From the Guidelines
The treatment for measles (Rubeola) primarily involves supportive care, including rest, hydration, and management of fever and discomfort with acetaminophen or ibuprofen, as well as vitamin A supplementation to reduce mortality and complication risks. The focus on supportive care is due to the lack of specific antiviral therapy for the measles virus itself. According to the guidelines for treating complications in populations affected by measles, such as those outlined in 1, standard treatments for complications like diarrhea and acute lower respiratory infections are crucial. However, these guidelines, although relevant for managing complications, do not directly address the primary treatment approach for measles.
Supportive Care and Vitamin A Supplementation
- Patients with measles should maintain adequate hydration and use over-the-counter medications like acetaminophen or ibuprofen to manage fever and discomfort.
- Vitamin A supplementation is a critical component, with recommended dosages being 200,000 IU for children over 12 months, 100,000 IU for those between 6-12 months, and 50,000 IU for children under 6 months, given once daily for two days, as it supports immune function and epithelial tissue integrity, thereby reducing the risk of complications and mortality.
Management of Complications
- Antibiotics may be prescribed if secondary bacterial infections, such as pneumonia or ear infections, develop, but they are not effective against the measles virus itself.
- Isolation is crucial to prevent the spread of the disease, with patients typically remaining isolated for four days after the rash appears.
- Severe cases may require hospitalization for intravenous fluids, respiratory support, or treatment of complications, highlighting the importance of monitoring the disease's progression.
Prevention
- The most effective strategy against measles is prevention through vaccination, which is significantly more effective than treating the disease after infection occurs, underscoring the importance of immunization programs in controlling and eliminating measles.
From the Research
Treatment for Measles (Rubeola)
The treatment for measles is mainly supportive, focusing on managing symptoms and preventing complications. Key aspects of treatment include:
- Vitamin A supplementation: Studies have shown that vitamin A can reduce morbidity and mortality in measles patients, particularly in areas with high case fatality rates 2, 3.
- Monitoring for and treatment of secondary bacterial infections with antibiotics: This is crucial in preventing further complications, such as pneumonia 4, 5.
- Rehydration in cases of severe diarrhea: This helps to prevent dehydration and electrolyte imbalances 4.
- Supportive therapy, such as rest, hydration, and nutrition: These measures can help to alleviate symptoms and support the body's recovery 6, 4.
Specific Treatment Options
Some studies have investigated the use of specific treatments for measles, including:
- Vitamin A dosage: A study found that 200,000 IU of vitamin A given for 2 days was associated with a reduction in overall mortality and pneumonia-specific mortality in hospitalized children 2.
- Measles vaccine: The vaccine can be used as a treatment option for patients who are pregnant, immunocompromised, or unvaccinated 6.
- Intravenous immunoglobulin: This may be used in certain cases, although its effectiveness is not well established 6.
- Ribavirin: This antiviral medication may be used in some cases, although its use is not widely recommended 6.
Prevention and Control
Prevention through vaccination is a critical aspect of measles control, with a safe and effective vaccine available 4, 5. Public education and vaccination efforts have led to a significant decrease in global measles deaths, highlighting the importance of continued vaccination efforts to eradicate the disease 5.