Facts and questions on Measles

Last updated: 25 April 2014

Key facts about measles in Viet Nam

  • Before the introduction of the measles vaccine in 1980, more than 100,000 measles cases were reported yearly in Viet Nam.
  • By 1988, measles vaccine coverage was at 90% which significantly reduced cases of measles to less than 10,000 per year but not enough towards complete elimination.
  • Over the past 15 years, with the support of the WHO, the UN Foundation and UNICEF, Viet Nam bolstered its commitment to reduce the incidence of measles outbreaks and conducted periodic measles vaccine campaigns targeting children nine months to 10 years of age.
  • In line with the global recommendations for measles elimination, Viet Nam ‘s national immunization programme introduced a routine second dose of measles vaccines for children at 18 months of age in 2011 in an effort to ensure complete immunity and reduce the number of measles infections.
  • A country needs to ensure that at least 95% of all children receive two doses of the measles vaccine to prevent outbreaks.
  • Although the vast majority of children in Viet Nam are fully immunized, over time it is possible for a pocket of unimmunized children to develop and for the disease

What is Measles?

Measles is a highly contagious, serious disease caused by a virus. In 1980, before widespread vaccination, measles caused an estimated 2.6 million deaths each year. It remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine. Approximately 122 000 people died from measles in 2012 – mostly children under the age of five.

Accelerated immunization activities have had a major impact on reducing measles deaths. Since 2000, more than one billion children in high risk countries were vaccinated against the disease through mass vaccination campaigns ― about 145 million of them in 2012. Global measles deaths have decreased by 78% from an estimated 562 400 to 122 000.

What are the signs and symptoms of measles?

The first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts four to seven days. A runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage. After several days, a rash erupts, usually on the face and upper neck. Over about three days, the rash spreads, eventually reaching the hands and feet. The rash lasts for 5 to 6 days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of seven to 18 days).

Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/AIDS or other diseases.

Most measles-related deaths are caused by complications associated with the disease. Complications are more common in children under the age of five, or adults over the age of 20. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, ear infections, or severe respiratory infections such as pneumonia. As high as 10% of measles cases result in death among populations with high levels of malnutrition and a lack of adequate health care. Women infected while pregnant are also at risk of severe complications and the pregnancy may end in miscarriage or preterm delivery. People who recover from measles are immune for the rest of their lives.

Who is at risk?

Unvaccinated young children are at highest risk of measles and its complications, including death.

Unvaccinated pregnant women are also at risk. Any non-immune person (who has not been vaccinated or was vaccinated but did not develop immunity) can become infected.

Measles is still common in many developing countries – particularly in parts of Africa and Asia. More than 20 million people are affected by measles each year. The overwhelming majority (more than 95%) of measles deaths occur in countries with low per capita incomes and weak health infrastructures.

How is measles transmitted?

The highly contagious virus is spread by coughing and sneezing, close personal contact or direct contact with infected nasal or throat secretions.

The virus remains active and contagious in the air or on infected surfaces for up to two hours. It can be transmitted by an infected person from four days prior to the onset of the rash to four days after the rash erupts.

Measles outbreaks can result in epidemics that cause many deaths, especially among young, malnourished children. In countries where measles has been largely eliminated, cases imported from other countries remain an important source of infection.

How is measles treated?

No specific antiviral treatment exists for measles virus.

Severe complications from measles can be avoided though supportive care that ensures good nutrition, adequate fluid intake and treatment of dehydration with WHO-recommended oral rehydration solution. This solution replaces fluids and other essential elements that are lost through diarrhoea or vomiting. Antibiotics should be prescribed to treat eye and ear infections, and pneumonia.

How can we prevent measles?

Routine measles vaccination for children, combined with mass immunization campaigns in countries with high case and death rates, are key public health strategies to reduce global measles deaths.

Viet Nam has conducted several measles vaccine campaigns targeting children 9 months to 14 years of age since 2002. In 2011, Viet Nam ‘s national immunization programme introduced a routine second dose of measles vaccines for children at 18 months of age in an effort to ensure complete immunity and reduce the number of measles infections. Another nationwide measles immunization campaign is set to kick off in mid 2014. Measles vaccines are provided free of charge to all children in Viet Nam.

Parents and caregivers must ensure their children are routinely vaccinated against measles and other childhood diseases. High vaccination coverage for measles among children in Viet Nam will prevent the disease from spreading, and will break the cyclical nature of the most recent measles cases.

Two doses of the vaccine are recommended to ensure immunity and prevent outbreaks, as about 15% of vaccinated children fail to develop immunity from the first dose.

Is the measles vaccine safe?

The measles vaccine has been in use across the globe for 50 years. It is safe, effective and inexpensive. Viet Nam began using a locally produced measles vaccine in 2011 and more than 90% of eligible children in Viet Nam have received this vaccine.

How is WHO supporting Viet Nam in the fight against measles?

WHO is a key technical support agency for Viet Nam’s National Immunization Programme through helping to improve the capacity/quality of laboratories, the quality of routine vaccination services and as well as provide disease surveillance for certain childhood illnesses such as polio, measles, meningitis, encephalitis and congenital rubella syndrome.

Both WHO and UNICEF have worked very closely with the Ministry of Health since the first measles cases were reported in early 2014. WHO is providing support to the national paediatric hospital to control the measles infection and reduce the severity and death caused by this disease.