From the Guidelines
Measles treatment primarily focuses on supportive care, including rest, adequate fluid intake, and fever management, as there is no specific antiviral therapy for the virus itself. The treatment approach should prioritize reducing morbidity, mortality, and improving quality of life. According to the available evidence, children with measles complications should be administered standard treatment, such as oral rehydration therapy (ORT) for diarrhea and antibiotics for acute lower respiratory infection (ALRI) 1. However, it is essential to note that antibiotics are not routinely needed unless bacterial complications like pneumonia or ear infections develop.
Key components of measles treatment include:
- Rest and adequate fluid intake to prevent dehydration
- Fever management with acetaminophen (10-15 mg/kg every 4-6 hours) or ibuprofen (5-10 mg/kg every 6-8 hours)
- Vitamin A supplementation to reduce mortality and complication risks, with dosing of 200,000 IU for children over 12 months, 100,000 IU for 6-12 months, and 50,000 IU for under 6 months, given once daily for two days
- Isolation for four days after rash onset to prevent transmission
- Hospitalization for severe cases requiring IV fluids, respiratory support, or treatment of complications
Prevention through vaccination remains the most effective approach to managing measles, as the virus is highly contagious and can cause serious complications, particularly in young children and immunocompromised individuals. While the provided study 1 focuses on recommendations for public health issues in famine-affected, refugee, and displaced populations, its findings on standard treatment for measles complications are relevant to the general treatment approach.
From the Research
Treatment for Measles (Rubeola)
The treatment for measles (Rubeola) involves several approaches, including:
- Vitamin A therapy: The World Health Organization (WHO) recommends administration of an oral dose of vitamin A (200,000 international units (IU), or 100,000 IU in infants) each day for two days to children with measles when they live in areas where vitamin A deficiency may be present 2, 3.
- Supportive care: Management involves best supportive care, correction of dehydration and nutritional deficiencies, treatment of secondary bacterial infections 4.
- Antiviral compounds: Research is being conducted to identify antiviral compounds that can inhibit measles virus dissemination in vitro, which may contribute to intervention strategies to limit the impact of future outbreaks 5.
Vitamin A Therapy
Vitamin A therapy has been shown to be effective in reducing mortality and pneumonia-specific mortality in children with measles, particularly when given in two doses 2, 3, 6. The evidence suggests that:
- Two doses of vitamin A (200,000 IU) on consecutive days can reduce the risk of mortality in children under the age of two years 2, 3.
- Two doses of vitamin A can also reduce the risk of pneumonia-specific mortality in children under the age of two years 2, 3.
- There is no significant reduction in mortality when vitamin A is given in a single dose 2, 3, 6.
Prevention
Prevention through measles vaccination has a cardinal role in eliminating measles, and public education and vaccination have led to an estimated 79% decrease in global measles deaths from 2000 to 2015 4. The effectiveness of measles vaccination and vitamin A treatment has been demonstrated in several studies, with vaccination being 85% effective in preventing measles disease 6.