On March 26th 2025, the Ministry of Health issued Decision No. 1019/QD-BYT regarding the issuance of the professional document “Guidelines for Diagnosis and Treatment of Measles”. This is the latest legal document replacing old guidelines, updating standards on diagnostic testing and treatment triage to respond to the current epidemic situation.

Definitive Diagnosis and Testing

Measles is an acute infectious disease caused by a virus, transmitted via the respiratory tract, with typical symptoms including fever, respiratory catarrh (cough, runny nose), conjunctivitis, and rash. According to the new guidelines, definitive diagnosis is based on IgM antibody or molecular biology test results:

• IgM Testing: The positive rate reaches 50-70% from the first day of the rash and up to 100% after 3 days.
• New Testing Point: In cases where the IgM measles test is negative but measles is still clinically suspected, doctors may prescribe a second test after 72 hours, or order a measles PCR test using nasopharyngeal fluid to confirm the diagnosis.

Treatment and Care Principles

The core principle is the early detection of complications and supportive care, as there is currently no specific antiviral treatment.

• Vitamin A Supplementation: All children with measles need high-dose Vitamin A to prevent ocular complications and reduce mortality. Children aged 6-11 months take 100,000 IU/dose; children aged 12 months and older take 200,000 IU/dose. The second dose is repeated after 24 hours. In cases of severe malnutrition or complications, a third dose is added after 4-6 weeks.
• Symptomatic Treatment: Reduce fever with Paracetamol (10-15mg/kg/dose, max 4 times/day) or Ibuprofen (5-10mg/kg/dose) when fever > 38.5°C.
• Important Note: Do not use systemic corticosteroids unless measles has been ruled out, except for other indications from a specialist.
• Care: Enhance nutrition, continue breastfeeding, and maintain daily hygiene of eyes, nose, and mouth.

Triage and Isolation

Proper triage helps reduce the load on upper-level hospitals and limits cross-contamination:

• District and Private Hospitals: Receive and treat uncomplicated measles cases and measles with mild complications.
• Referral to Upper Levels: Transfer only patients with severe complications such as pneumonia requiring respiratory support (oxygen therapy), encephalitis, sepsis, or patients with severe underlying diseases or immunodeficiency.
• Isolation: Patients must be isolated immediately upon suspicion of measles. The isolation period lasts at least 4 days after the onset of the rash to prevent community transmission.

Assoc. Prof. Dr. La Ngoc Quang – Center for Support & Continuing Education