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A fire in the electrical control room of Rangpur Medical College Hospital on Thursday morning injured at least 40 patients and relatives, most of them hurt as they hurried down darkened stairways to get out of the building.

The blaze started at about 6:15am on the ground floor, according to accounts from the hospital and the Fire Service. Smoke and flames spread quickly through the control room area, and news of the fire set off panic in wards on the second to fifth floors. One Fire Service unit reached the hospital and brought the fire under control in about half an hour, Dhaka Tribune Bangla reported.

The injuries came mainly during the evacuation rather than from the flames. Patients who could walk joined relatives in the rush for the stairs, while others were carried. In the nephrology ward on the second floor, at least 15 patients were hurt in the crush as people tried to get down, Bangla Tribune reported. One kidney patient, Safiul Alam, was being carried downstairs by two nephews when they fell; all three were injured.

The gynaecology ward faced the same scramble with mothers and newborn babies. Momtaz Begum, who had given birth five days earlier, said she was injured while carrying her daughter down the stairs after hearing about the fire.

The fire also cut the hospital's electricity supply. Officials said the whole building went dark and stayed without power for about six hours, and by 4pm several areas were still waiting for a full supply, including the director's office, cardiology, pathology, the skin and sexually transmitted disease ward, kidney dialysis and nephrology. Emergency operations and other treatment services were suspended for much of the day, leaving patients in wards without fans in the heat.

Dr Abdul Mokaddem, the hospital's acting director, said the fire had been caused by an electrical short circuit and that staff were working to restore connections. He did not give a damage estimate or say when normal services would resume.

The incident has drawn attention to the hospital's ageing electrical system. In September, Prothom Alo reported that 12 of the hospital's 40 wards had no emergency generator connection, and that doctors and nurses sometimes used mobile phone lights during load-shedding. A Public Works Department engineer said at the time that the hospital's six substations had capacity for about 5 megawatts against a demand of roughly 8 megawatts, and that generator connections were limited to operating theatres, intensive care and cabin wards.

Hospital authorities have not said whether the backup system worked as intended on Thursday, how much equipment was damaged, or whether any official investigation has been ordered. The exact number of injured people could also change; both outlets put the figure at at least 40, citing hospital sources, but no complete list has been released.

Rangpur Medical College Hospital is one of the main referral hospitals in northern Bangladesh, serving patients from several districts. Its dialysis and cardiac units are particularly busy, and even a few hours of lost power can interrupt treatment for people who depend on regular sessions.

The immediate task for the administration is to restore full electricity and resume emergency and dialysis services. Patients and their families will also want to know how a fire in the control room produced so much smoke, why the evacuation turned into a crush, and what will be done before the next outage or fire alarm.

The Fire Service and the hospital administration are expected to inspect the control room and the damaged switchboards. No death has been reported, and there has been no public statement yet from the health ministry about the incident.

Bangladesh recorded two more deaths with measles symptoms in the 24 hours to 8am on Thursday, taking the combined death toll from confirmed and suspected measles to 1,207 since 15 March, the Directorate General of Health Services (DGHS) said.

Both of the latest deaths were reported in Dhaka Division. They raised the number of suspected measles deaths to 1,103, while the count of laboratory-confirmed measles deaths stayed at 104 because no new confirmed death was recorded in the period. BSS reported that both of the latest victims were children.

The outbreak is still producing close to a thousand new suspected cases a day. The DGHS bulletin counted 995 new suspected infections in the 24 hours to Thursday morning, taking the cumulative suspected caseload to 217,760. Another 36 people tested positive for measles in the same period, bringing laboratory-confirmed infections since March to 23,248.

Hospitals admitted 913 of the newly reported patients, bdnews24 reported. Since 15 March, 193,608 people with suspected measles have been hospitalised and 185,927 have been discharged after treatment, according to the DGHS.

Dhaka Division carries the heaviest toll among suspected cases, with 496 deaths, followed by Sylhet with 194, Chattogram with 102, Rajshahi with 93, Mymensingh with 85, Barishal with 65, Khulna with 51 and Rangpur with 17.

The daily bulletin does not give an age breakdown, and it records only people who reach a hospital. Not every patient with symptoms is tested, so the directorate says the true number of infections cannot be established. Deaths are classified as suspected or confirmed, which is why the two figures are reported separately and then combined.

The outbreak has run since the middle of March, when the DGHS began tracking measles and measles-like illness. The government responded with a measles-rubella vaccination campaign in phases from April: first in 30 upazilas across 18 districts, then in four city corporations, and finally nationwide.

By 20 September, about 19.83 million children had received a measles-rubella dose, Health and Family Welfare Minister Sardar Md Sakhawat Husain said when he announced a further push. That month-long effort, called the Intensified MR Catch-up Vaccination campaign, began on 26 September and is due to run until 31 October, with a target of 3.4 million children aged six months to under five.

The government has described the campaign as a search for children who were missed the first time. Health workers and volunteers are going house to house to check vaccination status, including for children who were not on earlier campaign lists. Asked what would happen to children older than five who fall ill, Sakhawat said: "Whatever the situation, we are trying to cover everyone."

State Minister for Health and Family Welfare Dr M A Muhit, visiting a vaccination session at the Korail T&T playground in Dhaka this month, said about 20 million children had been reached and that the government wanted to bring in another 3.5 million within a month. "Our goal is to ensure that not a single child is left out of vaccination," he said.

Vaccine supply has been part of the difficulty. The health minister said in May that the Expanded Programme on Immunization had been affected by decisions of the previous government and that the current administration had cancelled open tendering and bought vaccines directly through UNICEF. He said Bangladesh had paid $83.6 million to UNICEF for about 95 million doses, and that a shipment of 1.5 million measles-rubella doses had arrived that month.

Researchers at a Bangladesh Medical University seminar in May pointed to gaps in coverage rather than a single cause. They cited missed EPI doses, vaccine hesitancy, disruption to routine immunisation during the covid pandemic, malnutrition, high population density and migration as reasons why immunity had fallen in places. They called for emergency vaccination, vitamin A supplementation, nutritional rehabilitation and closer monitoring of coverage.

What is not yet clear is how much of the toll is still to come. The daily count of new suspected cases has stayed near 1,000 in recent weeks, and the bulletin gives no indication yet that it is falling. The bulletin reports district death totals but does not explain why some areas are far worse hit, and it gives no age profile of the dead.

The immediate test is the catch-up campaign's final month. If the door-to-door searches reach the children who have so far been missed, the daily case count should begin to fall; if they do not, the outbreak will keep finding unvaccinated children. The health ministry has not said whether the campaign will be extended beyond 31 October, and Thursday's bulletin contained no new measures.

For families, the advice from health officials and the researchers at the May seminar is to vaccinate children, watch for fever and rash, and seek treatment early rather than waiting for the illness to become severe. The next few weeks of the campaign, and the daily figures that follow it, will show whether that message is reaching the households that need it most.