What is the treatment for measles?

Treatment of Measles

The treatment of measles primarily consists of supportive care, vitamin A supplementation, and management of complications, as there is no specific antiviral therapy for measles infection. 1

Supportive Care

• Fluid management: Provide oral rehydration therapy for patients with diarrhea and dehydration
• Fever control: Use appropriate antipyretics for fever management
• Nutritional support: Ensure adequate nutrition and monitor nutritional status
• Rest: Recommend bed rest during the acute phase of illness

Vitamin A Supplementation

Vitamin A supplementation is a crucial component of measles treatment:

• For children under 12 months: 100,000 IU orally on days 1 and 2
• For children over 12 months: 200,000 IU orally on days 1 and 2
• Additional dose: Administer another age-appropriate dose 1-4 weeks later if signs of vitamin A deficiency are present 1

Vitamin A supplementation has been shown to reduce mortality risk in children with measles.

Management of Complications

• Secondary bacterial infections: Administer appropriate antibiotics for bacterial complications such as pneumonia or otitis media based on local guidelines
• Respiratory support: Provide oxygen therapy for patients with respiratory distress
• Neurological complications: Monitor for and manage encephalitis, seizures, or other neurological manifestations

Post-Exposure Prophylaxis

For exposed susceptible individuals:

1. MMR vaccine: If administered within 72 hours of initial measles exposure, may provide some protection 2

   • Recommended for most persons ≥12 months exposed to measles
   • Can also be used for susceptible persons ≥6 months who are household contacts

2. Immune Globulin (IG): If administered within 6 days of exposure, can prevent or modify measles 2

   • Standard dose: 0.25 mL/kg of body weight (maximum 15 mL)
   • For immunocompromised persons: 0.5 mL/kg of body weight (maximum 15 mL)
   • Indicated for susceptible household contacts at high risk for complications (infants ≤12 months, pregnant women, immunocompromised persons)

Special Considerations

High-Risk Groups

• Infants and young children: Require closer monitoring due to higher risk of complications and mortality 1
• Immunocompromised patients: Need more aggressive supportive care as illness may be prolonged and severe 1
• Pregnant women: At increased risk for complications; should be monitored closely

Isolation and Infection Control

• Isolate infected individuals for at least 4 days after rash onset
• In healthcare settings, place patients in airborne-infection isolation rooms
• Healthcare workers should use N95 respirators or equivalent when entering the room 1

Common Pitfalls to Avoid

1. Failure to recognize measles early: The characteristic rash appears 3-4 days after initial symptoms; early recognition is crucial for infection control
2. Inadequate vitamin A dosing: Ensure proper dosing based on age
3. Overlooking complications: Vigilantly monitor for respiratory, gastrointestinal, and neurological complications
4. Neglecting post-exposure prophylaxis: Timely administration of MMR vaccine or IG to susceptible contacts is essential for outbreak control
5. Inappropriate antibiotic use: Antibiotics should only be used for confirmed bacterial complications, not for the viral illness itself

Early recognition, prompt treatment, and appropriate infection control measures are essential to reduce morbidity and mortality associated with measles.