DHAKA: The youngest generation of Bangladeshis could face lasting developmental complications from measles, doctors have warned, as the country battles an outbreak that has already killed more than 1,000 children.
The outbreak was officially declared on March 15, when the Directorate General of Health Services began to publish daily infection figures. At least 186,813 suspected cases and 1,087 deaths have been reported since, with most infections occurring in children below two years of age.
“I have never in my life seen measles in a three-month-old infant, but I saw it this time,” Dr. ASM Mahmuduzzaman, pediatrics professor at Shaheed Suhrawardy Medical College and Hospital in Dhaka, told Arab News.
“There is a concern that these children who had measles may face long-term complications.”
He estimated that while the official number of recorded confirmed and suspected infections was nearly 200,000, the actual figure could even be as high as 500,000.
One of the most dangerous measles complications is subacute sclerosing panencephalitis, a chronic, neurodegenerative illness caused by the persistence of the measles virus in the brain. The symptoms only become apparent after a few years.
“Suddenly, with or without fever, they will experience convulsions. If this doesn’t fall into the hands of a specialist or an experienced doctor, the underlying cause of these convulsions will remain unidentified,” Mahmuduzzaman said.
“The manifestations will be like myoclonic jerks. It could involve involuntary movements in a hand, a leg, or a specific muscle group, leading to convulsions. Without proper treatment, it will lead to brain damage.”
Diagnosis requires collecting and testing spinal fluid, which can only be carried out in a few places in Bangladesh. Testing samples have usually been sent to neighboring India.
Bangladesh’s vaccination campaigns have been able to contain measles for decades, but the mass immunization drive that should have taken place in 2024-25 was missed by the caretaker government led by Nobel laureate Muhammad Yunus, which ruled until mid-February this year.
When the outbreak was declared a month later, the new government began emergency measles-rubella immunization in early April and vaccinated 20 million children, but this was not enough to contain the outbreak. Another vaccination drive started on Saturday, targeting 3.4 million children who might have been missed earlier.
In case of measles, a highly contagious, airborne disease which is especially dangerous to the under-fives, transmission stops only when immunity reaches 95 percent.
“It’s evident that a vaccination failure led us to this measles outbreak. I am not blaming anyone, but there was a gap,” said Mahmuduzzaman.
“At the moment, it’s hard to determine how much damage has been done due to this vaccination gap. But due to this outbreak, many children face long-term neurological complications that could leave a portion of a generation disabled.”
According to Dr. Ariful Bashar from Infectious Diseases Hospital Mohakhali in Dhaka, SSPE “is estimated to occur in about 1 in every 1,000 cases.”
A much more common post-measles condition is immune amnesia, which causes the immune system to forget how to fight off illnesses it has defeated in the past.
Children who contract the disease will face its consequences for some years.
“Cases of other contagious diseases, especially childhood tuberculosis, are likely to increase … Infections of the ear and nose, and other respiratory infections also become more likely,” said Bashar.
“Measles consequences can be severe as immunity gets suppressed. It may trigger various secondary infections. These suppressed immunity conditions last for a certain period, usually three to four years, or slightly longer.”
