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Measles - Treatment and Prevention

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The treatment of measles includes various measures apart from medicine. To know more about the treatment approach for measles, read this article below.

Medically reviewed by

Dr. Shubadeep Debabrata Sinha

Published At January 20, 2023
Reviewed AtMay 26, 2023

Introduction:

Measles is a deadly disease. Everyone is aware of this well-known viral infection. The causative microorganism of measles is the Rubeola virus. This virus belongs to the Morbillivirus genus, which is part of the Paramyxovirus family. Measles virus and other paramyxoviruses, including mumps virus, respiratory syncytial virus (RSV), human parainfluenza viruses, zoonotic Hendra, and Nipah viruses, are considered major pathogens and can bring serious infections in both humans and animals. Measles is an air-born (spread through air) disease. It is transmitted by respiratory secretions from infected individuals, either through larger respiratory droplets spread from person to person or through aerosols spread into the air.

What Are the Treatment Options for Measles?

Treatment of measles aims entirely at providing relief from the symptoms. There is no specific medicine for the treatment of this serious disease. Measles treatment consists primarily of supportive care, such as maintaining enough hydration and replacing fluids lost due to diarrhea or vomiting. In cases of extreme dehydration, intravenous (IV) rehydration may be required.

Vitamin A supplementation should be considered, especially in youngsters and people with clinical symptoms of vitamin A insufficiency. In unvaccinated individuals, postexposure prophylaxis should be performed.The treatment options for measles are discussed below.

1. Supportive Care: In most cases, patients with measles only need supportive treatment. Hospitalization may be necessary for the treatment of measles complications, e.g., bacterial superinfection, pneumonia, dehydration, and croup (a disease that causes inflammation of airways and causes breathing difficulties).

Antibiotics should be used to treat secondary infections, such as otitis media (ear infection) or bacterial pneumonia. Patients with severe complicating infections, such as encephalomyelitis (inflammation of the brain and spinal cord), should be hospitalized for observation and antibiotic treatment as necessary for their clinical condition.

On rare occasions, patients who are noticeably feverish and who have become dehydrated need intravenous rehydration. Fever should be treated with normal fever reducers. Healthcare professionals who are susceptible should take five to 21 days off from work after exposure. During the period of spread of diseases, that is, airborne precautions are advised for hospitalized children. The contagious period includes the time period in healthy children, three to five days prior to the onset of a rash to four days after the rash appears, and during the duration of the illness in immunocompromised patients.

2. Antiviral Therapy: Unfortunately, no antiviral drug has been approved by FDA (food and drug administration) for treating measles. No medicines can destroy the virus.

3. Supplements of Vitamin A: Supplemental vitamin A has been linked to a 50 percent decrease in morbidity and mortality and may help avoid complications like vision impairment and eye damage. WHO (world health organization) advises that all children with measles should receive vitamin A supplementation based on their age, regardless of where they reside, because vitamin A insufficiency is linked to severe measles. The recommended doses by WHO are as follows:

  • For Babies Under Six Months of Age: The recommended dose is 50,000 IU (international unit) twice a day orally.

  • For Children Aged Six to Eleven Months: 100,000 IU twice a day by mouth.

  • For Children Over the Age of One Year: 200,000 IU per day orally, divided into two doses.

  • Children Who Exhibit Clinical Symptoms of Vitamin Insufficiency: Children are first given the appropriate two dosages and then treated with the third dosage according to their age two to four weeks later.

4. Vaccines: In the United States, the measles virus vaccination is typically administered in conjunction with attenuated rubella and mumps viruses as part of the measles-mumps-rubella (MMR) vaccine. The available vaccine in the United States includes the following:

  • Vaccination against the live measles, mumps, and rubella virus (MMR II).

  • Vaccination against the live measles, mumps, rubella, and varicella virus. (ProQuad)

As mentioned above, the preferred vaccination schedule for the vaccines is discussed below.

  • First Dose: 0.5 milliliter SC (subcutaneous), starting at 12 months (ideally 15 months).

  • Second Dosage: 0.5 milliliters at age four to six years; may be given earlier if at least 28 days have passed since the previous dose.

  • Catch-up Doses: if not previously immunized before the age of six, administer two doses of 0.5 milliliter SC, separated by at least four weeks.

However, safety and efficacy have not been proven in six-month-old infants.

5. Prevention After Exposure: Administering the MMR vaccine within 72 hours of exposure to measles-naive individuals can prevent or attenuate the disease. To prevent or modify measles in susceptible household contacts, immune globulin with a dose of 0.25 ml/kg, or 0.5 ml/kg for HIV (human immunodeficiency virus) patients, not to exceed 15 ml can be given IM (intramuscular) within six days of exposure.

How Can Measles Be Prevented?

Prevention is better than cure. In the case of measles, this saying is absolutely true. As there is no specific treatment for measles, it is better for individuals to prevent themselves from this serious infection. Recently in some countries, a measles outbreak was seen. On the other hand, some countries reported an increase in the number of annual cases of measles. The recommended guidelines for prevention are discussed below.

  • An adequate measles vaccination effectively removes measles susceptibility and gives long-lasting protection. Other preventative strategies include vitamin A and human immunoglobulin (Ig).

  • In the United States, it is recommended that the vaccination of children who travel or live abroad should start earlier than that of children in the United States.

