From the Guidelines
There is no specific antiviral treatment for measles, and treatment focuses on supportive care to manage symptoms while the body fights the virus. This approach is based on the most recent and highest quality studies available, including those from the Advisory Committee on Immunization Practices (ACIP) 1. The treatment includes rest, adequate fluid intake to prevent dehydration, and fever reduction with acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) according to package directions.
- Vitamin A supplementation is recommended for children with measles, as it can reduce severity and complications; typical dosing is 200,000 IU for children over 12 months (100,000 IU for 6-12 months) for two days.
- Antibiotics may be prescribed only if secondary bacterial infections develop.
- Isolation is crucial to prevent spreading the virus to others; patients should stay home for four days after the rash appears. Measles is highly contagious, and complications can be serious, so medical attention should be sought promptly, especially for high-risk individuals like young children, pregnant women, and those with compromised immune systems. Prevention through vaccination remains the most effective approach to measles control, with the ACIP recommending a two-dose measles, mumps, and rubella (MMR) vaccination schedule to produce immunity in the small proportion of persons who fail to respond immunologically to one or more of the components of the first dose 1. The most recent vaccine approved by the Food and Drug Administration is PRIORIX, which is considered safe, immunogenic, and noninferior to M-M-R II 1.
From the Research
Treatment for Measles
The treatment for measles primarily involves supportive care, as there is no specific antiviral therapy for the disease. Key aspects of treatment include:
- Vitamin A supplementation: Studies have shown that vitamin A supplementation can reduce mortality and complications from measles 2, 3, 4, 5.
- Monitoring for and treatment of secondary bacterial infections with antibiotics.
- Rehydration in the case of severe diarrhea.
Vitamin A Supplementation
Vitamin A supplementation has been recommended by the World Health Organization (WHO) for the treatment of measles, particularly in areas where vitamin A deficiency is common. The recommended dose is 200,000 IU per day for two days, with a lower dose of 100,000 IU per day for infants 3, 4. Research has shown that:
- Two doses of 200,000 IU of vitamin A can reduce overall mortality and pneumonia-specific mortality in children with measles 3, 4.
- The effect of vitamin A supplementation is greater in children under the age of two years 4.
- A single dose of 200,000 IU of vitamin A may not be sufficient to reduce mortality among children with measles 3, 4.
Supportive Care
Supportive care for measles includes:
- Rest and hydration to help manage symptoms.
- Monitoring for complications, such as otitis media, laryngotracheobronchitis, and pneumonia.
- Treatment of secondary bacterial infections with antibiotics.
- Rehydration in the case of severe diarrhea.
Prevention
Prevention of measles through vaccination is the most effective way to reduce morbidity and mortality from the disease. The measles vaccine is safe and effective, and two doses are recommended for all children 6, 5.