Vietnam Measles Outbreak ‘Could Have Been Prevented’: WHO

2014-04-23
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Families with their children suffering from measles wait at a state-run hospital in Hanoi, April 17, 2014.
AFP

The World Health Organization chief in Vietnam said the deadly measles outbreak in the country could have been prevented through a more effective vaccination program, but added that the authorities have strengthened their capability to contain the crisis.

Doctors say that more than 7,000 children have been affected by the highly contagious virus since it resurfaced in Vietnam late last year, while at least 127 have died—nearly all of whom were located in the capital Hanoi and other nearby localities.

And while authorities have launched an intensive inoculation campaign to combat the outbreak, WHO representative Takeshi Kasai said Wednesday that the government could have done more to prevent the crisis.

“We see children are dying and any death of children is a tragedy, particularly if we know those children’s deaths could have been prevented with an effective tool—vaccine,” Kasai told RFA’s Vietnamese Service in an interview.

“The most important thing [to prevent measles] is vaccinations. If the vaccination coverage was high enough, [the situation in Vietnam] could have been prevented,” he said.

“And that’s the reason why when the ministry got this information, they swiftly switched from an intensive surveillance system and also communication with the public, to starting … an intensified vaccine campaign.”

In Vietnam, children are recommended to have a first measles vaccination dose at 9 months old and a second after 12 months.

The WHO says two doses of the vaccine are needed to ensure immunity and prevent outbreaks, as about 15 percent of vaccinated children fail to develop immunity from the first dose, but experts have suggested that many have not received their second shot.

Kasai said that in addition to government efforts to ensure children are vaccinated, local communities must be made more aware of the need for the treatment.

Several countries in the region—including China, the Philippines and Japan—are also battling measles outbreaks, he said, adding that “the situation [Vietnam is] facing is similar to the challenges that even a developed country faces” and that authorities are “putting all of their measures [into place] that they can.”

Those measures include providing guidance, extra personnel and equipment to hospitals and health care facilities to tackle the disease, he said.

Epidemic?

Social media postings have recently accused authorities of downplaying the severity of the crisis by under-reporting numbers of deaths and refusing to label it an “epidemic” because acknowledging the problem would reflect a lack of efforts to eradicate measles in Vietnam by 2017.

Kasai said that the definition of an epidemic varies by country, with some declaring one after only a single case, others after a cluster of connected cases, and still others waiting until they see “an unusually high number of cases compared to their usual years.”

He did not say whether the situation in Vietnam was considered an epidemic by WHO standards.

But he said that the recent outbreak “redoubles all our [the WHO and the Vietnamese government] efforts to ensure that Vietnam will reach this goal” of eliminating the disease within three years.

Kasai said it was “very difficult to speculate” whether the government was likely to contain the current outbreak in the near future.

“But what I can say is that the Ministry of Health … has experienced so many [disease] events and every time they strengthen their capacity.”

In the meantime, he said, the WHO and other agencies of the United Nations, including UNICEF, would continue to work closely with the government to end the threat.

Kasai said that, as a technical agency, the WHO had largely been providing the Vietnamese government with advice on how to monitor the situation and how to organize its response campaign, as well as guidance on infection control within hospitals.

Lack of vaccinations

A report by the Ministry of Health confirmed 3,430 confirmed cases and more than 5,800 suspected ones as of last Sunday, in what doctors have called the country’s worst-ever measles outbreak.

On April 4, the ministry issued an urgent order urging cities and provinces to step up their efforts in coping with measles outbreak and vaccinating children.

At that time, the outbreak had spread to 59 provinces and cities in the country, it said, saying a main factor in the spread of the disease was that many children had not been properly vaccinated.

A previous outbreak of measles in 2009-2010 prompted UNICEF and WHO to launch a vaccination campaign in an effort to eradicate it by 2012, but the current crisis has raised concerns that not enough children in the country were treated.

Earlier this month, former vice director of Ho Chi Minh Hospital for Tropical Diseases Tran Tinh Hien said that during the last outbreak, the government was only calling for children to receive one dose of vaccine, while they are currently calling for two.

He said that parents are also concerned about complications from the vaccination, so fewer are bringing their children to receive the injection.

Ministry criticized

Health Minister Nguyen Thi Kim Tien has come under criticism for being slow to declare an outbreak and under-representing the number of children who have died as a result of the virus.  

Last week, Tien rejected claims that she had covered up the true number of deaths in the outbreak by reporting to the public that only 25 deaths were directly attributable to measles, while doctors at hospitals in Hanoi reported scores of young children dying from measles-linked infections.

After the doctors in the Vietnamese capital reported more than 100 deaths linked to measles, the Ministry of Health issued a statement acknowledging the higher figure but maintaining that its original, lower one was more precise, according to reports.  

Measles deaths are usually a result of complications from the disease, according to the WHO.

Vietnam’s health ministry has said it will only declare an epidemic if it detects mutations in the measles virus, according to the Thanh Nien newspaper.

However, the paper reported on Tuesday that the virus now appears to be attacking patients' respiratory system, rather than the brain as it did in previous years, leading to fatality rates higher than usual, citing doctors speaking during a conference held by the Ministry of Health.

Reported by RFA’s Vietnamese Service. Written in English by Joshua Lipes.