What is the treatment for measles?

Treatment for Measles

The treatment for measles is primarily supportive care, with vitamin A supplementation being essential for all children with clinical measles (200,000 IU for children over 12 months; 100,000 IU for younger children), and antibiotics should be administered for measles complications such as pneumonia and other bacterial infections. 1

Supportive Care

Supportive care forms the backbone of measles treatment and includes:

• Adequate hydration and nutrition
• Antipyretics for fever management
• Rest
• Monitoring for complications

Vitamin A Supplementation

Vitamin A supplementation is a critical component of measles treatment:

• For children ≥12 months: 200,000 IU orally on day 1
• For children <12 months: 100,000 IU orally on day 1
• For complicated measles (pneumonia, otitis, croup, diarrhea with dehydration, or neurological problems): a second dose on day 2
• This should be repeated every 3 months as part of routine vitamin A supplementation 1

Management of Complications

Measles complications occur in 10-40% of patients and require specific interventions:

• Diarrhea: Oral rehydration therapy (ORT)
• Acute lower respiratory infections: Appropriate antibiotics
• Otitis media: Antibiotics as indicated
• Neurological complications: Supportive care and close monitoring

For patients with vitamin A deficiency symptoms (xerosis, Bitot's spots, keratomalacia, or corneal ulceration), follow this treatment schedule:

• 200,000 IU oral vitamin A on day 1
• 200,000 IU oral vitamin A on day 2
• 200,000 IU oral vitamin A 1-4 weeks later
• Children <12 months receive half doses 1

Special Populations

Immunocompromised Patients

For immunocompromised patients exposed to measles:

• Immune globulin (IG) should be administered as soon as possible after exposure
• Dosage: 0.5 mL/kg of body weight intramuscularly (maximum dose = 15 mL)
• This corresponds to approximately 82.5 mg/kg of IgG protein 1

Pregnant Women

Pregnant women with measles require close monitoring due to increased risks of:

• Premature labor
• Spontaneous abortion
• Low birth weight infants 1

Post-Exposure Prophylaxis

For susceptible individuals exposed to measles:

• Measles vaccine may provide protection or modify disease severity if administered within 3 days of exposure 1
• For those with contraindications to vaccination, IG (0.25 mL/kg, maximum 15 mL) should be given as soon as possible after exposure 1

Nutritional Support

All children with measles should:

• Have their nutritional status monitored
• Be enrolled in a feeding program if undernourished 1

Infection Control Measures

To prevent transmission:

• Report suspected cases to local health departments immediately
• In healthcare settings, use airborne precautions including N-95 masks and isolation in airborne infection isolation rooms 2
• Isolation in emergency camp settings is not indicated 1

Common Pitfalls to Avoid

• Delaying vitamin A supplementation - this should be given promptly
• Failing to monitor for and treat complications
• Not reporting cases to public health authorities
• Underestimating the severity of measles - it can cause significant morbidity and mortality
• Withholding vaccination during outbreaks - immunization efforts should be accelerated during outbreaks 1

Remember that undernutrition, fever, respiratory tract infection, and diarrhea are NOT contraindications for measles vaccination. In fact, undernutrition should be considered a strong indication for vaccination to prevent severe disease 1.