The Ministry of Health and Population on Monday launched a measles vaccination drive in disease-hit areas of Malangawa Municipality as part of the outbreak response.

At least seven children tested positive, and 16 others were hospitalised with measles infection in the first week of January.

“Around 8,000 children between six months and 14 years from ward-3 and its adjoining wards—2, 4, 7, 8, 9, 10 and 11 will be vaccinated,” said Dr Abhiyan Gautam, chief of the Immunisation Section at the Family Welfare division, under the Department of Health Services. “We are using vaccines from our own stock, which was purchased for routine immunisation.”

Measles is a highly contagious viral disease transmitted through fluids from the nose, mouth or throat of an infected person. It can be potentially deadly for unvaccinated people. The disease can be prevented with a two-dose vaccine, administered to babies at 9 months and 15 months. The government provides measles vaccines free of charge from health facilities across the country.

Nepal had aimed to eliminate measles by 2026, as there had been no outbreak since June 2023. However, the outbreak of the contagious virus in Malangawa hindered the country’s progress towards meeting the goal.

The country earlier missed the 2019 and 2023 deadlines. A massive measles outbreak occurred in 2022 and 2023.

Health officials say there is a heightened risk of spillover of the virus into other areas and districts due to the ongoing public movement to and from disease-hit areas. The scheduled March 5 parliamentary election has further increased the risk, as public movement is expected to increase during the elections.

Measles-like symptoms have already been detected in ward 4 of the municipality, prompting health workers to call an epi-confirmed measles case.

The 16 lab-unconfirmed cases are epi-linked (linked to a confirmed case) measles cases, according to officials. Seven new suspected cases have been reported from disease-hit areas, according to the Health Ministry.

Meanwhile, the Health Ministry has requested the Measles & Rubella Partnership, a global alliance of major international organisations working to eliminate measles and rubella, to provide vaccines for all vulnerable children in Malangawa Municipality.

Officials say there is no system in place to track people’s movements, so the risk of virus spread is high in the adjoining areas.

“We have requested the Measles & Rubella Partnership for vaccines,” said Gautam. “If we receive them, we will administer vaccines to all children under 15 in the municipality.”

Health workers in the district said measles-like symptoms first appeared in children in Muslim settlements on January 6.

Child health experts say the outbreak in Muslim communities in Sarlahi points to gaps in Nepal’s vaccination coverage.

“There could be several other settlements and communities where vaccination coverage is low, or children are not being immunised,” said Dr Shyam Raj Upreti, former director general of the Department of Health Services.

“The outbreak has also hindered Nepal’s aim to meet the Sustainable Development Goals (SDG) targets, as more outbreaks could occur in the coming days.”

The SDGs, a follow-up on the Millennium Development Goals (MDGs), aim to end poverty, hunger and all forms of inequality in the world by 2030. Nepal has committed to meeting the targets.

To declare measles eliminated, the number of cases should be fewer than five per 1,000,000 people per year. The country must verify progress through foreign, independent verification. For independent verification, there should be no new outbreak for three consecutive years, officials say.

Doctors say people of all age groups are vulnerable to measles. Underage children, pregnant women, elderly people and those with weak immunity, such as HIV-infected people, are particularly susceptible.

Early symptoms, which usually appear 10-12 days after infection, include high fever, runny nose, bloodshot eyes and white, tiny spots inside the mouth. Several days later, rashes develop on the face, upper neck and other parts of the body.

Some people may suffer from severe complications, such as pneumonia and encephalitis, and these diseases may also lead to death.

Child health experts say a low vaccination coverage, floating populations, lack of public awareness of the importance of vaccines and apathy of government agencies for plugging the loopholes are some reasons behind the regular outbreaks of measles in various parts of the country.

Measles was endemic in Nepal, and an average of 90,000 cases were recorded every year from 1994 to 2004. Routine measles vaccination began in the country in 1979, starting with three districts. The campaign was made nationwide after 10 years.