Disease prevention and control - Lessons from Pieng Cooc

(Baonghean) - As of now, the measles outbreak in Pieng Cooc village, Mai Son commune, Tuong Duong district has temporarily subsided, with no new patients appearing. Children with measles-like rashes have returned home and resumed normal activities and schooling… The issue is that the Nghe An Health Department and local authorities need to promptly assess the epidemic control efforts at the "hotspot" Pieng Cooc to draw practical lessons…

Doctors and nurses examine and treat children in Piêng Coọc. Photo: Nhật Lân

This stems from the local people's lifestyle habits and awareness of disease prevention: "Children are only brought to the health station when they are seriously ill or have a long-term illness." On the other hand, the dissemination of knowledge about infectious diseases in border areas is limited; many health workers only know their own ethnic language and not other ethnic languages, while the working area has many different ethnic groups living there; the level of medical staff in mountainous communes is still inadequate (Mai Son commune has no doctor; two children with the disease from Pha Danh and Pom Bai villages in Laos were brought through Mai Son to the Nhon Mai commune health station where a Hmong doctor, Va Ba Tua, works); awareness of disease prevention and control is not high, and when suspected cases appear in children, they do not monitor or report them promptly to the district and provincial health agencies.

Besides the efforts of the health sector and local authorities in treating and controlling the outbreak, other favorable factors helped to contain the epidemic and prevent it from spreading widely. Firstly, 95% of children aged 1-14 in Piêng Coọc had received the measles-rubella vaccine on October 1st, so two weeks after vaccination, their bodies had already produced antibodies against measles, thus the disease subsided and their health recovered quickly. Secondly, Piêng Coọc is a small, isolated village with limited interaction and travel between areas, so the containment and control efforts were relatively easy to implement. The final fortunate factor was that children in neighboring communes such as Nhôn Mai, Hữu Dương, and Hữu Khuông were all vaccinated at the same time as children in Mai Sơn commune.

During the recent measles outbreak in Piêng Coọc, the government and health sector of Tương Dương district responded quickly in containing and suppressing the outbreak, treating sick children, and promptly implementing support and assistance programs for the children. According to Dr. Trần Văn Cương, Deputy Director of Nghệ An Obstetrics and Pediatrics Hospital – Head of the medical team sent by the Department of Health to Piêng Coọc for support: “The prevention and control of the epidemic was carried out systematically and thoroughly by all levels of government and the district's health sector. Treatment followed the Ministry of Health's protocol correctly…” The measles outbreak in Piêng Coọc also provided Tương Dương district in particular, and other mountainous and border districts in general, with valuable experience in disease prevention and control.

Mr. Vi Tan Hoi, Vice Chairman of the District People's Committee, said: "The district has gained more experience in preventing and controlling outbreaks of infectious diseases. This includes paying special attention to disseminating information about the disease so that all citizens take their children for vaccinations, and when a disease appears, they immediately take their children to the nearest health facility. Appropriate methods of communication are necessary, especially in mountainous areas where many people take their children into the forest for months at a time during the farming season. When outbreaks occur, the entire local political system promptly and actively supports the health sector in establishing field hospitals, environmental sanitation, containing the outbreak, and preventing people from entering and leaving the affected area. To combat the outbreak, the health sector needs to prepare sufficient equipment and medicine, strengthen monitoring and reporting of the disease situation; the education sector proactively monitors the situation to allow children to stay home from school to avoid cross-infection... After the outbreak, Tuong Duong district promptly rewarded individuals and groups who were active and disciplined those who were critical." "This applies to groups and individuals who show signs of inertia in controlling the epidemic."

According to Dr. Pham Dinh Du, Deputy Director of the Provincial Center for Preventive Medicine, the outbreak in Pieng Cooc has been brought under control, however, the possibility of a resurgence cannot be ruled out. The success of the outbreak in Pieng Cooc was due to the coordinated efforts of various departments and agencies, especially the local government; the quick and timely response of many units in the health sector in mobilizing personnel, medicines, and medical equipment from provincial hospitals to support the field treatment area in the affected region, ensuring effective patient admission and treatment, minimizing severe complications and deaths. However, there are also areas that need improvement, such as the need for more attention to nutrition for children in remote areas (with weak immune systems); the slow detection and handling of outbreaks in mountainous areas; and the need for greater attention to the role of school health staff.

Following the measles outbreak in Piêng Coọc, public opinion highly praised the leadership and control efforts of the Nghe An Provincial People's Committee, the Nghe An Health Department, and Tuong Duong District. However, concerns were also raised regarding the possibility of a measles outbreak in the plains, coastal areas, and urban centers – areas with high levels of interaction and difficulty in isolation. Discussing this issue, Dr. Pham Dinh Du stated: “The risk of a measles outbreak in the plains and urban areas from now until the end of the year exists, but it is very low. Recently, most children in these areas have participated in numerous measles vaccination campaigns, and their bodies already possess antibodies against the disease; if an outbreak occurs, its scale will certainly not be large. Currently, the health sector has also developed contingency plans for timely response.”

Regarding the prevention and control of measles-like rash, on October 16th, the Provincial People's Committee issued another document requesting the Department of Health, the Department of Education and Training, Tuong Duong district, and other relevant units to strengthen the prevention and control of measles-like rash, preventing a resurgence of the disease in Pieng Cooc village and surrounding areas. In the spirit of this document and the province's plan for disease prevention and control in humans, the Nghe An Health Department is continuing to strengthen coordination with the Education Department to accelerate the measles-rubella vaccination campaign for children before an outbreak occurs; strengthening communication efforts to raise public awareness about the disease, especially among people in remote areas; proactively monitoring, detecting, and containing outbreaks; and simultaneously planning and preparing medicines, equipment, and establishing centralized treatment areas with the support of higher-level health facilities.

The proactive preparation by all levels, sectors, and localities played a crucial role in successfully preventing and controlling the measles outbreak in Piêng Coọc. However, this also leads to the conclusion that the key factor in disease prevention and control is awareness, knowledge about the disease, and the proactive prevention and control efforts of the people.

Thanh Son