A-Z Index × Submit A-Z Index × Submit A-Z Index Search Dropdown × Submit Facebook Twitter LinkedIn Syndicate Emerging Infectious Disease journal ISSN: 1080-6059 Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.
The global resurgence of measles is a major public health concern. After the success of its Expanded Programme on Immunization, Bangladesh experienced a measles resurgence in 2026. The country faced major setbacks after measles vaccination coverage declined because of political instability, discontent among field-level staff, change in procurement policy, COVID-19–related service disruptions, and delayed supplementary immunization campaigns. During March 15–September 13, 2026, Bangladesh reported 170,638 suspected and 20,006 confirmed measles cases, including 919 deaths among suspected and 100 deaths among laboratory-confirmed cases. The outbreak disproportionately affected unvaccinated and underimmunized children. Political turmoil during 2024–2025 disrupted vaccine procurement, delayed mass vaccination campaigns, weakened the health workforce, and compromised financial and logistic continuity. Simultaneously, disruptions in vitamin A supplementation and worsening child malnutrition amplified disease severity. To prevent future resurgence, immunization programs must be depoliticized, supported by buffer vaccine stocks, strengthened through microlevel surveillance, and integrated with nutrition and primary healthcare services.
Measles is an extremely contagious viral disease; each primary case generates an average of 12–18 secondary infections ( 1 ). Although global measles cases declined by 71% from 2000 to 2024, the World Health Organization (WHO) reported 395,521 cases in 2024 and 254,384 in 2025; by the end of April 2026, global case counts had reached 86,503 ( 1 , 2 ). Like other countries, Bangladesh’s measles outbreak during early 2026 served as a clear reminder that public health achievements are never permanent; they are dynamic states of equilibrium that require constant maintenance, political or structural stability, and resource security.
Bangladesh was praised as a global exemplar of the Expanded Programme on Immunization (EPI) for decades; its successful vaccination coverage increased from 2% in the late 1970s to near-universal levels by the 2010s ( 3 , 4 ). Measles-containing vaccine (MCV) 1 coverage increased from 74% in 2000 to 94% in 2016, and MCV2, a routine second MCV dose introduced in 2012, reached 93% in 2016 ( 5 ). Bangladesh achieved its regional rubella control goal in 2018 and subsequently targeted measles and rubella elimination by 2020 ( 6 ). However, the COVID-19 pandemic and the early 2026 measles outbreak have challenged that narrative, revealing underlying weaknesses in Bangladesh’s health system. The 2026 measles outbreak was not merely a biological phenomenon driven by a highly contagious virus, it was a systems-sensitive emergency that exposed the intersection of vaccination disruption resulting from political upheaval ( Appendix Table), nutritional neglect, disruption of regular vaccine procurement, perceived adverse effects of COVID-19 vaccination, widespread misconceptions, and the long-term disruption of routine immunization services in the aftermath of the COVID-19 pandemic ( 7 – 9 ).
Previous publications have documented the early measles resurgence, immunization…