Post-measles pneumonia, malnutrition driving child deaths as outbreak persists
Most affected children found unvaccinated, malnourished
Highlights:
- Many die within 24-72 hours due to late hospital arrival
- Majority of deaths among children under 10 months
- Over 15,600 cases and 136 deaths reported in Dhaka
- Malnutrition and weak immunity worsening outcomes
There are no signs of improvement in Bangladesh's measles outbreak, with hospital data showing that post-measles pneumonia and malnutrition account for nearly 90% of child deaths, alongside complications such as meningoencephalitis (33%) and septicaemia (22%), with most affected children unvaccinated.
An analysis of 66 deaths at Dhaka's Infectious Diseases Hospital, Bangladesh Shishu Hospital, and DNCC Dedicated Covid Hospital found 59 were due to pneumonia and malnutrition.
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Case analysis shows one in three children died within 24 hours of hospital admission, and 40% within 72 hours, indicating late arrival in critical condition. About 18% of deaths were among infants under six months, 50% among those aged 7-10 months, and 32% among children over one year.
So far, 15,643 children have been treated for measles or related symptoms in Dhaka, with 136 deaths reported. Of these, 6,400 cases and 66 deaths were recorded at the three hospitals. However, the Directorate General of Health Services (DGHS) has yet to begin a formal death review.
Dr FA Asma Khan of the Infectious Diseases Hospital said measles is increasingly followed by severe pneumonia and respiratory distress, making treatment at district-level facilities difficult.
Many patients are referred to Dhaka after their condition worsens, often arriving after visiting multiple facilities. She noted that nearly all admitted children have severe pneumonia alongside measles. Citing research, she said one in 20 infected children develops pneumonia, the leading cause of death.
Between 8am Monday (27 April) and 8am yesterday (28 April), nine children died while 1,276 patients were admitted nationwide, including 163 lab-confirmed cases. This year, 47 confirmed deaths and 266 suspected deaths have been reported, with 4,856 confirmed cases and 34,662 suspected cases identified overall.
Experts say malnutrition is a major risk factor among children. With weakened immunity, malnourished children are more vulnerable to severe infections. At the same time, low measles vaccination coverage has further increased infection risks.
Complications and delayed care
Dr Kamruzzaman, assistant professor at the Bangladesh Shishu Hospital and Institute, confirmed to The Business Standard that most measles-related child deaths are now being driven by complications such as severe pneumonia and encephalitis.
He said a significant number of admitted children are suffering from complicated pneumonia, including cases linked to adenovirus, while some are developing encephalitis – a brain infection that sharply raises the risk of death.
He warned that gaps in preventive care are compounding the crisis. Irregular vitamin A campaigns over the past year have weakened children's immunity, even though guidelines require supplementation every six months.
Deficiency, he said, leaves children more vulnerable to severe post-measles complications. He also pointed to a declining trend in breastfeeding, which may be further undermining immunity among affected children.
Hospitals are using bubble CPAP to manage respiratory distress, but delayed hospital visits remain a critical problem. Many children are brought to Dhaka from outside the capital in advanced stages of illness, limiting the chances of recovery.
He urged parents to act quickly at the first sign of breathing difficulty or pneumonia, seek qualified medical care, avoid informal treatment, isolate infected children, and ensure proper nutrition, breastfeeding, and post-recovery vitamin A supplementation.
