The vaccination status of most infected people, including children in the recent measles outbreaks in Sarlahi and several local units of Baglung, was unknown. Health workers deployed for case investigation and vaccination reported that parents of infected people could neither present vaccination cards nor confirm whether their children had received the measles vaccine.

Health facilities of the respective local units and districts also could not present proof of immunisation.

“Recent outbreaks of the measles virus could be the result of a long gap in vaccination,” said Dr Shyam Raj Upreti, an immunisation expert and former director general of the Department of Health Services. “This is also an equity issue, all children may not have got access to vaccination or lack awareness of its importance.”

Measles is a highly contagious disease transmitted through respiratory droplets from the nose and mouth of an infected person. It can be potentially deadly for unvaccinated people.

At least four outbreaks of the deadly viral disease have been reported—one in Sarlahi and three in Baglung—since the start of 2026.

Immunisation and child health experts warn that Nepal could face a massive measles outbreak at any time, as health authorities have yet to launch a mass vaccination campaign despite ongoing outbreaks.

Vaccination drives were launched in the affected local units in Sarlahi district and Dhorpatan Municipality in Baglung, but no such campaign has been launched in the two local units of Baglung—Nishikhola and Badigad rural municipalities.

Immunisation experts say all vulnerable people should be vaccinated immediately to tackle the outbreak. They say that the absence of a vaccination drive even a month into the outbreak, and no plans to start soon, exposes serious gaps in the country’s disease control system.

They warn that Nepal could also witness a Bangladesh like situation, if authorities concerned keep ignoring the issue. At least 130 measles deaths have been reported in Bangladesh in the past one month.

“We could have also faced a Bangladesh-like situation, but due to our better vaccination status, we avoided such a scenario,” said Upreti. “If we continue ignoring the risks, we could also face tragic situations in the coming days.”

Experts urge focus on certain pockets of poor and marginalised communities, where immunisation coverage is very low. They also ask authorities to ensure a budget for emergency response and buffer stock of life-saving vaccines.

Health officials say they neither have vaccines buffer stock for possible outbreak response nor dedicated budgets. They say aid agencies used to offer vaccine and other budgetary support for the emergency response in the past, but have recently been slow in delivering immediate assistance.

Measles 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.

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.

Nepal had aimed to eliminate measles by 2026, as there had been no outbreak since June 2023. However, recent outbreaks of the contagious virus 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.

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 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.

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.