After years of eradication, measles has returned to the Maldives with 11 confirmed cases in 2026, sparking urgent vaccination drives and highlighting global risks from declining immunization rates.

In a stark reminder of the fragility of disease elimination efforts, the Maldives is grappling with a resurgence of measles, a highly contagious viral illness once declared eradicated in the island nation. Health authorities have confirmed 11 cases in 2026, prompting swift action from the Health Protection Agency (HPA) and hospitals to contain the spread and protect vulnerable populations.

This development comes amid a broader global uptick in measles cases, fuelled by gaps in vaccination coverage, vaccine hesitancy, and increased international travel. Maldives achieved measles elimination status in 2017, but the return of the disease underscores the ongoing need for vigilance in public health.

Historical Context: From Prevalence to Elimination

Measles has deep roots in Maldivian history. Prevalent in the 1950s, the disease prompted the introduction of vaccination services in the late 1970s, with the measles vaccine formally rolled out in 1983. Multiple outbreaks occurred over the decades – in 1981, 1985, 1995, and 2005 – leading to expanded immunization programmes. The last endemic case was recorded in 2009, paving the way for the World Health Organization (WHO) to declare Maldives measles-free in June 2017.

Sporadic imported cases appeared post-elimination, such as in 2020 and 2023, but large-scale campaigns, including the massive 2020 measles-rubella drive (#MavesJahaifin), helped maintain control. The two-dose MMR vaccine schedule – first at 9 months and second at 18 months – remains central to prevention, offering up to 97 per cent protection when completed.

The 2026 Outbreak: Timeline and Response

The current resurgence began in mid-May 2026. On May 13, the HPA detected the first two positive cases. Contact tracing identified two more by May 20. By late May, cases climbed, with Indira Gandhi Memorial Hospital (IGMH) establishing a dedicated help desk outside its emergency area for suspected patients. The desk advises masking, minimizing companions, and triage for adults and children.

Public Health Director Naashiya Abdul Ghafoor emphasized proactive measures, including accelerating second-dose vaccinations for contacts, healthcare workers, and unvaccinated individuals. By early June, six of nine initial cases were confirmed, rising to 11 total, with a notable cluster in the Greater Malé Region. The HPA is importing additional vaccines to bolster supplies.

Symptoms to watch for include high fever, cough, runny nose, red watery eyes, and a characteristic red rash. While often mild, complications like pneumonia or encephalitis can be severe, particularly in young children and immunocompromised people.

Global Context: A Worldwide Challenge

The Maldives is not alone. The United Nations reported over 184,000 measles cases across 155 countries by mid-May 2026. Regional hotspots include Southeast Asia (29 per cent of cases), the Eastern Mediterranean (21 per cent), and the Americas and Africa (19 per cent each). Bangladesh, also in the South Asia region, has faced a devastating outbreak with tens of thousands of suspected cases, thousands confirmed, and hundreds of deaths, prompting emergency vaccination campaigns.

In the Americas, cases surged dramatically in 2025–2026, threatening elimination statuses. The U.S. reported thousands of cases, with outbreaks in multiple states. Globally, declining routine immunization – exacerbated by COVID-19 disruptions, misinformation, and access issues – has reversed decades of progress. WHO data highlights how even small immunity gaps can fuel rapid transmission due to measles’ extreme contagiousness.

International support has flowed to the Maldives, with India dispatching 20,000 doses of MR vaccine and medical supplies under its Neighbourhood First policy, including medicines, syringes, and diagnostic kits.

Vaccine Hesitancy: The Hidden Threat

A key driver of resurgence is growing vaccine scepticism. HPA officials warn that falling coverage could undo hard-won gains against not just measles but other vaccine-preventable diseases. Education campaigns stress the vaccine’s safety and efficacy, countering myths amplified online.

In the Maldives, where tourism and inter-island travel are lifelines, an unchecked outbreak could impact public health and the economy. Tourists are being advised to ensure MMR vaccination before travel.

Looking Ahead: Strengthening Defences

Health authorities continue contact tracing, surveillance, and community outreach. The focus remains on achieving high two-dose coverage, especially in the Greater Malé area and outer islands. Long-term, sustaining elimination requires robust routine immunization, rapid response systems, and public trust.

The resurgence serves as a wake-up call. As one official noted, diseases once controlled can return swiftly without sustained effort. For the Maldives – a nation that overcame geographic challenges to eliminate measles before – the goal is clear: reclaim elimination status through collective action.

With global travel resuming, no country is an island when it comes to infectious diseases, say experts, emphasising that measles is entirely preventable.