On the frontlines of measles control

Strong community trust, proactive frontline engagement, and data-driven rapid response can transform outbreaks into opportunities — reaching underserved populations and strengthening a more resilient and inclusive public health system. This was demonstrated by the public health response to measles outbreaks in Gwalior and Morena districts of Madhya Pradesh during the first quarter of 2026, when Gwalior reported three outbreaks and Morena six. These sporadic outbreaks also highlighted the critical importance of measles-rubella (MR) vaccination in protecting children and communities, particularly in preventing escalation into large measles outbreaks, such as the ongoing one in Unakoti district, Tripura.

In the winter chill of Tikari village in the Morena district in Madhya Pradesh, the initial cases of runny noses were dismissed as bouts of the common cold.  But when children developed fever and rash within days, the village ASHA (community health volunteer) Ms Ramraja Gurjar urged families to seek treatment at Banmore Community Health Centre.  

Over January and February 2026, 41 children were diagnosed with measles in Tikari. For Ms Ramraja, the days grew longer as she increased the frequency of home visits to ensure no child missed diagnosis during the outbreak. The next two months tested not just reach of the health services, but the trust and resilience of the community that is not a stranger to outbreaks.

In the districts of Gwalior and Morena, measles outbreaks rose sharply in the first quarter of 2026 compared to the same period in 2025. The rising numbers told a deeper story: of migratory populations, vaccine hesitancy, and communities living at the margins of access to health care. For the district health administration and the frontline workers, each missed child was a signal. It meant a family not yet connected to the health system, a community where trust needed strengthening, or simply a new migratory settlement. As outbreaks spread, they traced the gaps—revealing how closely disease follows exclusion.

If 2025 exposed the cracks, 2026 showed what determined action could achieve.

ASHA Ms Ramraja Gurjar conducts a home visit to monitor 19-month-old Sanvi Baghel following her recovery from measles in January. WHO field teams supported rapid outbreak response, including measles-rubella vaccination for children between the ages of nine months and 10 years (Photo: © WHO India/ Sanchita Sharma)

In 2025, the health department strengthened meticulous data collection and community-centered public health efforts. Home visits led to Ms Ramraja to identifying nine measles cases. Among them were two of Ms Ramraja and Mr Bharat Singh Gurjar’s three grandchildren who tested positive for measles in January. “When one child fell ill, the family agreed to get all three children tested for measles. Eight-year-old Kapil, and Jatin, who is seven years old, tested positive for measles, but Sakshi tested negative. The family followed medical advice and all three recovered without complications,” said Ms Ramraja, who knows everyone in the village by name.

Another lab-confirmed measles case was that of 19-month-old Sanvi Baghel, whose parents also got her tested for measles on Ms Ramraja’s advice. “The frontline workers ensured community awareness about measles was high—there was no vaccine hesitancy following the outbreak. Additional MR vaccine doses were given to all children between the ages of nine months and 10 years as part of the outbreak response. In all, 322 children were vaccinated,” said Ms Sunita Baradia, the auxiliary nurse midwife, who worked closely with frontline workers like Ms Ramaraja to ensure no child was missed.

As part of measles–rubella elimination efforts in India, a WHO team counsel the priest and women devotees at a Sheetla Mata temple to seek prompt treatment for children with fever and rash. Families pray to the goddess Sheetla to protect children from disease. (Photo: © WHO India/ Sanchita Sharma)

“Families pray to Sheetla Mata (goddess Sheetla) to protect their children from disease and visit the temple to seek blessings for cure against infectious diseases, especially those causing fever and rash such as measles and chicken pox. The priest guides families to seek MR vaccination and prompt treatment for children with fever and rash,” said Ms Kanta Dadria, Lady Health Visitor (female health supervisors).

With WHO support, district health teams carried out active surveillance and a rapid response, including MR vaccination for all children between nine months and 10 years. WHO also supports routine immunization surveillance.

By March 2026, a surge of effort brought measles outbreaks down to one each in both Gwalior and Morena. The experience from both districts is a reminder that public health progress is rarely linear. Setbacks can surface hidden challenges—but they can also drive stronger, more inclusive responses. In this case, a year of rising outbreaks became the catalyst for a more responsive and sustainable health system, one that closed gaps and reached further than before.

Ultimately, this is a story of progress driven by people—health workers who walked the extra mile, administrators who prioritized data-driven action, and communities that embraced the importance of immunization. Together, they have transformed a year of concern into a pathway of hope, bringing both districts closer to the goal of eliminating measles and ensuring healthier futures for their children.