In January 2026, an ASHA worker named Ramraja Gurjar in Tikari village, Morena district, started noticing that children around her were coming down with runny noses. What looked like ordinary cold season turned out to be something more dangerous. By February, 41 children in that one village had been diagnosed with measles.
It is a scenario playing out across India and across the world right now. Measles — a disease that vaccination can prevent almost entirely — is making a comeback. The reasons are a combination of pandemic-disrupted immunisation campaigns, vaccine hesitancy in some communities, and the basic biological fact that measles is the most contagious human pathogen known to science.
What Is Measles and Why Is It So Dangerous?
Measles is an acute viral respiratory infection caused by an RNA virus in the Paramyxoviridae family. It spreads through the air — when an infected person coughs or sneezes, the virus can remain infectious in the air or on surfaces for up to two hours.
It is extraordinarily contagious. One infected person, in an unvaccinated population, can infect 12 to 18 others. This is why the WHO requires over 95% vaccination coverage at a population level to achieve herd immunity and prevent outbreaks. Below that threshold, the virus finds its gaps and spreads.
Symptoms include high fever, runny nose, cough, red and watery eyes (conjunctivitis), and a characteristic rash that starts on the face and spreads downward. The rash typically appears 3–5 days after the initial symptoms.
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Complications include:
- Pneumonia (the most common cause of measles death)
- Brain inflammation (encephalitis)
- Severe diarrhoea and dehydration
- Blindness
- Death, particularly in children under five who are malnourished
There is no specific antiviral treatment. The disease is preventable almost entirely through the measles-rubella (MR) vaccine.
India's Current Situation
The first quarter of 2026 has seen multiple outbreaks across India.
Madhya Pradesh was among the worst affected. Morena district saw six separate outbreaks and Gwalior recorded three. In Tikari alone — a single village in Morena — 41 children were diagnosed between January and February 2026. WHO field teams were deployed for rapid outbreak response, conducting measles-rubella vaccination for children between 9 months and 10 years of age.
Tripura presents a more serious and sustained situation. Unakoti district has been experiencing an ongoing large measles outbreak that public health authorities were still managing through early 2026.
In 2023, India reported 65,150 measles cases — the second highest in the world that year, after the Democratic Republic of Congo. The number for 2025 and early 2026 is still being consolidated, but early signals suggest the burden remains high.
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India's government set a target to eliminate measles and rubella by 2026, in line with WHO's South-East Asia Regional objectives. The health minister's March 2025 statement noted that 332 districts had reported zero measles cases and 487 districts zero rubella cases in the January-March 2025 period — which is encouraging. But outbreaks in other districts show the job is far from finished.
Why Is This Happening? The Vaccine Coverage Problem
India's Universal Immunisation Programme (UIP) provides two doses of the MR vaccine free of cost to children. Coverage for the first dose nationally is around 87%. Coverage for the second dose has historically been around 30%. That gap — between the first and second dose — is where the virus finds its opening.
To achieve herd immunity against measles, both doses are needed, and coverage needs to be above 95% for both. India has not reached that threshold at the national level, and several states and districts fall well short.
Why the gap?
- Families who got the first dose often don't return for the second, particularly in rural and tribal areas where health infrastructure is sparse.
- The COVID-19 pandemic disrupted routine immunisation services from 2020 to 2022, creating a cohort of children who missed their vaccines entirely.
- Vaccine hesitancy — often linked to religious beliefs or misinformation — plays a role. In Maharashtra, coverage was notably lower in certain communities.
- Hard-to-reach populations, including those in remote tribal areas, seasonal migrant communities, and slum settlements, consistently have lower vaccination rates.
The Global Picture: This Is Not Just India's Problem
The situation is far worse globally. As of April 2026, the United States has recorded 1,748 confirmed measles cases — across 19 outbreaks — in a country that had declared measles eliminated in 2000. For the full year of 2025, the US reported 2,288 confirmed cases.
In January 2026, the WHO announced that six European countries — Armenia, Austria, Azerbaijan, Spain, the United Kingdom, and Uzbekistan — lost their measles elimination status. Canada lost its status in late 2025. This means measles is no longer a sporadic, imported event in these countries; it is circulating freely.
The re-emergence is directly linked to declining vaccine coverage globally, driven in large part by the COVID-19 pandemic's disruption to routine immunisation and a resurgence of vaccine hesitancy movements.
India's Response: The Zero Measles-Rubella Campaign
In April 2025, Union Health Minister J.P. Nadda launched the National Zero Measles-Rubella Elimination Campaign 2025-26, timed to coincide with World Immunisation Week. The campaign prioritised:
- Catch-up vaccination for children who missed doses
- Strengthened surveillance and case reporting
- Community outreach through ASHAs and ANMs, particularly in high-risk areas
- Multi-language IEC (Information, Education, Communication) materials for awareness
India won the Measles and Rubella Champion Award from the Measles & Rubella Partnership in 2024, recognising progress made. But the minister acknowledged that sustained effort was needed, citing the example of polio — where India achieved elimination through persistent, decade-long campaigns.
The lesson from Tikari village in Morena is actually hopeful in one sense: ASHA Ramraja Gurjar's proactive home visits and community trust meant cases were caught early, the outbreak was contained rapidly, and the vaccination response was swift. Strong frontline health workers, it turns out, are the first and most important line of defence.
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What Parents Should Watch For
If your child has not received both doses of the MR vaccine, get them vaccinated. The first dose is given at 9–12 months; the second at 16–24 months. Both are available free at government health centres.
Watch for these signs in unvaccinated children:
- High fever lasting 3 or more days
- Runny nose, cough, red eyes
- White spots inside the mouth (Koplik's spots — an early, specific sign)
- A spreading rash starting from the face
If you suspect measles, isolate the child and contact a doctor. Do not send them to school, crèche, or any public gathering.
Sources: WHO, PIB, Ministry of Health, PMC