Treatment for Measles
The treatment for measles is primarily supportive care, with vitamin A supplementation recommended for all children with severe measles to reduce morbidity and mortality. 1, 2
Diagnosis Confirmation
Before initiating treatment, confirm measles diagnosis through:
- Clinical presentation: Fever ≥38.3°C (≥101°F), generalized maculopapular rash lasting ≥3 days, and at least one of: cough, coryza (runny nose), or conjunctivitis 3
- Laboratory confirmation:
- Positive serologic test for measles IgM antibody
- Significant rise in measles antibody level
- Isolation of measles virus from clinical specimen 3
Treatment Protocol
Supportive Care
- Fever management with antipyretics
- Adequate hydration and nutritional support
- Rest and isolation to prevent transmission
- Monitoring for complications
Vitamin A Supplementation
- Recommended for all children with severe measles 2
- Dosing (based on age):
- 50,000 IU for infants <6 months
- 100,000 IU for infants 6-11 months
- 200,000 IU for children ≥12 months
- Repeat dose the next day and at 4 weeks for children with clinical signs of vitamin A deficiency
Management of Complications
- Bacterial superinfections: Prompt treatment with appropriate antibiotics 4
- Otitis media: Antibiotic therapy if bacterial infection confirmed
- Pneumonia: Respiratory support and antibiotics if bacterial
- Diarrhea: Rehydration therapy 1
- Neurological complications: Supportive care and close monitoring
Special Considerations
Immunocompromised Patients
- Higher risk for severe disease and complications
- May require immune globulin (IG) administration:
- Standard dose: 0.25 mL/kg body weight (maximum 15 mL)
- For immunocompromised patients: 0.5 mL/kg body weight (maximum 15 mL) 3
Pregnant Women
- Increased risk for premature labor, spontaneous abortion, and low birth weight infants 3
- Supportive care with close monitoring for complications
Prevention Measures During Treatment
- Isolation of infected individuals until 4 days after rash onset
- Vaccination of susceptible contacts within 72 hours of exposure may prevent or modify disease
- Immune globulin for high-risk exposed individuals when given within 6 days of exposure 3
Important Clinical Pitfalls
Delayed recognition: Measles can be mistaken for other viral exanthems; maintain high index of suspicion in unvaccinated individuals 2
Underestimating severity: Despite being considered "benign" by some, measles has significant mortality (>5% in developing countries) and frequent complications 5
Neglecting vitamin A: Failure to administer vitamin A to children with severe measles increases risk of complications and death
Inadequate infection control: Measles is highly contagious; failure to isolate patients can lead to outbreaks, particularly in healthcare settings 3
Missing secondary bacterial infections: These are common complications and require prompt antibiotic treatment 4