HOW TO MONITOR, DETECT, AND CARE FOR CHILDREN WITH MEASLES
Since early 2019, measles outbreaks have occurred with complex developments both in Vietnam and worldwide. Contracting measles can lead to acute dangerous complications and long-term effects such as blindness, malnutrition, immunodeficiency, increased susceptibility to diseases, and a higher risk of mortality even months after recovery.
3/21/2025 11:25:09 AM
With the increasing number of measles cases requiring hospitalization, parents need essential knowledge to monitor, detect early, and properly care for children with measles.
What is measles?
Measles is a highly contagious disease transmitted directly from person to person through respiratory droplets (from coughing and sneezing), caused by a virus.
The initial symptoms of measles infection often include: cough, runny nose, high fever, and red eyes. White spots with red rings (Koplik spots) may appear on the inner cheeks during the early days of the disease.
A red rash typically erupts between the 3rd and 5th day of the illness, sometimes accompanied by a high fever. The rash usually starts on the forehead, spreads across the face, then down the neck and trunk to the arms, legs, and feet. Fever and rash gradually subside after a few days.
However, the most concerning aspect is the complications of measles.
Common complications include:
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Pneumonia
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Diarrhea
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Laryngotracheobronchitis
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Malnutrition
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Otitis media
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Mouth ulcers
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Eye complications (due to secondary infections, corneal ulcers causing blindness)
Less common but very dangerous complications: Encephalitis – meningitis – acute myelitis; myocarditis…
Who is susceptible to measles?
Individuals at higher risk of contracting measles include:
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Infants too young to be vaccinated
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Those who have never been vaccinated against measles
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Individuals who have not received the full two doses of the measles vaccine
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People who were vaccinated but did not develop effective immunity
Who is at risk of severe complications when contracting measles?
These groups include:
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Young children
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Malnourished individuals
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Residents in densely populated areas
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Those with immunodeficiency
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Individuals with vitamin A deficiency
How to care for children with measles?
Four general principles when caring for children with measles:
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Supportive treatment for symptoms such as fever, cough, nasal congestion, red eyes, and mouth pain.
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Provide nutrition and encourage breastfeeding.
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Supplement with vitamin A.
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Monitor for severe signs.
Fever:
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Give the child paracetamol when they have a fever.
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Keep the environment cool; avoid overdressing or wrapping the child in blankets.
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Continue breastfeeding or formula feeding, offer small frequent feeds, and ensure the child drinks plenty of water.
Cough: If the child has a cough but is not breathing rapidly, they can be given a cough medicine prescribed by a doctor or a safe herbal remedy like lemon tea with honey (consult a doctor; do not use honey for children under 1 year old).
Nasal congestion: This can make eating and feeding difficult; saline nasal drops can be used to clean the nose before feeding or eating.
Red eyes (conjunctivitis): No special treatment is needed; gently clean the child's face with a soft, moist cloth. If there is eye discharge, take the child to see a doctor.
Mouth ulcers: Rinse the mouth with clean water (preferably saline) as often as possible, at least four times a day. Ensure regular fluid intake.
Nutrition: A child's nutritional status can be affected by the disease itself, diarrhea, vomiting, or loss of appetite due to mouth ulcers. Increase breastfeeding, offer small frequent meals, and provide soft, easily digestible foods (porridge, cereal, milk…) to ensure the child receives adequate fluids and energy.
High-dose vitamin A supplementation: According to the Ministry of Health's measles treatment protocol, children with measles should receive high-dose vitamin A supplementation:
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Children under 6 months: 50,000 IU/day for 2 consecutive days.
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Children 6–12 months: 100,000 IU/day for 2 consecutive days.
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Children over 12 months and adults: 200,000 IU/day for 2 consecutive days.
In cases where the child shows signs of vitamin A deficiency, an additional dose should be given after 4–6 weeks.
Prevention:
Measles can be prevented by vaccination. When vaccinated, over 85% of children will be protected against measles.
According to the Ministry of Health, over 50% of children with measles are unvaccinated, and 40% have not received the full two doses of the vaccine.
The Ministry of Health recommends:
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Proactively vaccinate children aged 6 months to 2 years who have not been vaccinated or have not received the full two doses of the measles vaccine, and children aged 1 to 14 years with the Measles-Rubella vaccine, ensuring timely and complete vaccination.
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Measles is highly contagious; do not allow children to come into close contact with those suspected of having measles. Caregivers should wash their hands with soap frequently when caring for children.
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Maintain personal hygiene, including cleaning the nose, throat, eyes, and mouth daily. Ensure living spaces and restrooms are well-ventilated and clean. Enhance nutrition for children.
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Preschools, kindergartens, and schools where many children gather should maintain cleanliness and ventilation; regularly disinfect toys, learning tools, and classrooms with common disinfectants.
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When signs such as fever, cough, runny nose, and rash appear, promptly isolate and take the child to the nearest medical facility for examination, consultation, and timely treatment. Avoid unnecessary hospital transfers to prevent hospital overcrowding and cross-infection.
Note the signs and symptoms of severe measles that require immediate medical attention:
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Rapid breathing:
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Children under 1 year: >50 breaths per minute
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Children over 1 year: >40 breaths per minute
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Signs of dehydration: dry lips, no tears when crying, thirst, irritability…
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Stridor, hoarse voice when crying
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Mouth ulcers
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Poor appetite
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Diarrhea, vomiting
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Eye pain, eye discharge
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Ear pain
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Fever lasting more than 4 days
Children need hospitalization when:
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Unable to drink or breastfeed
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Seizures
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High fever difficult to reduce
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Lethargy, difficult to wake
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Severe mouth ulcers
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Rapid breathing, chest indrawing, stridor
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Corneal ulcers, reduced vision
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Mastoiditis
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Severe dehydration: dry lips, decreased skin turgor, no tears when crying, reduced urination
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Severe malnutrition