with 94% of reported deaths among children under 5 years old, the WHO said.
Bangladesh’s experience shows the challenge of containing an outbreak when vaccination coverage falls below 95%, a level the WHO says is needed to prevent outbreaks. Bangladesh almost achieved that in recent years, but coverage dropped in 2025.
A Reuters review of WHO documents, alongside interviews with more than a dozen scientists, health workers and officials, shows that Bangladesh was also hampered in its emergency response by data that left out millions of children, shortcomings in preparation and a failure to reach enough parents.
“This is a real warning to every country,” said Mark Jit, a WHO vaccine adviser and professor at the School of Global Public Health at New York University.
Preventing an outbreak through vaccinations is easier, cheaper and safer than responding to an emergency, he said.
“The response will stop the outbreak eventually, but in the meantime, many will have had measles, and some will have died,” he said.”
“Bangladesh is battling to contain the world’s worst measles outbreak, a crisis exacerbated by weak data, inadequate outreach and vaccination gaps that experts say offers a warning to other nations about the deadly risk of falling immunization rates.
Bangladesh, whose routine vaccination program faltered in 2025, has reported 202,000 suspected measles cases — 22,000 of them laboratory-confirmed — from the start of the outbreak in mid-March to Oct. 9, the World Health Organization said. That’s more suspected cases than any other country this year.
So far, 1,147 people have died of the highly contagious disease, with 94% of reported deaths among children under 5 years old, the WHO said.
Bangladesh’s experience shows the challenge of containing an outbreak when vaccination coverage falls below 95%, a level the WHO says is needed to prevent outbreaks. Bangladesh almost achieved that in recent years, but coverage dropped in 2025.
A Reuters review of WHO documents, alongside interviews with more than a dozen scientists, health workers and officials, shows that Bangladesh was also hampered in its emergency response by data that left out millions of children, shortcomings in preparation and a failure to reach enough parents.
“This is a real warning to every country,” said Mark Jit, a WHO vaccine adviser and professor at the School of Global Public Health at New York University.
Preventing an outbreak through vaccinations is easier, cheaper and safer than responding to an emergency, he said.
“The response will stop the outbreak eventually, but in the meantime, many will have had measles, and some will have died,” he said.” (2)
“Still, when the measles outbreak erupted, Bangladesh responded swiftly and initially seemed to be winning the battle.
An emergency programme was followed by an initial slowdown in new cases after almost 20 million children received a vaccination in April and May. The government said it had covered every child in the target age group of six months to five years.
But in reality the programme fell short. This emerged when another routine health intervention in June had a target list with 4 million more children than the measles campaign despite covering the same age group.
“There is a gap,” prime ministerial adviser Hyder told Reuters on September 14, as measles cases rose again, blaming vaccine hesitancy by parents or child illnesses for keeping kids away.
Documents detailing meetings in April and August between the government, the WHO and other health partners, reviewed by Reuters and not previously reported, show how efforts to act fast may have led to shortcomings.
Minutes from the April 19 meeting outlined how the government opted for just one round of so-called readiness checks before launching its emergency vaccination programme due to time constraints, instead of the typical four rounds. Checks cover everything from ensuring fridges are available for keeping vaccines cool to determining how many children should be vaccinated.
The single round of checks suggested most – but not all – districts were ready, according to the minutes.
“When preparedness checks are not done properly, it is often the poorest and hardest-to-reach children who miss out on vaccination and pay the price,” said Professor Mahmudur Rahman, an epidemiologist and chair of Bangladesh’s National Verification Committee for Measles and Rubella Elimination.” (3)
“While officials are commenting on measles outbreaks when asked about them and agencies are continuing to issue support, infectious disease specialists say a strong messaging campaign at the federal level would go a long way toward boosting the measles response.
Jeanne Marrazzo, CEO of the Infectious Diseases Society of America and former director of the National Institute of Allergy and Infectious Diseases (NIAID), opined that an overarching informational message explaining what the MMR vaccine does would be a good start, especially given how many outbreaks there have been this year — 42 at the most recent count.
“I don’t think that pronouncements from the federal government are necessarily going to fill that much more complex space where decisionmaking is impacted by a lot of things we often don’t understand or aren’t articulated,” said Marrazzo.
“I do think that a national message can be crafted to encompass a more broad kind of acceptance of people’s vaccine hesitancy,” she added. “We just haven’t really seen that because, again, I don’t think we’ve seen a full-throated endorsement or explanation of why the vaccine right now is so critical.”
And while experts in the field hold out for stronger messaging from the top, some argue that what has been said publicly may have done more harm to countering the measles spread.
“With an ongoing increase in cases, the standard response is to provide support to jurisdictions, including vaccine, financial resources, and offer staff. These things are currently still happening,” said Demetre Daskalakis, former director of CDC’s National Center for Immunization and Respiratory Diseases and chief medical officer at Callen-Lorde.
“What is atypical is the friction created by CDC second-guessing Pennsylvania on their adjudication of deaths attributed or related to measles,” he added. “It is also atypical to have a secretary that is a disinformation agent that distorts data to support his personal agenda.” “
““When there are mixed messages coming at any of the levels of governmental public health, it makes it a lot harder for the local health departments to do their job,” said Casalotti. “But it also makes it harder for people to figure out ‘What should I be doing?’ when you’re hearing different things.” “ (1)
EXCLUSIVE: Ex-CDC Vaccine Advisor Says Measles Outbreak Bigger Than Reported, Slams RFK Jr’s ‘No-See Evil’ Approach, https://www.healthandme.com/health-wellness/exclusive-ex-cdc-vaccine-advisor-says-measles-outbreak-bigger-than-reported-slams-rfk-jrs-no-see-evil-approach-article-156363040
U.S. Measles Cases Reach 4,410 After 330 New Infections in One Week, Highest Yearly Total Since 1991, By Elena Vega, https://www.medicaldaily.com/us-measles-cases-4410-weekly-jump-hospitalizations-480084
Sixth person who had measles has died in Pennsylvania, local coroner says, https://www.washingtonpost.com/health/2026/10/12/sixth-person-who-had-measles-died-pennsylvania-local-coroner-says/
Canada’s fight to regain measles elimination status shouldn’t stop at the border, https://www.theglobeandmail.com/opinion/article-canadas-fight-to-regain-measles-elimination-status-shouldnt-stop-at/
England reports 27 additional measles cases in past month, Robert Herriman, https://outbreaknewstoday.substack.com/p/england-reports-27-additional-measles
1.Infectious disease veterans call for clearer federal message on measles, by Joseph Choi, https://thehill.com/policy/healthcare/6149649-us-measles-outbreak-messaging-gap/
2.Measles outbreak in Bangladesh is a ‘real warning’ to other nations, experts say, By Reuters, https://www.nbcnews.com/world/asia/measles-outbreak-bangladesh-real-warning-other-nations-rcna604295
3.Bangladesh is battling measles. It’s a ‘real warning’ to other nations, By Ruma Paul, Jennifer Rigby, Sam Jahan and Zia Chowdhury, https://www.reuters.com/world/bangladesh-is-battling-measles-its-real-warning-other-nations-2026-10-17/
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai