Dr Mattias Larsson*
Hương is a devoted mother to her bright and active 11-month-old daughter, Ngọc. She has diligently followed the recommended vaccination schedule and ensured proper nutrition for her baby, continuing to breastfeed as advised by the paediatrician at Family Medical Practice (FMP). Breastfeeding not only supports Ngọc’s immune system, but also adapts to her growing needs.
Ngọc has thrived, her growth following the middle of standard pediatric growth curves. She’s now a curious explorer — pulling herself up, taking her first wobbly steps and eagerly investigating everything around her. She’s even started saying “mama” and “papa” and seems to understand much of what’s said to her.
One day, Ngọc developed a high fever (39°C), with a cough, runny nose and red, watery eyes. Concerned, Hương took her to a local doctor, who diagnosed a lung infection and prescribed antibiotics. The next day, Hương herself fell ill with fever and coughing.
Two days later, Ngọc broke out in a blotchy red rash that spread from her face down her body. Soon after, Hương developed a similar rash, while Ngọc’s cough worsened, and she began struggling to breathe. Alarmed, Hương rushed her back to FMP to see the paediatrician.
During the examination, the doctor noticed tiny white spots with bluish-white centres inside Ngọc’s mouth — Koplik’s spots, a classic sign of measles. The paediatrician asked Hương if she had ever been vaccinated against measles or had the disease herself. Unsure, Hương called her parents, but they couldn’t recall her ever receiving the vaccine or having measles as a child.
Tests confirmed that both had measles, while Ngọc’s X-ray and blood test showed that she also had a secondary bacterial pneumonia.
The doctor explained that measles is highly contagious — one infected person can spread the virus to up to 15 others if they are unvaccinated. Beyond the rash and fever, measles weakens the immune system, leaving patients vulnerable to severe secondary infections like pneumonia or encephalitis (brain infection), and can even cause death.
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| Early symptoms of measles can include distinctive lesions and rashes. — Photo courtesy of FMP |
Normally, the MMR (Measles, Mumps and Rubella) vaccine is given at 12 months, as maternal antibodies, passed on during pregnancy and breastfeeding, provide some early protection. However, since Hương had no prior immunity, either from vaccination or past infection, she couldn’t pass on protective antibodies to Ngọc, leaving them both susceptible.
In outbreak settings, the measles vaccine can be given as early as nine months, followed by the standard second dose at four to six years of age. Unvaccinated adults are also encouraged to get immunised. The doctor stressed that herd immunity — achieved when over 95 per cent of a population is vaccinated — is crucial to preventing outbreaks.
Hương asked where they might have been exposed. The doctor explained that Việt Nam is currently facing a measles outbreak. Since early 2025, there have been over 68,000 suspected cases, with 7,000 laboratory confirmed infections (testing isn’t universally available) and eight reported deaths. Unvaccinated infants under one year old are at highest risk, along with older children and adults who missed their shots.
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| The characteristic rash is a key indicator of this contagious disease. — Photo courtesy of FMP |
Because Ngọc developed secondary pneumonia, she was hospitalised and given IV antibiotics. Both mother and daughter were advised to rest and stay hydrated, use a humidifier or saline spray for respiratory relief and isolate at home for at least four days after the rash appeared to avoid spreading the virus.
As Hương comforted Ngọc, she couldn’t help but wonder: if I had known about my own vaccination status, could this have been avoided? The doctor reassured her that measles is preventable — and urged all families to check their vaccine records and protect their children with timely MMR vaccination. Family Medical Practice
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| Dr Mattias Larsson. Photo courtesy of Family Medical Practice |
*Dr Mattias Larsson is a paediatric doctor at Family Medical Practice and associate professor at Karolinska Institutet and has a long experience in research on infectious diseases. He has worked with the Oxford University Clinical Research Unit and the Ministry of Health of Việt Nam. He is fluent in English, Swedish, Vietnamese, German and some Spanish.
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