From the Guidelines
The recommended treatment for a 4-year-old child with measles is primarily supportive care, including vitamin A supplementation at a dose of 200,000 IU orally, as this has been shown to improve outcomes in children with measles 1. The child should get plenty of rest and maintain adequate fluid intake to prevent dehydration. For fever and discomfort, acetaminophen (Tylenol) can be given at a dose of 10-15 mg/kg every 4-6 hours as needed. For a typical 4-year-old weighing about 16 kg, this would be approximately 160-240 mg per dose. Some key points to consider in the treatment of measles include:
- Isolating the child from others, especially pregnant women and immunocompromised individuals, for at least 4 days after the rash appears
- Monitoring for complications like pneumonia, ear infections, or encephalitis, which require prompt medical attention
- Considering a second dose of vitamin A on day 2 if the child develops complicated measles, such as pneumonia or severe dehydration 1
- Ensuring other family members are protected against measles through vaccination, as the disease is highly contagious and preventable. It's also important to note that antibiotics are not effective against the measles virus itself but may be prescribed if bacterial complications develop. Overall, the goal of treatment is to manage symptoms, prevent complications, and keep the child comfortable during recovery, as measles is caused by a virus that must run its course.
From the Research
Treatment for Measles in Children
The recommended treatment for a 4-year-old child with measles includes:
- Vitamin A supplementation, as it has been shown to reduce mortality and complications in children with measles 2, 3, 4
- Supportive therapy, such as monitoring for and treatment of secondary bacterial infections with antibiotics, and rehydration in the case of severe diarrhea 5
- There is no specific antiviral therapy for the treatment of measles, and disease control largely depends on prevention 5
Vitamin A Supplementation
- The World Health Organization (WHO) recommends administration of an oral dose of 200,000 IU (or 100,000 IU in infants) of vitamin A per day for two days to children with measles in areas where vitamin A deficiency may be present 4
- Studies have shown that two doses of 200,000 IU of vitamin A can reduce mortality and pneumonia-specific mortality in children with measles 2, 4
- However, a single dose of 200,000 IU of vitamin A may not be associated with reduced mortality among children with measles 4, 6
Considerations for High-Income Countries
- Evidence supporting the use of vitamin A supplementation for measles in high-income countries is lacking 6
- A study conducted in a high-income country found that vitamin A supplementation did not reduce the risk of complications or change the clinical course of measles infection in children hospitalized for measles 6