Treatment of Measles in Adults

Immediate Infection Control Measures

The Centers for Disease Control and Prevention recommends isolating the patient immediately in an airborne infection isolation room for at least 4 days after rash onset, as patients remain contagious from 4 days before through 4 days after rash appearance 1, 2
All healthcare workers must wear N95 respirators when entering the room, regardless of immunity status 1, 2
Only staff with documented immunity should provide direct care 1
Immunocompromised patients may shed virus for prolonged periods and require extended isolation 3

The World Health Organization recommends all adults with clinical measles receive 200,000 IU of vitamin A orally as the standard dose 1
The standard dosing is 200,000 IU orally on days 1 and 2 for complicated measles 1, 3
A third dose of 200,000 IU should be administered at 1-4 weeks after initial doses if any eye symptoms of vitamin A deficiency are present 1, 3

The American Academy of Family Physicians recommends monitoring and correcting dehydration with oral rehydration therapy 1
The Centers for Disease Control and Prevention suggests assessing nutritional status and enrolling in feeding programs if indicated 1, 3
Antipyretics should be provided for fever, avoiding aspirin in younger adults due to Reye syndrome risk 3
Antibiotics should be administered for acute lower respiratory infection and other bacterial complications 1
Secondary bacterial infections are common and require prompt antibiotic therapy 3

Pregnant women cannot receive measles vaccine and face increased risks of spontaneous abortion, premature labor, and low birth weight 2, 4, 5
Pregnant women should have received immune globulin within 6 days of exposure if susceptible 1, 2
Immunocompromised patients should have received IG if exposed, regardless of vaccination status 1, 2
Up to 9.3% of healthcare workers born before 1957 may be susceptible despite presumed immunity 2, 4, 5

The Centers for Disease Control and Prevention recommends administering MMR vaccine within 72 hours of exposure to susceptible adults for maximum protection 2
If vaccination is contraindicated or >72 hours have passed, IG should be given within 6 days of exposure 2

Do not use standard droplet precautions or surgical masks—measles requires airborne precautions with N95 respirators 2
Do not forget vitamin A supplementation, which is often overlooked but critical for reducing mortality 1, 3
Do not assume the patient is "out of the woods" at 10 days—encephalitis characteristically presents around this time and requires vigilant monitoring 3
Do not assume adults born before 1957 are immune, particularly healthcare workers, as up to 9.3% may be susceptible 2
Do not use aspirin for fever control in younger adults due to Reye syndrome risk 3

Monitor for subacute sclerosing panencephalitis, which occurs in 4-11 per 100,000 measles-infected individuals 3
Ensure all susceptible contacts received MMR vaccine within 72 hours of exposure or IG within 6 days 3
Contacts who received IG should receive measles vaccine 3 months later 3