Treatment Approach for Measles

Supportive Care and Vitamin A Supplementation

• The Centers for Disease Control and Prevention recommends vitamin A supplementation for all children with clinical measles, with 200,000 IU orally on day 1 for children ≥12 months and 100,000 IU orally on day 1 for children <12 months 1
• For children with complicated measles, a second dose of vitamin A should be administered on day 2, with the same dosage as day 1 1

Management of Complications

• The Centers for Disease Control and Prevention recommends treating secondary bacterial infections with appropriate antibiotics 1
• For diarrhea, oral rehydration therapy is recommended 1
• For acute lower respiratory infections, standard antibiotic treatment is recommended 1
• Monitoring nutritional status and enrolling in a feeding program if indicated is also recommended 1

Post-Exposure Prophylaxis

• For persons with contraindications to measles vaccination requiring immediate protection, the Centers for Disease Control and Prevention recommends administering immune globulin (IG) 0.25 mL/kg body weight (maximum 15 mL) as soon as possible after exposure 3
• For immunocompromised persons, 0.5 mL/kg body weight (maximum 15 mL) of IG is recommended 3
• Measles vaccine may provide protection if administered within 3 days of exposure 1

Diagnostic Confirmation

• The Centers for Disease Control and Prevention recommends collecting serum for measles IgM antibody testing during the first clinical encounter 5
• If IgM testing is negative within the first 72 hours of rash onset, obtaining another specimen at least 72 hours after rash onset is recommended 5
• Consider molecular characterization of measles virus from urine or nasopharyngeal specimens 6

Common Pitfalls and Caveats

• Vitamin A deficiency increases the severity and mortality of measles; supplementation is critical, as recommended by the Centers for Disease Control and Prevention 1
• Undernutrition is not a contraindication for measles vaccination; it should be considered a strong indication for vaccination, according to the Centers for Disease Control and Prevention 1