Islamabad: Measles cases have risen alarmingly at the start of 2026, signalling a deepening public health crisis after the disease killed at least 143 children across Pakistan in 2025, with fresh data showing a 26 percent increase in suspected cases in the first week of 2026 compared to the same period last year, even as other vaccine-preventable diseases continue to surface.
New surveillance figures show that 740 suspected measles and rubella cases were reported nationwide in Week-1 of 2026, of which 276 were laboratory-confirmed measles cases, compared to 491 suspected cases and 239 confirmed measles cases during the same week of 2025, indicating that transmission has intensified rather than declined.
Health experts warn that the early surge suggests measles transmission chains were never broken in 2025, when Pakistan recorded more than 50,000 suspected cases, over 15,700 confirmed infections and 143 measles-related deaths, most of them among children under five.
Doctors say many measles deaths never reach major hospitals and are likely underreported, particularly in urban slums and peri-urban settlements where families seek care late or rely on unqualified practitioners.
Measles is one of the most contagious viral diseases known, spreading through coughing, sneezing and shared air. It suppresses a child’s immune system for weeks, increasing the risk of pneumonia, severe diarrhoea, blindness and brain inflammation. In malnourished children, the disease can be fatal, a reality reflected in Pakistan’s persistently high death toll.
Karachi remains one of the epicentres of the outbreak. Sindh reported over 11,000 suspected measles cases in 2025, with more than 4,200 confirmed infections and 65 deaths, the highest toll among all provinces.
Pediatricians at Aga Khan University Hospital, the Sindh Infectious Diseases Hospital, the National Institute of Child Health and the Sindh Institute of Child Health and Neonatology say they continue to see a steady influx of measles patients, many arriving late with severe complications.
Doctors say the disease is no longer confined to poor or remote areas. Islamabad has reported some of the highest test positivity rates, while hospitals in Peshawar have repeatedly flagged clusters among children under five.
Khyber Pakhtunkhwa recorded over 14,600 suspected cases and more than 5,700 confirmed infections in 2025, while Punjab accounted for the largest share of suspected cases nationwide.
Early 2026 data show that 52 percent of measles cases were completely unvaccinated, while 93 percent occurred in children under five years of age, underlining the failure of routine immunisation to protect the most vulnerable.
Alarmingly, 55 confirmed measles cases were reported in infants younger than nine months, an age group too young to receive routine vaccination, indicating intense community spread.
Among unvaccinated children, 30 percent were younger than nine months, while 22 percent were older than nine months and eligible for vaccination but missed, pointing to both programmatic gaps and parental neglect, experts say.
Beyond measles, surveillance data also point to the continued presence of other vaccine-preventable diseases. Three new diphtheria cases were reported in the first week of 2026, all from Khyber Pakhtunkhwa, while two cases of neonatal tetanus were also reported from the same province, highlighting ongoing risks linked to poor immunisation coverage and unsafe delivery practices. Although no new pertussis cases were reported during the week, health officials say sporadic cases continue to appear annually, largely among under-immunised children.
An adverse event following immunisation was also reported from Sindh during the same week, a reminder, experts say, of the need for better monitoring and transparent reporting to maintain public trust in vaccination programmes.
Public health specialists say the simultaneous persistence of measles, diphtheria and neonatal tetanus reflects structural weaknesses in the Expanded Programme on Immunisation, particularly in urban outreach, follow-up of missed children and documentation of non-vaccination reasons.
Pediatricians and public health experts are urging authorities to treat the rising 2026 figures as an emergency warning, strengthen routine immunisation rather than rely on sporadic campaigns, and directly confront vaccine hesitancy. At the same time, they stress that parents who delay or refuse vaccination are putting not only their own children but entire communities at risk.
“Every measles death is preventable,” said a senior pediatrician in Karachi. “When children are still dying of measles in 2025 and now 2026, it reflects failures by the health system and by families who choose not to vaccinate.”
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