Every day, Ho Chi Minh City uses nearly 200 vials of Immunoglobulin (IVIG) for children with severe hand, foot and mouth disease, most of which are transferred from other provinces. The medicine is expected to run out by the end of July, while there will be a new import at the end of August.
This content has just been mentioned in the document of the Ho Chi Minh City Department of Health reporting to the Ministry of Health on the situation of hand, foot and mouth disease. IVIG is one of the essential drugs, effectively treating children with severe hand, foot and mouth disease, reducing the rate of progression as well as serious complications. The drug has not been produced domestically but must be completely imported from abroad, the global supply has been scarce for the past two years due to the impact of the Covid pandemic.
According to the Department of Health, many hospitals in the southern provinces lack IVIG, forcing Ho Chi Minh City to receive and treat many cases from other provinces and cities (about 60-80%). Of these, many cases progressed very quickly and became critical. This put the city in the second of three scenarios proposed to respond to the hand, foot and mouth disease this year. Corresponding to the second scenario, the number of hand, foot and mouth disease cases hospitalized each day increased by 50-100, 200-700 inpatients and 20-70 cases progressed to severe.
Although preparations have been made for drug supply, the amount of medicine in Ho Chi Minh City’s reserve is expected to be insufficient to meet the rapidly evolving epidemic situation, as the number of severe cases transferred from other provinces continues to increase. In early July, hospitals used 80-150 vials of IVIG per day, now it has increased to nearly 200 vials and shows no signs of stopping.
"There is definitely a risk of IVIG shortage from the end of July onwards if patients are as severe as they are now, or the medicine will run out sooner if the situation continues to worsen rapidly," the Health Department's dispatch stated.
Children with severe hand, foot and mouth disease receive intensive care at Children's Hospital 1 (HCMC). Photo: Le Phuong
In the context of the EV71 strain being dominant, the city's health sector predicts that the number of cases and severe cases will continue to increase, leading to a high number of hospitalizations. This virus strain causes severe illness in infected people, with a higher risk of death than other agents, and has caused major epidemics in 2011 and 2018. The common characteristic of hand, foot and mouth disease caused by this strain is that it usually lasts 4-5 months.
The health sector held a meeting with experts and decided that if a child with severe hand, foot and mouth disease needs two doses according to the protocol, only one dose should be used for monitoring and further evaluation, saving the medicine for more serious cases.
The Department of Health recommends that the Ministry of Health assign end-line hospitals of some provinces and cities with capacity in receiving and treating hand, foot and mouth disease such as Ca Mau Obstetrics and Pediatrics Hospital, Can Tho Children's Hospital, Dong Nai Children's Hospital... to receive and treat patients from neighboring provinces, ensuring that severe cases are treated early and that the transfer of patients is safe and effective.
In addition, the Ministry needs to have directions and solutions to ensure the supply of hand, foot and mouth disease treatment drugs for the southern provinces. The Drug Administration of Vietnam prioritizes approving import orders for IVIG drugs.
At the end of June, the leader of the Ho Chi Minh City Department of Health proposed that the authorities have policies to encourage and attract pharmaceutical enterprises to research and produce IVIG instead of relying on imports, in the context of the long-term hand, foot and mouth disease.
Le Phuong
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