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Measles threat looms dangerously over Vietnam
Publication Date : 10-02-2014
The Vietnam health ministry has ordered all provinces to intensify measles prevention and quarantine measures as the epidemic is likely to spread due to the humid and cold weather and increase in number of travellers at the beginning of the year.
According to the National Institute of Hygiene and Epidemiology and the Pasteur Institute in HCM City, over 620 cases were reported showing signs of measles from the beginning of 2014 to February 5.
Of the number, 30 cases were recorded in Hanoi, 138 in HCM City, 120 in Lao Cai province and 80 in Son La province. Yen Bai province recorded 253 measles patients and one death.
Most of the patients have not been fully vaccinated against measles.
Not fully protected
Tran Thi Thanh Thuy of HCM City's Binh Tan District saw her 11-month-old son get measles after she delayed his vaccination.
He was hospitalised for five days for treatment.
Her local ward health centre sent home a reminder notice that her son should get his first shot of single measles vaccine at nine months, but she chose to go to a private vaccination centre in District 3 instead.
But the place did not have the single vaccine; it only had the measles-mumps-rubella triple vaccine, and told her to come back for that shot when her son was a year old.
It was during that three-month window that he contracted measles, Thuy said, angry but relieved that the child did not develop complications.
According to Dr Truong Huu Khanh, head of the HCM City Peadiatric Hospital No.1's neurology and infectious diseases department, infants are at high risk of getting measles in the period between nine and 12 months.
Besides, when the child turns 12 months old many people forget to take them for the measles vaccination, he said.
Many parents like Thuy lack knowledge and are not provided counselling about vaccinations.
Khanh said vaccination counsellors should update their knowledge and provide sound advice to people.
They should think not only of the commercial aspect but also children's health, he said, adding that parents too should look for information about babies' vaccination.
The three-old-year son of Nguyen Thanh Mai of Tan Phu District did get his measles vaccine at nine months but not the booster shot at one and a half.
He too got the disease and had to be hospitalised.
"I thought one dose was enough," Mai said.
Besides, the media buzz about infants' deaths allegedly caused by 5-in-1 vaccines had made her too scared to get the child vaccinated.
Many other mothers have the same fear.
Nguyen Tri Dung, head of the HCM Preventive Health Division, said this had been common in recent times, with many people feeling scared to even get measles shots.
The media focused too much on the side effects of vaccines and ignored their benefits, he said, adding that as a consequence there had been a drop in the rate of immunisation.
The number of babies getting measles shots, for example, reduced by 50 per cent last November and December compared to the early part of the year, he said.
The recent measles outbreak is closely related to this, he added.
Khanh said 80 per cent of the children in his ward had either not been vaccinated at all or did not get two doses, he said.
The hospital admitted more than 100 children with measles in January, and more since then, he said.
On February 7 alone 16 were admitted, all in serious condition, he said.
Since January there had been seven patients with serious pneumonia caused by the disease, he added.
It was for the first time in four years that the hospital had been getting children with measles.
The HCM Hospital for Tropical Diseases reported that it admitted 14 patients with the measles virus in 2011 and 2012, and only two in the first 10 months of 2013. But the number surged to 48 in the last two months of the year.
Since the beginning of this year the hospital has received 72 measles patients, including 59 from HCM City.
According to the Preventive Health Division, many districts have seen a high incidence of the disease, including Binh Chanh, Binh Tan, Tan Phu, Tan Binh, Hoc Mon, 12, 8, and 6.
Health experts have said there is no cause for worry because measles is easily treated through vaccination.
Dung said since the measles vaccination rate among babies was high for a long time, there was high immunity in the community, and that was why the outbreak was not serious.
The Preventive Health Division asked its offices at the district level to step up vaccination of children aged nine months to three years.
It instructed them to get kindergartens and nurseries to check their children's health records and tell the parents of those who have not been vaccinated to complete the task.
Teachers there who have not been vaccinated should also be asked to get shots, Dung said.
Dissemination of information about measles and vaccines would also be strengthened, especially in areas with large immigrant populations, he said.
Babies born in such communities are at high risk since their vaccination rate is low, according to the official.
The division is working with local authorities to persuade such people to get immunised.
But there are instances in the city of children getting two shots yet contracting measles, according to the Hospital for Tropical Diseases.
Dung said the effectiveness rate of the vaccine is 95 per cent.
The remaining 5 per cent of babies remain unprotected from the disease, and their number has increased gradually over the years, leading to the outbreak, he explained.
Khanh said measles was a highly infectious viral disease that spreads rapidly.
"A baby who has not got the two shots or the disease itself would definitely contract it when they come into contact with someone with measles," he said.
"The effectiveness of the first dose in preventing measles is 80-85 per cent, and the booster shot increases it to 95 per cent."
Children should get another booster when they are five years old, he advised.
Babies under one could easily develop complications from measles — like pneumonia, bronchitis and infections of the airway and lungs, and eye and middle ear infections – and even die, he warned.
People should take their babies to hospital when they see symptoms like consistent high fever, red eyes, tiredness, irritability, and a general lack of energy and dry cough, he said.
They should also be isolated, he added.
A combined measles-rubella vaccine is expected to be available for children aged nine months to 14 years in October under an immunisation programme to eliminate the diseases in Vietnam funded by Global Alliance for Vaccines and Immunisation.