Measles stronger in Vietnam, even as infection rates drop

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Children with measles at the Central Hospital of Pediatrics in Hanoi. Photo courtesy of Tuoi Tre
Measles infection rates are dropping in Vietnam, however the infections have been more severe this year, including 25 related deaths.
Tuoi Tre newspaper on Tuesday cited a Health Ministry report that said the number of new measles infections has dropped from the maximum 300 cases a week in February and early March to 25.
The pediatrics department at Bach Mai Hospital is treating 14 severe cases at the moment.
Dr Nguyen Tien Dung, head of the department, said the rate of critical complications ia the strangest thing about measles this time around.
“In many cases, the virus directly attacked the children’s lungs. They would have no breathing or respiratory problem when admitted in the morning, but in the afternoon, they would need respirators.”
Dung said that normally, complications, if any, only come after the skin rashes are gone.
The only fatal measles case at the department occurred in a child who became critical just one day after admitted, he said.
He said as studies from the Central Institute of Hygiene and Epidemiology have not found any change in the virus type, so the severe complications are likely to come from new forms of attacks.
Many fatal measles cases at the Central Pediatrics Hospital were children of premature birth or those born underweight.
Truong Huu Khanh, head of the infection department at the Ho Chi Minh City Children’s Hospital No.1, also said that since February, the hospital received unusually high numbers of measles patients with clear symptoms like high fever, heavy coughing and poor appetite.
Khanh said the hospital in previous years only received measles patients with clear symptoms every once in a while.
The health ministry said it has received fatalities reports from hospitals but it needs to double check the figures to remove those killed by other conditions.
Doctors have blamed the outbreaks this year on parents not having their children vaccinated – the first shot at nine months and the second at one a half years old – but some patients were below nine months old, the period when they’re supposed to still carry antigens from their mothers.
The youngest measles patients this year was three months old. The mother and an older sibling were also infected.
Khanh said a child infected with measles will suffer long-term undernourishment, be likely to have middle ear diseases and reduced hearing.
Doctors have suggested the health ministry announce a national outbreak as the disease has been reported in 59 out of 63 cities and provinces, infecting at least 5,000 children since late January.
But a ministry official told Tuoi Tre that measles is among a group of diseases whose outbreaks are only announced when there’s confirmed changes in the causal factors.
Vaccination scare
Khanh’s hospital was treating more than 50 measles inpatients on Monday, and most of them were not vaccinated at their due ages.
Many parents said they were discouraged after a scandal with Dutch-made pentavalent vaccine Quinvaxem.
More than ten babies died after being administered the drug between November 2012 and May last year, and several more since it was reintroduced last October. 
The Health Ministry said the drug was not to blame for the deaths and lifted a ban put in place after the first spat of deaths. 
Vietnam has reported other deaths related to improper vaccinations, and cases when medical staff used expired drugs or the wrong doses or the wrong drugs.
The mother of a 17-month-old patient at the hospital told Tuoi Tre her husband had insisted of not having the baby vaccinated as “the television kept giving news about vaccination deaths.”
The baby from the Mekong Delta’s Kien Giang Province has only received a tuberculosis shot.
Nguyen Thi Thuy Binh, a 30-year-old mother from the city, said her son was infected at nine months and eight days old as she and her husband were still undecided about giving him the shot.
They were weighing between the free shot under the country’s extended vaccination program, or the three-in-one shot with rubella and mumps, which is given to children from one year old at a premium price.
Quinvaxem is given for free, and the deaths related to it have caused suspicion among parents against free vaccines.
Khanh said measles spreads very fast, and the best way to protect children is to vaccinate them.
He said parents not only had their children skip measles vaccine, but many other vaccinations, which poses the risk of other outbreaks in the years to come.

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