Malangwa Municipality in Sarlahi has witnessed a fresh outbreak of measles virus, with around two dozen children infected. The outbreak, first in more than 2 years, exposes a vaccination gap that has also shattered Nepal’s efforts to eliminate the deadly disease.

Dr Nawal Kishor Jha, chief of the Health Office, Sarlahi, confirmed the outbreak in a telephone conversation with the Post. The National Public Health Laboratory in Kathmandu confirmed the cases, he added.

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 Malangwa hindered the country’s progress towards meeting the goal.

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

Jha said that measles-like symptoms appeared in children from Muslim settlements on January 6. Of the 23 suspected cases, seven tested positive in the laboratory. The rest are called epi-confirmed (epidemiologically confirmed) cases of measles.

Health authorities are planning to launch an immunisation drive in the affected and nearby areas for all children under 14 years.

Child health experts have said that the outbreak of measles in the Muslim communities of Sarlahi shows a gap in Nepal’s vaccination status.

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

“The outbreak 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 the deadly disease. Underage children, pregnant women, elderly people and those with weak immunity, such as HIV-infected people, are highly susceptible to measles.

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 population, 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.