  • In addition to standard precautions, airborne precautions are recommended for hospitalized children during the period of communicability three to five days before the rash appears to four days after the rash develops in healthy children and for the duration of illness in immunocompromised people.

  • If there is a case of measles, all children and staff who have been exposed and do not have confirmation of immunity should be asked to refrain from coming to school from the fifth to the 21st day after exposure; similarly, susceptible healthcare employees should be asked to refrain from the workplace for the same period.

  • The best strategy to stop outbreaks or reduce them if they do happen is to maintain two-dose coverage with the MMR vaccine.

Conclusion:

Measles is a highly contagious disease. Although it affects individuals of any age, children are more susceptible to this illness. It can lead to several complications like pneumonia, seizures, brain damage, and even death. The best way to prevent measles is by getting timely vaccination, exercising, and eating a healthy and balanced diet.

Frequently Asked Questions

1.

What Is the Name of the Measles Vaccine?

The M-M-R II (Measles, Mumps, and Rubella Virus combination Live) and PRIORIX vaccines are the two MMR (measles, mumps, and rubella combination vaccination) vaccines available in the United States. M-M-R II and PRIORIX are interchangeable for all conditions for which the MMR vaccination is recommended. The "Jeryl Lynn" strain of the mumps virus, comprised of the JL1 and JL2 viral lineages, is present in the MMR II vaccine. The only JL1-containing RIT4385 strain is present in PRIORIX. Children can also receive the MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox).

2.

Which Strategy Does Public Health Employ to Reduce Measles Incidence?

Key public health measures to lower measles mortality worldwide include routine childhood vaccination against the disease and massive immunization drives in nations with high case and death rates. Since around 60 years ago, there has been a measles vaccine available. A two-dose measles vaccination regimen is typical. Some other strategies include keep-up, defined as routine services aiming at vaccinating more than 90% of each subsequent birth cohort. In contrast, catch-up is described as a one-time vaccination program targeting all children aged nine months to 14 years, regardless of prior measles exposure or vaccination status.

3.

How Long Did the Measles Vaccine Development Take To Develop?

A typical vaccine development takes 5 to 10 years, and occasionally more, to complete the regulatory approval procedures, manufacture enough vaccine doses for widespread distribution, and determine if the vaccine is safe and effective in clinical trials. However, the first MMR was successfully developed in just two years. It took four years to be market-ready owing to much of the foundational work already done during World War II.

4.

What Organism Causes Measles?

Measles is caused by a single-stranded, enveloped RNA virus with one serotype. It is classified as a Morbillivirus, a genus of the Paramyxoviridae family. Only humans are normally infected by the measles virus.

5.

What Does a Measles Infection Look Like?

Flat red patches start at the hairline of the face and go down to the neck, torso, arms, legs, and feet. There would be a few little raised bumps above the flat red dots. As the spots expand from the head to the rest of the body, they can converge. Additional symptoms include high temperature (may reach more than 104°F), rash (3-5 days after symptoms start), cough, runny nose (coryza), red, watery eyes (conjunctivitis), and cough.

6.

How Many Times Can a Person Get Measles?

Once a person has had measles, their body develops immunity to the virus, making it extremely unlikely to have it again. This is referred to as active immunity. However, measles can cause significant, even fatal, consequences in certain individuals.

7.

How Does a Measles Rash Appear?

It often appears blotchy and red but is not irritating. Typically, a measles rash develops on the head before moving down the body. Normally, it lasts 4 to 7 days. The rash from measles features crimson, barely raised patches that are sometimes blotchy but not irritating. The rash typically appears 14 days (between 7 and 18 days) after exposure to the virus.

8.

What Is Common Between “Having the Measles” and “Having the Vaccine”?

An active immunity. There are two ways that one might get measles immunity. Natural immunity is when people who have had measles at some point in their lives will be immune to it going forward and won't get it again. Immunity based on vaccines includes two doses of the measles vaccination, which confers long-term protection on 97 out of 100 recipients.

9.

How Long Does a Measles Vaccination Be Effective?

As a stable virus that cannot multiply, measles is an example, and researchers may anticipate that protection would remain for a very long period. According to the U.S. immunization schedule, recipients of the MMR vaccine are often thought to be permanently immune to measles and rubella. Children should receive two doses of the MMR vaccine, the first between the ages of 12 and 15 months and the second between the ages of 4 and 6. Both adults and adolescents should have had their MMR immunizations.

10.

What Kind of Vaccination Is the Measles Vaccination?

It is a live viral vaccination that has been attenuated (weakened). Live vaccinations use a disease-causing bacterium or virus that is weakened (or attenuated). These vaccines produce a potent and robust immune response because they closely resemble the natural illnesses they help avoid.

11.

Which Animal Did the Measles Originate From?

There is no evidence that measles originated in or affects animals; it is a human disease.

12.

When Is the Measles Vaccination Given to Infants?

All children are advised to have the MMR (measles, mumps, and rubella) vaccine twice, first between the ages of 12 and 15 months and the second time between the ages of 4 and 6 years, or as long as at least 28 days since the first dose.

13.

What Kind of Infection Is Measles?

Measles is a severe respiratory viral disease. Cough, coryza, conjunctivitis, and fever (up to 105°F) precede the Koplik spots, followed by a maculopapular rash. In most cases, the rash develops 14 days after exposure.
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Dr. Shubadeep Debabrata Sinha
Dr. Shubadeep Debabrata Sinha

Infectious Diseases

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