Abstract / Summary
Abstract Background Measles has resurged globally in the post-pandemic period as routine immunisation recovery remains below the two-dose threshold required to interrupt transmission. Bangladesh, previously nearing measles–rubella elimination, entered 2026 with widening coverage gaps, depleted vaccine stocks, and increasing numbers of missed children. We conducted a situation analysis to assess the scale, concentration, and programmatic implications of the outbreak. Methods We performed a rapid mixed-evidence review from 11–15 April 2026 using data from WHO, UNICEF, DGHS bulletins, PubMed/MEDLINE, ReliefWeb, SEARO updates, and Bangla-language media. Of 46 records screened, 19 were included. Analysis was based on aggregated, publicly available surveillance and programme data. Findings The DGHS measles press release dated 15 April 2026 reported cumulative totals since 15 March of 19,161 suspected cases, 2,973 confirmed cases, 166 suspected deaths, and 32 confirmed deaths; a WHO update dated 15 April reported 58 affected districts. The cumulative suspected-case burden was spatially concentrated: Dhaka and Rajshahi together accounted for 62.7% of suspected cases, and the division-level HHI was 0.255. Children under five comprised 81% of cases, including 34% infants under nine months. Vaccination status showed 72% zero-dose and 16% partially vaccinated cases. Valid MR1 coverage declined from 88.6% in 2019 to 86.1% in 2023, while valid MR2 coverage declined from 89.1% to 80.7%, indicating a widening immunity gap. Interpretation The resurgence reflects accumulated immunity gaps rather than vaccine failure, driven by subnational inequities and programme disruption. Urgent priorities include targeted vaccination campaigns, restoration of vitamin A supplementation, strengthening paediatric care capacity, and integrating real-time surveillance into outbreak response.