Overcrowded living conditions in Chattogram’s densely populated neighbourhoods are accelerating the spread of measles, with unvaccinated children emerging as the primary victims and potential spreaders of the virus.
Health data and hospital records indicate a sharp rise in suspected measles cases in the city, where infection rates are significantly higher than in surrounding upazilas. According to the Chattogram Civil Surgeon’s Office, the prevalence in the metropolitan area is currently 14 times higher than in rural areas.
As of April 1, a total of 71 suspected cases have been reported in the city, compared to just five across 15 upazilas. On the same day alone, 16 new suspected cases were identified in the city, while only two were recorded outside it. The highest number of cases is being reported from Bakalia, Lalkhan Bazar, Khulshi, and Chandgaon areas.
Medical experts say the condition is being driven largely by gaps in routine immunisation coverage. Hospital authorities said, most of the admitted children never received vaccine under the Expanded Programme on Immunisation (EPI). Chattogram International Medical College Hospital reported that all 10 children admitted with measles symptoms in March had not been vaccinated.
Parents have cited a range of reasons for missed vaccinations, including mild illnesses at the scheduled time and lack of awareness. In some cases, caregivers were unsure whether their children had received the measles vaccine at all.
Adding to concerns, several children are being infected before reaching the eligible vaccination age of nine months. Cases such as five-month-old Jawad and five-and-a-half-month-old Abdullah highlight the vulnerability of infants in high-transmission settings.
Doctors warn that while measles itself is highly contagious, its complications pose a greater threat to the children’s lives. Many patients are presenting with pneumonia, diarrhoea and respiratory distress. In March, five out of 10 children admitted to CIMCH required support in the Pediatric Intensive Care Unit (PICU).
A suspected measles-related death has already been reported in Chattogram, involving a child undergoing treatment at Chattogram Medical College Hospital.
Efforts to confirm cases are further complicated by the absence of a dedicated measles testing laboratory in Chattogram. Samples must be sent to Dhaka’s National Polio and Measles Laboratory (NPML) or the Institute of Public Health (IPH). Of the 111 samples sent so far, only eight have been confirmed positive.
Public health experts emphasise that low awareness and misconceptions about vaccination are key drivers behind the outbreak. They said that children who have not been vaccinated even after reaching nine months of age can still receive the vaccine at nearby health centres up to the age of five.
Chattogram Civil Surgeon Dr Jahangir Alam said there is no shortage of measles vaccines and urged parents to ensure timely immunisation of their children.
With high population density facilitating rapid transmission, experts warn that failing to bring all children under vaccination coverage and address misinformation could make the outbreak increasingly difficult to control. Strengthening immunisation efforts and community awareness in urban hotspots is now critical to containing the spread.
