Measles continues to pose a significant public health hazard worldwide, despite the availability and efficacy of vaccines. The impact of measles is even more significant in children, especially those with chronic illnesses.
A study was conducted to evaluate the proportion of vaccinations in children with chronic diseases, and the role of hospital-associated infections during the 2017-2019 measles outbreak in northern Vietnam. The study encompassed 2,064 children between 0-15 years, admitted to the National Children’s Hospital during the outbreak period. Various data points were gathered from different sources, including electronic medical records, vaccination documents, and parental interviews.
The study revealed a direct relationship between population density and the rate at which provincial hospitals referred cases to the National Children’s Hospital. Measles transmission within hospital settings was observed before the disease appeared in the community. Children older than 18 months, diagnosed with chronic diseases, had a significantly lower rate of vaccinations (9.4%) compared to those without chronic conditions (32.4%). Unvaccinated patients had a higher fraction of hospital-acquired infections compared to vaccinated patients. Children having chronic diseases also manifested a higher percentage of hospital-associated infections.
The World Health Organization advises a vaccination coverage of 90-95% for achieving herd immunity, but limited vaccination rates, weakened surveillance due to the COVID-19 pandemic, social factors like safety concerns, and mistrust in public vaccination programs have kept measles outbreaks consistently high. Amidst such significant outbreaks, hospitals can easily become overwhelmed due to an influx of patients, augmenting the risk of nosocomial infections – which can, in turn, magnify the scale of epidemics.
In light of these findings, it is vital to raise parental awareness about the importance and safety of measles vaccinations to protect these susceptible individuals. Hospital infection control practices also need to be enhanced, with an emphasis on staff training, improved early detection, and isolation during non-outbreak periods. This includes requiring all staff and visiting students to be vaccinated, establishing separate treatment units and rooms for measles patients, and enforcing use of personal protective equipment in alignment with international recommendations for measles.
Source: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09816-w