Measles kills 459 children in 64 days, outpacing Covid’s early death toll

Bangladesh has lost 459 children to measles and measles-like symptoms in just 64 days – a toll that exceeds the number of deaths recorded in the first two months of the Covid-19 pandemic, when 386 people died in the same window after the disease was first detected.

Public health experts say that although measles is a long-known, vaccine-preventable disease with established treatment protocols, its rapid death toll compared to the early days of Covid-19 exposes deeper systemic failures, with a healthcare system struggling under pressures it was never built to bear.

Meanwhile, five more children died in the 24 hours until 8am today (18 May), taking the total death toll from measles and measles-like illnesses to 464, according to the Directorate General of Health Services (DGHS). During this period, 1,405 patients with measles-like symptoms were admitted to hospitals nationwide, of whom 89 cases were confirmed as measles.

A crisis hiding in plain sight

The DGHS began formally tracking measles and suspected measles patients on 15 March. Since then, laboratory tests have confirmed 7,767 measles cases nationwide, while the number of suspected cases has risen to 57,846.

Of those patients, 37,744 have been discharged after treatment.

Of the 459 child deaths recorded over the 64 days until 17 May, 75 were confirmed as caused by measles, while 384 children died with symptoms consistent with the disease.

The comparison with Covid-19 has alarmed health experts.

Bangladesh detected its first coronavirus case on 8 March 2020, while the first Covid-related death was recorded ten days later. It took more than three months for the country's Covid death toll to exceed 400.

Measles, by contrast, crossed that threshold in less than two months.

Experts say the contrast is particularly striking because Covid-19 was a new and globally unknown virus at the time, whereas measles is a long-established disease with vaccines and known treatment protocols.

'Our system cannot cope'

"Covid and measles are different diseases, but the trajectory of deaths and pressure on the health system can be compared," said Dr M Mushtuq Husain, speaking to The Business Standard. "When patient numbers surge, our system cannot manage it – that is a stark reality."

He warned against authorities giving assurances that the situation was fully under control if the healthcare response remained inadequate. "If the message is that everything is under control when it is not, the risk only grows. If patients are not reached before their condition becomes critical, ICU dependency will rise – and that is very difficult to manage," he said.

Mushtuq also pointed to the concentration of specialist care in major urban hospitals as a key challenge, saying many patients arrive only after their conditions have seriously deteriorated.

This, he said, increases pressure on doctors and limits the ability of hospitals to provide adequate care to all patients. "There is no alternative to strengthening public health infrastructure now if we are to achieve universal healthcare coverage by 2030," he added.

High transmission rate linked to surge in morality

Mahmudur Rahman, former director of the Institute of Epidemiology, Disease Control and Research, said the highly contagious nature of measles was a major factor behind the scale of the outbreak.

"A single measles patient can infect 15 to 18 others on average. At its peak, Covid's rate was around five," he said. "More infections mean more deaths."

But he said transmission alone could not explain the high mortality rate.

"Malnutrition, low breastfeeding rates, vitamin deficiencies, weakened immunity, and delays in hospital admission – all of these together create the conditions for mortality," he said.

Mahmudur added that improved infection prevention measures and better ward management in hospitals could help reduce deaths without requiring new medical technologies or treatments.

"It requires no new science or medicine, only the will to act on what is already known," he said.