Measles mortality surges as outside-Dhaka patients arrive late at hospitals 

Highlights: 

• DMCH records 15 child deaths, 11 of them referred from outside Dhaka 
• Infectious Diseases Hospital reports 10, majority transferred from other dists
• DNCC Covid hospital reports only 25% admissions from within Dhaka city 
• Pattern shows late referral and deteriorated patient condition on arrival

Confirmed measles cases and suspected infections in Bangladesh have crossed 60,000, with at least 430 child deaths, according to health professionals. Doctors say a large share of patients referred from outside Dhaka arrive in critical condition, with most deaths occurring among late-stage cases.

Nine more children died from measles and related symptoms between 8am Wednesday and 8am yesterday, according to the Directorate General of Health Services (DGHS). In the same period, 1,489 patients were admitted with measles-like symptoms, including 126 confirmed cases.

Medical experts have called for urgent training for district and divisional physicians and a national treatment guideline to reduce preventable deaths. Professor Dr Mirza Md Ziaul Islam of Bangladesh Shishu Hospital and Institute said many patients from outside the capital are not receiving proper initial care.

He said measles with pneumonia requires timely oxygen support, and delays can quickly worsen lung damage. "Basic measures such as vitamin A, nutrition support, and oxygen monitoring are not being followed properly, leading to rapid deterioration," he said.

Dr Islam said at least 29 children have died at the hospital since January, most arriving in extremely critical condition. "In many cases, it is clear on arrival that there is a very high risk of death within 24 to 48 hours, as major organs are already affected," he added.

He called for an immediate "Measles Management Manual" and nationwide training for doctors. "The situation is becoming more complex. Doctors need updated training," he said, adding that early intervention at the field level could reduce severe cases and deaths.

Late arrival at hospital increasing death toll

Health authorities said they reviewed 60 measles-linked child deaths this year. Of these, 48 occurred in Dhaka hospitals, including 18 from Dhaka district and 30 referred from other districts. Outside Dhaka, 12 deaths were recorded.

At Dhaka Medical College Hospital, 15 children died, 11 referred from outside Dhaka. At the Infectious Diseases Hospital, 10 died, six transferred from other districts, reflecting a pattern of late referral and severe condition on arrival.

Dr Asif Haider, spokesperson for the DNCC COVID Dedicated Hospital, said about one-quarter of admissions come from within Dhaka, while most arrive from outside in severe condition.

"These patients often require immediate intensive care," he said, adding many had been treated elsewhere before referral. He noted that a child who died Wednesday afternoon had also been referred from outside Dhaka.

Additional Director General of DGHS, Professor Dr Jahid Rayhan, said most children admitted to hospitals in severe condition are already in poor health by the time they leave home. As a result, their condition worsens further before they are eventually brought to Dhaka. He said earlier treatment at the upazila or district hospitals could have prevented many severe cases.

He added that though measles management is not complex, health complications raise the mortality risk. Specialist capacity exists outside Dhaka, and unnecessary transfers should be avoided. Despite strengthened ICU facilities, deaths continue.

He also said guardians often move patients between hospitals, worsening outcomes. "Our objective is to stabilise patients at a designated treatment centre," he said.

Prime Minister's Special Assistant on Health Affairs Dr SM Ziauddin Haider described the rising deaths as "a matter of shame" for authorities.

Speaking at the DGHS briefing, he said the government aimed to vaccinate 18 million children, but coverage has reached 104% as additional children were included. He said the programme has helped stabilise transmission and mortality trends.