What is the treatment for measles infection?

Treatment for Measles Infection

The treatment of measles primarily consists of supportive care, vitamin A supplementation, management of complications, and isolation measures to prevent transmission. 1

Core Management Strategies

Vitamin A Supplementation

• Administer vitamin A immediately with the following dosing regimen 1:
  • Children >12 months: 200,000 IU orally on days 1 and 2
  • Children <12 months: 100,000 IU orally on days 1 and 2
  • This intervention reduces the risk of complications and mortality

Supportive Care

• Manage fever with antipyretics
• Provide adequate hydration:
  • Oral rehydration therapy for moderate to severe dehydration due to diarrhea 1
  • IV fluids if necessary for severe dehydration
• Nutritional support and monitoring 1
• Rest and symptomatic relief for cough, coryza, and conjunctivitis

Management of Complications

• Antibiotics should be administered for secondary bacterial infections such as pneumonia and acute lower respiratory infections 1
• Common complications requiring treatment include:
  • Otitis media
  • Pneumonia
  • Laryngotracheobronchitis
  • Stomatitis
  • Diarrhea 2

Special Populations Management

Immunocompromised Patients

• Severely immunocompromised patients exposed to measles should receive immune globulin (IG) prophylaxis regardless of vaccination status 3
• For patients receiving intravenous immune globulin (IGIV) therapy:
  • Standard dose of 100-400 mg/kg should be sufficient to prevent measles infection after exposures occurring within 3 weeks after administration of IGIV
  • For exposures >3 weeks after receiving standard IGIV dose, an additional dose should be considered 3

Post-Exposure Prophylaxis

• For non-immunocompromised individuals:
  • MMR vaccine if administered within 72 hours of initial measles exposure 3, 1
  • Immune globulin (IG) within 6 days of exposure for those who cannot receive the vaccine 1

Infection Control Measures

• Isolate the patient for at least 4 days after rash onset 1
• Place in an airborne infection isolation room 1
• Healthcare personnel should use N95 respirators or equivalent 1, 4
• Immediate notification to public health authorities 1

Clinical Pearls and Pitfalls

Important Considerations

• Measles is highly contagious with one infected person potentially infecting 9-18 susceptible individuals 1
• The contagious period lasts from 4 days before to 4 days after the appearance of the rash 1
• Neurological complications are uncommon but serious and can occur during or after the acute disease 2

Common Pitfalls to Avoid

1. Delayed vitamin A administration: Vitamin A should be given immediately upon diagnosis, not delayed 1
2. Failure to recognize complications: Monitor closely for pneumonia, which accounts for most measles-associated mortality 5
3. Inadequate isolation: Failure to implement proper isolation measures can lead to nosocomial spread 4
4. Missing the diagnosis: Consider measles in patients with fever, rash, and at least one of the "3 C's" (cough, coryza, conjunctivitis) 1

Monitoring

• Assess for complications affecting multiple organ systems
• Monitor respiratory status closely
• Follow nutritional status, especially in children
• Evaluate for neurological complications which may develop during or after the acute illness 2

There is currently no specific antiviral therapy approved for the treatment of measles, highlighting the importance of prevention through vaccination 2.