Measles kills 18 in Moulvibazar with over 2,300 infected, as seven more children die across the country in a day

The measles outbreak has taken a grave turn in Moulvibazar district of Sylhet Division — 18 people have so far died of measles in the district and the number infected has passed 2,300. The nationwide picture is equally alarming: in the last 24 hours, seven more children have died with measles symptoms and 1,135 children have been newly infected.

The latest nationwide figures were released on Friday (23 October) in a press release sent from the control room of the Directorate General of Health Services. According to the release, the seven children died between 8am on Thursday (22 October) and 8am on Friday. However, no one died of laboratory-confirmed measles during this 24-hour period; all seven who died were being treated with measles symptoms.

In the same 24 hours, a total of 1,135 children were infected with measles and measles symptoms across the country. Of them, 1,110 were suspected measles patients and measles was confirmed by testing in 25. With more than a thousand new patients identified every day, the figures suggest the outbreak is still not under control.

According to the health directorate's count, from 15 March this year until today, 1,110 children have died in the country with measles symptoms. During the same period, a further 104 children died after measles was confirmed by testing. Combined, child deaths from measles and measles symptoms since the outbreak began now stand at 1,214.

The overall infection picture is even larger. From 15 March to today, the total number of suspected measles patients in the country has reached 218,870. Among them, 23,273 are patients with measles confirmed by testing. In other words, measles was laboratory-confirmed in only a portion of those treated for symptoms; the rest were treated on the basis of their symptoms.

Hospital admissions have also been enormous. In the same period, 194,633 suspected measles patients were admitted to hospital. Of them, 186,798 recovered and were discharged after treatment. These statistics show both the pressure on the country's hospitals and the fact that the large majority of those infected were able to return home after treatment.

Within this national picture, the situation in Moulvibazar is causing particular concern. With 18 deaths and more than 2,300 infections in a single district, this district of Sylhet Division is now being identified as one of the centres of the outbreak. Anxiety over measles was already running across the division; Moulvibazar's numbers have deepened that anxiety.

It is important to understand this statistical division: the health directorate counts 'suspected', symptom-based patients separately from laboratory-'confirmed' measles patients. Every child arriving with measles-like symptoms such as fever and rash first enters the suspected list; those in whom measles is confirmed by testing are added to a separate count. That is why two sets of figures are published for both deaths and infections.

Almost all of those who have died are children — the daily updates on deaths and infections are centred on children. In this outbreak, which has continued for more than seven months, it is children who are losing their lives most, deepening fear among parents.

The long continuity of the outbreak, from 15 March through to late October, also raises questions. In the daily updates the numbers sometimes dip and sometimes rise — but the stream of deaths and new infections does not stop. The 1,135 new patients of the last 24 hours are the latest example of that continuity.

Containing district-level spread like that in Moulvibazar is now the biggest challenge. With infections in the district having passed 2,300 in this way, the pressure on local hospitals and the treatment system is believed to be steadily rising.

The health directorate's next daily update will show whether the pace of the outbreak is slowing or rising further. For now, Moulvibazar's 18 deaths together with the loss of seven children in a single day across the country make measles the country's biggest public health concern — one that everyone is watching.