Measles Outbreak in Vietnam’s Remote Highlands Claim Young Lives

A suspected measles outbreak in the mountainous Nam Trà My District of Quảng Nam Province, central Vietnam, has claimed the lives of two children and left over 200 others battling fever and rashes, prompting urgent action from health authorities. The Department of Disease Prevention (DDP) under Vietnam’s Ministry of Health has called for immediate measures to curb the spread of the highly contagious disease in this remote, hard-to-reach region, where cultural practices and systemic challenges have compounded the crisis.

Since late January, 255 children in Nam Trà My District have been admitted to local medical facilities with symptoms of fever and rashes, with 19 cases confirmed as measles through laboratory testing. Of these, 104 children remain under treatment at centres such as the Nam Trà My Medical Centre and the Obstetrics and Paediatrics Hospital, while 149 have recovered. Tragically, two young lives were lost in Trà Dơn Commune, highlighting the dire consequences of delayed medical intervention in isolated communities.

The first victim, an eight-year-old girl from Village 3, developed a cough, high fever, and diarrhoea on 26 February. Despite efforts by village health workers, teachers, and officials to convince her family to seek treatment at the commune health station, the family opted to stay home and pray, adhering to local customs. Her condition deteriorated, and she passed away on 5 March after days of vomiting and exhaustion. The second child, a ten-year-old boy from Village 2, followed a similar trajectory, with his family citing financial constraints as a barrier to seeking care. He died on 9 March, also from exhaustion after battling fever and diarrhoea since early March.

The DDP has warned that infections may persist in the near term due to the district’s challenging terrain and dispersed population, predominantly comprised of ethnic minority groups. Nam Trà My lies in Vietnam’s central highlands, where travel is arduous, and access to healthcare remains limited. “Many locals still rely on traditional practices like prayer during illness,” a DDP spokesperson noted, underscoring the cultural barriers that health workers face. This, combined with years of inadequate vaccination coverage, has created a perfect storm for outbreaks like measles, a preventable disease that can be fatal without timely intervention.

A Legacy of Vaccination Gaps

Health officials have pointed to systemic issues exacerbating the crisis. During the COVID-19 pandemic, many children in remote areas like Nam Trà My missed routine immunisations, including the measles vaccine, due to disrupted healthcare services. Compounding this, a nationwide shortage of vaccines for several months in 2023 further eroded community immunity. A new vaccination campaign launched this month has achieved a coverage rate of nearly 50 per cent in the district, but this falls far short of the threshold needed to prevent outbreaks.

Measles is a highly contagious viral disease spread through respiratory droplets, often affecting young children who are unvaccinated. It can lead to severe complications such as pneumonia, encephalitis, and death, particularly in malnourished or immunocompromised individuals. In Vietnam, the measles vaccine is typically administered in two doses as part of the national immunisation programme, but reaching remote communities remains a logistical challenge. The DDP has now prioritised catch-up vaccinations for children who missed doses, targeting high-risk and economically disadvantaged areas.

The Ministry of Health has mobilised rapid response teams to support Nam Trà My, focusing on communes like Trà Dơn and Trà Leng, where cases are concentrated. Medical units are conducting field investigations, coordinating with local authorities and schools to identify sick children, and mandating families to seek treatment at health stations for isolation and care. Online training for measles prevention and treatment is also underway for local health workers, while additional staff have been deployed to bolster commune-level facilities.

Cultural and Economic Barriers

The deaths in Trà Dơn Commune have cast a spotlight on the intersection of cultural beliefs, economic hardship, and public health in Vietnam’s rural highlands. In both fatal cases, families resisted medical intervention—whether due to reliance on spiritual practices or lack of resources—despite persistent outreach by health workers and community leaders. This reflects a broader challenge in regions where traditional customs often take precedence over modern healthcare, particularly among ethnic minority groups who may distrust or lack access to formal medical systems.

Economic constraints further complicate the situation. Many families in Nam Trà My live in poverty, with limited means to travel to health stations or afford treatment, even when it is available. The DDP and local authorities are now working to address these barriers by providing free care and supplies, including high-dose vitamin A supplements, which can help reduce measles-related complications in children.

Quảng Nam Province’s Department of Health, in collaboration with the Pasteur Institute in Nha Trang City, is ramping up testing to confirm the causative agent and tailor prevention strategies. Medical stations have been instructed to prevent cross-infections by isolating patients and referring severe cases to higher-level facilities for specialised care. Yet, the mountainous terrain continues to hinder rapid response efforts, with scattered villages often cut off from main roads during adverse weather.

A Call for Systemic Change

This outbreak serves as a stark reminder of the persistent health disparities between Vietnam’s urban centres and rural hinterlands. While the country has made significant strides in reducing child mortality and improving vaccination rates over the past decades, pockets of vulnerability remain in areas like Nam Trà My, where geography, poverty, and cultural factors intersect. The Ministry of Health’s push for catch-up vaccinations and enhanced epidemic surveillance is a critical step, but long-term solutions will require investment in infrastructure, education, and community trust-building.

Public health experts have urged the government to prioritise outreach programmes that address cultural sensitivities while ensuring access to care. “It’s not enough to deliver vaccines; we must also deliver understanding,” said Dr. Tran Minh, a public health consultant based in Hanoi. “Engaging with local leaders and tailoring interventions to respect traditions can bridge the gap between communities and the health system.” If confirmed, such initiatives could prevent future tragedies in Vietnam’s most vulnerable regions, though sustained funding and political will remain essential.

In early March 2025, the Laos Ministry of Health, with the support of international partners in Australia and the World Health Organization, unveiled their Vaccine Alliance initiative that aims to boost the administration of measles, rubella, and polio vaccine across urban areas of the country.

The measles outbreak in Quảng Nam Province also raises broader questions about Vietnam’s preparedness for infectious disease threats in the post-COVID era. With global health systems still recovering from the pandemic’s disruptions, immunity gaps for preventable diseases like measles pose a growing risk, particularly in underserved areas. The DDP’s response in Nam Trà My may serve as a test case for strengthening rural healthcare resilience, but time is of the essence as infections threaten to spread to neighbouring communes.

For now, the focus remains on containing the outbreak and protecting the district’s children. As health workers brave difficult conditions to screen and treat patients, the loss of two young lives stands as a poignant call to action. In the highlands of Quảng Nam, the fight against measles is not just a medical battle but a race against systemic inequities that have left too many behind.