What is the relationship between Vitamin A and measles?

From the Guidelines

Vitamin A supplementation is crucial for children with measles, particularly in areas where vitamin A deficiency is prevalent, as it significantly reduces mortality and complications from the disease. The relationship between Vitamin A and measles is well-established, with Vitamin A playing a vital role in supporting the immune system's response to the measles virus, maintaining the integrity of epithelial tissues, and reducing the severity of measles-related complications 1.

Key Considerations

• Vitamin A deficiency is involved in the severity of measles and can lead to severe complications, including pneumonia and diarrhea 1.
• The standard regimen for Vitamin A supplementation in children with measles is 200,000 IU for children 12 months and older, or 100,000 IU for infants 6-11 months, given immediately upon diagnosis and repeated the next day 1.
• For infants under 12 months, a dose of 100,000 IU is recommended, as stated in the guidelines for famine-affected, refugee, and displaced populations 1.
• Vitamin A supplementation should be given even if the child has received vitamin A prophylaxis within the previous month, as measles rapidly depletes vitamin A stores in the body.

Evidence-Based Recommendations

• The most recent and highest quality study 1 emphasizes the importance of ensuring sufficient supplementation with vitamins and minerals, including Vitamin A, to potentially reduce the negative impact of viral infections.
• The study highlights that Vitamin A has been defined as an "anti-infective" vitamin, and its adequate supply is essential for the body's defenses against infection.
• While the study focuses on COVID-19, its findings on the importance of Vitamin A supplementation can be applied to other viral infections, including measles.

Clinical Implications

• Vitamin A supplementation should be prioritized for children with measles, especially in areas where vitamin A deficiency is prevalent or for children who are at risk of deficiency.
• Healthcare providers should ensure that children with measles receive the recommended dose of Vitamin A supplementation, as it can significantly reduce mortality and complications from the disease.
• The supplementation should be given promptly, even if the child has received vitamin A prophylaxis within the previous month, to rapidly replenish depleted vitamin A stores.

From the Research

Relationship Between Vitamin A and Measles

• Vitamin A deficiency is a recognized risk factor for severe measles infections 2, 3, 4, 5
• The World Health Organization (WHO) recommends administration of an oral dose of vitamin A to children with measles in areas where vitamin A deficiency may be present 2, 3, 4
• Studies have shown that vitamin A therapy can reduce mortality and pneumonia-specific mortality in children with measles, particularly when given in two doses of 200,000 IU on consecutive days 2, 3, 4
• A reduction in the incidence of croup and otitis media has also been observed with vitamin A therapy 3
• High-dose vitamin A therapy (400,000 IU) has been shown to reduce measles-associated morbidity and mortality in hospitalized children 6
• Vitamin A may have immunomodulating properties, boosting immune responses in individuals with measles and other infectious diseases 5

Dosage and Administration

• Two doses of 200,000 IU of vitamin A on consecutive days are associated with a reduced risk of mortality and pneumonia-specific mortality in children under the age of two years 2, 3, 4
• A single dose of 200,000 IU of vitamin A is not associated with a reduced risk of mortality among children with measles 2, 3, 4
• High-dose vitamin A therapy (400,000 IU) has been shown to be effective in reducing measles-associated morbidity and mortality in hospitalized children 6

Population-Specific Effects

• Children under the age of two years may benefit more from vitamin A therapy, with a greater reduction in mortality and pneumonia-specific mortality observed in this age group 2, 3, 4
• Hospitalized children in areas with high case fatality may also benefit from vitamin A therapy, with a reduction in mortality and pneumonia-specific mortality observed in these populations 4, 6