What are the symptoms and treatment options for measles (rubeola)?

From the Guidelines

Vaccination with the MMR vaccine, such as PRIORIX, is the most effective method to prevent measles and its complications, and it is recommended to be given in two doses: the first at 12-15 months and the second at 4-6 years of age. Measles is a highly contagious viral infection characterized by a distinctive red rash, fever, cough, runny nose, and red, watery eyes. According to the most recent study 1, the Advisory Committee on Immunization Practices (ACIP) recommends the use of PRIORIX as an option to prevent measles, mumps, and rubella, and it is considered safe, immunogenic, and noninferior to M-M-R II.

The disease can be severe and is most frequently complicated by diarrhea, middle ear infection, or bronchopneumonia, with encephalitis occurring in approximately one of every 1,000 reported cases, and death occurring in 1-2 of every 1,000 reported measles cases in the United States 1. Treatment is primarily supportive, including rest, fluids, acetaminophen or ibuprofen for fever (avoiding aspirin in children), and vitamin A supplementation in severe cases or areas with deficiency, with children with complicated measles receiving a second dose of vitamin A on day 2 1.

Key points to consider in the management and prevention of measles include:

• Vaccination with the MMR vaccine, such as PRIORIX, is the most effective method to prevent measles and its complications
• The vaccine is typically given in two doses: the first at 12-15 months and the second at 4-6 years of age
• If exposed to measles, unvaccinated individuals should receive the vaccine within 72 hours or immune globulin within 6 days to prevent or reduce symptom severity
• Treatment is primarily supportive, including rest, fluids, and vitamin A supplementation in severe cases or areas with deficiency
• Measles can lead to serious complications like pneumonia, encephalitis, and even death, particularly in young children, pregnant women, and immunocompromised individuals.

From the Research

Definition and Symptoms of Measles

• Measles is a highly contagious, potentially fatal, but vaccine-preventable disease caused by measles virus 2.
• Symptoms include fever, maculopapular rash, and at least one of cough, coryza, or conjunctivitis, although vaccinated individuals can have milder or even no symptoms 2.
• Measles virus is transmitted by the respiratory route and illness begins with fever, cough, coryza, and conjunctivitis followed by a characteristic rash 3.

Complications and Management

• Complications can affect many organs and often include otitis media, laryngotracheobronchitis, pneumonia, stomatitis, and diarrhoea 2.
• Neurological complications are uncommon but serious, and can occur during or soon after the acute disease or months or even years later 2.
• Patient management mainly involves supportive therapy, such as vitamin A supplementation, monitoring for and treatment of secondary bacterial infections with antibiotics, and rehydration in the case of severe diarrhoea 2.
• There is no specific antiviral therapy for the treatment of measles, and disease control largely depends on prevention 2.

Prevention and Vaccination

• Measles is best prevented through vaccination, and the major reductions in measles incidence and mortality have renewed interest in regional elimination and global eradication 3.
• Vaccination against measles is effective, cost-effective, and safe 4.
• There is no link between the measles vaccination and autism 4.
• Measles can be eliminated from a population; this outcome requires coverage with 2 doses of vaccine at rates of 93% to 95% of the population 4.

Global Impact and Public Health Issues

• Measles remains a considerable cause of childhood mortality worldwide, with estimates that >100,000 fatal cases occur each year 5.
• Case fatality ratio estimates vary from <0.01% in industrialized countries to >5% in developing countries 5.
• All six WHO regions have set goals to eliminate endemic transmission of MeV by achieving and maintaining high levels of vaccination coverage accompanied by a sensitive surveillance system 5.
• Disrupted vaccination activities during the pandemic increase the potential for another resurgence of measles in the near future, and effective, timely catch-up vaccination campaigns, strong commitment and leadership, and sufficient resources will be required to mitigate this threat 2.