Bangladesh is facing a growing health crisis as measles cases and deaths remain high while dengue hospitalisations surge, putting additional pressure on hospitals already struggling with a heavy patient load.
Experts say measles has effectively been left to run its course despite vaccination campaigns, while a lack of coordinated measures to control dengue has allowed infections to rise sharply.
Since Mar 15, the Directorate General of Health Services (DGHS) has recorded 973 deaths among people with measles or measles-like symptoms, including 99 confirmed measles deaths.
A total of 157,991 patients have been logged with measles-like symptoms, while 19,312 have tested positive for the highly-contagious disease.
Dengue hospitalisations have also risen sharply. According to Monday's bulletin, 35,846 people have been admitted with dengue since the beginning of the year and 97 have died.
August alone accounted for 20,536 dengue hospitalisations, compared with 9,206 in July, more than double the previous month's figure. There were 2,907 admissions in June, 714 in May, 640 in April and 353 in March.
Public health specialist Mushtuq Husain said the lack of coordinated action was making the situation more difficult.
"Measles is no longer being discussed in the same way. There had been warnings much earlier that dengue would increase, but no coordinated measures were taken," he said.
The simultaneous spread of the two diseases is particularly concerning for children recovering from measles, experts say.
Mushtuq said a person who develops dengue after measles could become physically weaker than other patients, increasing the risk of death.
Hospitals are already struggling to accommodate patients. As of Aug 30, 99 measles patients and 37 dengue patients were admitted to Bangladesh Shishu Hospital and Institute.
At Shaheed Suhrawardy Medical College Hospital, 236 dengue patients were occupying beds, nearly twice its capacity, while 83 measles patients were admitted.
A doctor at the hospital said patients were being admitted mainly when their condition was severe because there were no beds available.
The hospital's Acting Director Nanda Dulal Saha said the facility was trying to provide treatment and admit as many patients as possible, stressing the importance of timely hospital visits and proper fluid management for dengue patients.
Bangladesh Shishu Hospital Director Prof Mirza Ziaul Islam said four or five patients had tested positive for both measles and dengue and had become critically ill, although they recovered with intensive treatment.
Measles and Dengue Control Measures
The government launched an emergency measles vaccination campaign in high-risk areas in April, eventually covering children aged six to 59 months nationwide. More than 19.6 million children received vaccines, exceeding the target of 18 million.
However, experts said the campaign had not brought measles under control.
On Aug 16, the government decided to vaccinate another 1.6 million children who had been missed in different areas.
Experts have also repeatedly warned that dengue could rise during the rainy season.
Prof Mahmudur Rahman, former director of the Institute of Epidemiology, Disease Control and Research (IEDCR), said measles appeared to have been left to "nature", with the expectation that transmission would eventually decline after widespread infections and deaths.
Mushtuq recommended expanding dengue testing at the local level so cases can be detected early and patients receive appropriate treatment at Upazila health complexes, reducing pressure on major city hospitals.
He said a group of children affected by measles were either aged between six and nine months or over two years old, but no decision had yet been made on how to address their vaccination needs.
“As a result, measles is not coming under control. A detailed study is needed to decide what should be done for these children, but none is being conducted. How, then, can measles be brought under control?” he said.
Public health specialist Mustaq said he saw a lack of commitment from the government to controlling measles.
“Measles is no longer being discussed in the same way. There had been warnings long ago that dengue would rise, but no coordinated measures were taken. As a result, the situation is becoming increasingly complicated,” he said.
Kabirul Bashar, a zoology professor and entomologist at Jahangirnagar University, said controlling dengue mosquitoes required “home-to-home” involvement, which had not happened.
“Mosquitoes spread more widely in and around homes than on roads, so mosquito control cannot be achieved by city corporations alone. It requires public awareness and community participation,” he said.
On measles, DGHS Additional Director General Prof Zahid Raihan said herd immunity needed to be established before the disease could be brought under control.
“Herd immunity has not yet developed. Our vaccination programme is continuing. Herd immunity develops when at least 95 percent of people in a community receive the vaccine against the disease circulating there. We hope that will happen soon and the disease will come under control,” he said.
Regarding deaths among confirmed or suspected measles patients, he said health authorities were conducting an in-depth investigation to determine whether the patients had actually died from measles or “pure pneumonia”.
“We want to remove suspected measles from this list or category, but because it was published from the beginning, we are unable to do so,” he said.
Dengue Rises Despite Tk 3.22bn Mosquito Control Budgets
The DGHS dengue bulletin for Aug 31 recorded 1,163 new hospital admissions, the highest single-day figure so far this year. Of them, 182 patients were admitted to hospitals in Dhaka North City Corporation and 123 in Dhaka South City Corporation areas.
DNCC’s mosquito-control budget rose from Tk 493 million in the 2019-20 fiscal year to about Tk 1.88 billion in 2025-26.
DSCC allocated Tk 307.5 million for mosquito control in 2022-23 and increased the allocation to Tk 574.4 million in its 2025-26 budget.
For the ongoing 2026-27 fiscal year, DNCC has allocated Tk 2.08 billion and DSCC Tk 1.14 billion for mosquito control.
The two city corporations spent a combined Tk 6.05 billion on mosquito control over the five years from 2021-22 to 2025-26.
DNCC accounted for Tk 4.09 billion of the spending and DSCC Tk 1.96 billion.
DNCC Chief Health Officer Brig Gen Imrul Kayes Chowdhury said the corporation was placing greater emphasis this year on “source reduction” to control dengue.
“The main focus is on reducing the sources where mosquito larvae breed, particularly places where rainwater accumulates,” he said.
He said DNCC had assigned staff to 10 hospitals where large numbers of dengue patients were being admitted.
“We have someone with every patient. Our staff remain at these 10 hospitals and collect the patients’ accurate addresses every day. We also collect information about where they live and work,” he said.
The staff have been trained to collect the data using a two-page questionnaire prepared by the chief health officer.
“Every day, I receive all the information on patients at hospitals in the north city area, including where they live. After information from all the zones is compiled in the evening, it is sent back to the relevant teams. The QRT teams then go to wherever a dengue patient has been identified that night or the following morning,” he said.
“No one else in Bangladesh has carried out this kind of active case surveillance.”
On the use of insecticides, Imrul said DNCC’s approach differed from that of other city corporations and municipalities.
“Their activities are largely the same: using larvicide in the morning followed by fogging. But we are also moving away from fogging to some extent because of public health concerns. Fogging is no longer being given very high priority,” he said.
DSCC Chief Health Officer Jahane Ferdous Binte Rahman said its regular mosquito-control activities were continuing.
She said a survey conducted in May had identified 27 areas as particularly high-risk, following which the findings were publicly disclosed at a press briefing.
“We then conducted a month-long crash programme across those 27 areas, working in different areas on an alternating basis,” she said.
DSCC has also deployed staff from some of its projects to hospitals and assigned them responsibility for specific areas.
They visit hospitals serving those areas to determine whether patients have come from within Dhaka or from outside the city.
“If we find that a patient has come from an area under Dhaka South City Corporation, we conduct a crash programme there. For example, if a patient is identified as coming from Nandipara, we conduct the programme there for three or four days,” she said.
Local representatives are also being involved in the operations, she said, including BNP committee presidents and general secretaries in the relevant areas and, in some cases, former councillors.
On larvicide use, she said, “We apply temephos in the morning. Temephos is a very effective larvicide. When applied to larvae in the morning, it kills them before they can develop into adult mosquitoes.”
