Latest guidelines on isolating measles cases.

Kinhtedothi - The Ministry of Health has issued Decision No. 1019/QD-BYT on the promulgation of professional documents guiding the diagnosis and treatment of measles. Accordingly, the 2025 guidelines include several new points regarding paraclinical examinations, diagnosis, treatment, and supplementary content.

Here are some key changes in the 2025 guidelines for the diagnosis and treatment of measles compared to the 2014 guidelines:

Clinical examination

Basic clinical tests: guidelines for the diagnosis and treatment of measles 2025 will add arterial blood gas analysis in cases of respiratory failure and tests to assess inflammatory response: Ferritin, LDH, and interleukin when measles is complicated by severe bacterial infections.

Clinical diagnostics: The 2025 guidelines for the diagnosis and treatment of measles add the following: “If the measles IgM test is negative but clinical symptoms are still suggestive of measles, a second test can be performed after 72 hours, or a measles PCR test can be ordered using nasopharyngeal swab samples” and “virus isolation from blood and nasopharyngeal swabs in the early stages of the disease”.

Diagnose

The 2025 guidelines for the diagnosis and treatment of measles add risk factors for severe disease progression in children under 12 months of age; unvaccinated or incompletely vaccinated individuals; congenital or acquired immunodeficiency; severe underlying disease; severe malnutrition; vitamin A deficiency; and pregnant women.

On the other hand, the new guidelines add suspected cases: a history of contact with a measles patient within 7-21 days or living in an area where measles is endemic; and clinical symptoms suggestive of measles (fever and upper respiratory tract inflammation).

Deputy Minister of Health Tran Van Thuan inspects the measles admission and treatment work at the National Children's Hospital.

The 2025 guidelines add clinical cases: fever, cough, runny nose or conjunctivitis, Koplik spots or measles-like rash.

In addition, the new guidelines adjust the diagnostic criteria for suspected or clinical cases of measles, which include a positive IgM antibody test or PCR test for measles.

In addition, the differential diagnosis guidelines include diseases such as Mycoplasma pneumoniae infection, scrub typhus, Epstein-Barr virus infection, and purulent meningitis.

Treatment

The new guidelines provide more specific details on the treatment of pneumonia complications in measles patients, and respiratory support according to the levels of respiratory distress (diagrammed).

Regarding the use of intravenous immunoglobulin (IVIG): specific guidelines range from indications for severe infections with evidence of increased inflammatory response; rapidly progressing respiratory failure; encephalitis to IVIG dosage of 0.25 g/kg/day for 3 consecutive days (total dose may be 1 g/kg, administered for 2-4 days); administered by slow intravenous infusion over 8-10 hours.

New guidelines detail treatment tiers for different units.

Specifically, commune health stations and private clinics provide outpatient examination and treatment for patients with uncomplicated measles; they refer patients with complicated measles, immunosuppression, or severe underlying conditions to higher-level treatment facilities.

District hospitals and private hospitals examine and treat patients with uncomplicated measles and those with complicated measles; they refer patients with complicated measles requiring oxygen therapy, encephalitis, sepsis, immunosuppression, or severe underlying conditions to higher-level facilities for treatment.

Provincial general hospitals, regional general hospitals, and specialized infectious disease or pediatric hospitals: examine and treat measles patients. Consult with and guide lower-level facilities in treating severe or difficult-to-treat cases.

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In addition, the 2025 guidelines for the diagnosis and treatment of measles include several additional points: nursing care; patient management with a focus on longer isolation for immunocompromised individuals.

Post-exposure prophylaxis: vaccination, intravenous administration of Immune Globulin (IG), intramuscular or subcutaneous injection. Immune Globulin is indicated for post-exposure prophylaxis in certain special cases: severely immunocompromised individuals, children under 9 months of age with severe and progressive underlying medical conditions, and consideration should be given to pregnant women.

Source: https://kinhtedothi.vn/huong-dan-moi-nhat-ve-cach-ly-ca-mac-soi.html