Measles cases increase rapidly, Ho Chi Minh City lacks emergency medicine for seriously ill children

The information was given by Dr. Ngo Ngoc Quang Minh, Deputy Director of Children's Hospital 1, when working on epidemic prevention with Deputy Minister of Health Nguyen Thi Lien Huong on the morning of August 29. It is expected that the hospital will be able to purchase medicine in September.

The number of measles cases in this area has increased recently. Of the 368 children hospitalized, 42 are in severe condition and require intensive care, many on ventilators. Notably, all of the severe cases have not received two doses of measles vaccine, while 15% have only received one dose.

Since the beginning of the year, this place has bid for reserve drugs to treat seriously ill children such as intravenous immunoglobulin (IVIG) and emergency drugs. However, currently, Dopamine is still not available. This is an important drug used to treat children with measles as well as dengue fever and severe hand, foot and mouth disease. The hospital has held a professional council meeting to find some alternative drugs, but they are not as effective and have unwanted side effects.

"IVIG is currently relatively sufficient, but in the future when the epidemic spreads more widely, or other epidemics such as hand, foot and mouth disease occur, we do not know whether the supply can continue to be stable or not," said Dr. Minh, recommending that the Ministry of Health create favorable conditions to support hospitals nationwide to have a stable source of anti-epidemic and emergency drugs.

Deputy Minister of Health Huong requested relevant units to support hospitals in stabilizing the supply of drugs and supplies. Treatment facilities should proactively contact the Drug Administration to coordinate in finding sources of supply, ensuring timely resources for epidemic prevention.

According to Ms. Huong, recently, many countries in the world have recorded an increase in measles cases, including Vietnam. The UK, France and some countries have declared a state of emergency for the measles epidemic. One of the reasons for the increase in this disease is that the Covid-19 pandemic has created a large gap in vaccination. Countries are focusing their efforts on fighting Covid, affecting resources to control other diseases.

On the other hand, the consequence of the lockdown is that people limit contact, leading to a decrease in human immunity to common infectious diseases. The trend of international integration and cooperation after the pandemic, environmental pollution, drug resistance, shortage of drugs and supplies, difficulties in drug research and development, and outdated treatment regimens have also caused measles to re-emerge after many years of absence.

"Measles is increasingly causing many difficulties and challenges for the whole country, especially Ho Chi Minh City, which has to deal with patients transferred from other provinces and cities," said Ms. Huong. Nearly 75% of children with severe measles requiring intensive care at Nhi Dong 1 are from other provinces and cities. Therefore, it is necessary to strengthen training for lower-level hospitals, especially private clinics, and to classify patients appropriately to avoid overload.

Localities have good plans to respond, classify, admit, treat, isolate, and reduce deaths. Review and organize additional vaccination for children from 1 to 10 years old, prioritizing the 1-5 year old group, and medical staff who have not been fully vaccinated and have contact with patients.

The Ministry of Health is speeding up updating the measles treatment regimen, as the old regimen has been issued for more than 10 years. The Ministry also continues to mobilize epidemic prevention experts to support provinces and cities. Ho Chi Minh City is increasing information exchange with localities, as there are measles patients in the city who have spread the disease to other provinces.

"Be careful not to let one epidemic overlap another. In addition to measles, hand, foot and mouth disease and dengue fever are also starting to increase. We need to have plans to simultaneously prevent other epidemics," said Ms. Huong.

Dr. Nguyen Vu Thuong, Deputy Director of the Pasteur Institute in Ho Chi Minh City, predicted that in the coming time, the cool weather and the back-to-school season will create favorable conditions for the disease to spread. If urgent preventive measures are not implemented, the disease will continue to increase. In addition to the vaccination campaign, it is necessary to reduce the pressure on children from lower-level hospitals to Ho Chi Minh City to avoid overload. It is necessary to control disease prevention right in the hospital to prevent the spread.

On the afternoon of August 27, the Ho Chi Minh City People's Committee announced a measles epidemic in the area to deploy preventive measures and organize vaccination. This is the first time Ho Chi Minh City has announced a measles epidemic and is the first locality in many years to announce this epidemic.

From the beginning of the year to August 22, the city recorded 353 measles cases, while from 2021 to 2023 there was only one positive test case. In the next two days, about 300,000 doses of measles-rubella (MR) vaccine will arrive in the city to implement a vaccination campaign for all children aged 1-5, regardless of previous vaccination history; children aged 6-10 will be given catch-up shots if they have not been fully vaccinated.

Measles is transmitted through the respiratory tract by coughing, sneezing, close contact with infected people or nasal secretions... The disease is characterized by fever, inflammation of the respiratory tract, conjunctivitis and rash, which can lead to many complications such as pneumonia, encephalitis, and otitis media.

Children with the disease are treated symptomatically, and most recover on their own. However, some groups such as children with immunodeficiency, cancer, chronic diseases, congenital heart disease... are at risk of severe progression, possibly death. Measles also weakens resistance, making children susceptible to other diseases.