At least three cases of measles infection have been reported in Ward-6 of Ratuwamai Municipality of Morang district in what is the latest in a series of outbreaks of the deadly virus.

Officials at the Ministry of Health and Population said that the outbreak, first reported at the start of 2023 from Nepalgunj in Banke district, has already spread to several local units in five provinces including Lumbini, Karnali, Sudurpaschim, Madhesh and Province-1.

“We have launched a door-to-door campaign in the disease-hit villages,” said Kanhaiya Shah, an immunisation officer at the Health Office Morang. “Some samples of suspected cases have been collected and sent to Kathmandu for testing.”

Measles is a contagious disease transmitted through fluids from the nose, mouth or throat of infected persons and through the air. The virus infects the respiratory tract, and then spreads throughout the body. It remains a big cause of death among young children globally despite the availability of a safe and effective vaccine, according to the World Health Organisation (WHO).

Officials at the health ministry said that measles cases have also been recorded from Gaushala Municipality of Mahottari district.

“We have stepped up the surveillance in the affected areas and are in contact with agencies under the Ministry of Health and Population,” said Bala Yadav, chief of the Health Office, Mahottari.

Outbreaks of the deadly virus that started from the Nepalgunj Sub-metropolitan City have been reported from Bardiya and Dang districts in Lumbini Province, and Surkhet, Mugu and Rukum West districts of the Karnali province.

Health authorities in Sudurpaschim province informed that several cases of measles infection have been confirmed in Kailali and Kanchanpur districts.

“Eight cases of measles infection have been confirmed in three local levels of Kailali—two in Dhangadhi Sub-metropolitan City, five in Godavari Municipality and one in Gauriganga Municipality,” Lal Bahadur Dhami, chief of Health Office Kailali told the Post over the phone from Dhangadhi. "We have been launching mass vaccination drives in the disease-hit areas.”

Officials from the Health Office in Banke district said all children between six months and 15 years of the district have been administered with measles vaccine. The district has recorded one death and 322 positive cases as of Thursday.

“We have administered the measles vaccine to over 168,000 children during the mass vaccination drive,” said Naresh Shrestha, a key vaccination official at the Health Office Banke, told the Post over the phone from Nepalgunj. “Vaccination campaign is still continuing. More children will be vaccinated.”

Multiple health officials from Sudurpaschim to Province-1 the Post talked to say most measles cases have been reported among marginalised and minority religious communities—Muslims and Catholics—as well as other backward groups, where the level of awareness of regular immunisation is low.

“Outbreaks of the measles virus have occurred in children of ethnic Santhal community,” said Shah, an immunisation officer serving at the health Office, Morang. “Vaccine coverage is low among people living along the Nepal-India border who keep traveling to India frequently. Most of them opt out of vaccine programmes run by both Nepal and India.”

Low vaccination coverage, internal migration, lack of awareness on the importance of vaccines and government apathy are among the reasons for regular outbreaks of measles in the districts, according to health experts.

Health Ministry officials said that even if the country witnessed a massive measles outbreak in five provinces out of seven, they do not have any plan to launch a nationwide measles vaccination drive.

“We have been launching vaccination drives in the disease-hit areas only,” said Sagar Dahal, chief of the Immunisation Section at the family Welfare Division under the Department of Health Services. “We have not yet discussed launching a nationwide vaccination drive against measles.”

Measles was endemic in Nepal in the past and hundreds of children would die from the disease every year.

Routine measles vaccination in Nepal began in 1979, starting with three districts. The campaign was made nationwide after 10 years. Despite measles being included on the regular immunisation list, an average of 90,000 cases were recorded every year, from 1994 to 2004.

Nepal had committed to eliminating measles by 2023. To declare measles as eliminated, the number of cases should be less than five per one million people throughout the year, but the ongoing outbreak of the virus in many districts has hindered the prospect of eliminating the disease.