Treatment algorithm
Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups: see disclaimer
supportive care
There is no specific treatment of measles except for supportive care.
Appropriate antipyretics can be given to relieve fever.[35]Prymula R, Siegrist CA, Chlibek R, et al. Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Lancet. Lancet. 2009 Oct 17;374(9698):1339-50. http://www.ncbi.nlm.nih.gov/pubmed/19837254?tool=bestpractice.com [36]Chen RT, Clark TA, Halperin SA. The yin and yang of paracetamol and paediatric immunisations. Lancet. 2009 Oct 17;374(9698):1305-6. http://www.ncbi.nlm.nih.gov/pubmed/19837236?tool=bestpractice.com
If there is photophobia, the patient may be more comfortable in a dimly lit environment.
Respiratory support in the event of pneumonia and neurologic support in the event of encephalitis should be given.
Primary options
acetaminophen: children: 10-15 mg/kg orally every 4-6 hours when required, maximum 75 mg/kg/day; adults: 325-1000 mg orally every 4-6 hours when required, maximum 4000 mg/day
OR
ibuprofen: 5-10 mg/kg orally every 6-8 hours when required, maximum 40 mg/kg/day; adults: 400-800 mg orally every 6-8 hours when required, maximum 2400 mg/day
vitamin A supplementation
Treatment recommended for SOME patients in selected patient group
Vitamin A is recommended in all serious cases of measles, even in countries where measles is not usually severe. A Cochrane review demonstrated a clinically meaningful association between vitamin A supplementation and decreased morbidity and mortality in children, though a specific association of vitamin A supplementation with reduction of measles morbidity and mortality was not shown.[37]Imdad A, Mayo-Wilson E, Haykal MR, et al. Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age. Cochrane Database Syst Rev. 2022 Mar 16;3(3):CD008524.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008524.pub4/full
http://www.ncbi.nlm.nih.gov/pubmed/35294044?tool=bestpractice.com
Some studies have shown that high doses of vitamin A can decrease morbidity and mortality in children with measles.[2]Measles vaccines: WHO position paper – April 2017. Wkly Epidemiol Rec. 2017 Apr 28;92(17):205-27.
https://www.who.int/publications/i/item/who-wer9217-205-227
http://www.ncbi.nlm.nih.gov/pubmed/28459148?tool=bestpractice.com
[21]Committee on Infectious Diseases, American Academy of Pediatrics. Measles. In: Kimberlin DW, Banerjee R, Barnett ED, et al, eds. Red Book: 2024-2027 Report of the Committee on Infectious Diseases. 33rd ed. Itasca, IL: American Academy of Pediatrics; 2024.
https://publications.aap.org/redbook/book/755/chapter-abstract/14079321/Measles
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What are the effects of vitamin A for treating children with measles?/cca.html?targetUrl=https://cochranelibrary.com/cca/doi/10.1002/cca.105/fullShow me the answer
Consider vitamin A in children who: are up to 2 years of age; are hospitalized with measles; have complications of measles; have immunodeficiency; have clinical evidence of vitamin A deficiency; have impaired intestinal absorption and malnutrition; or have recently emigrated from areas where measles mortality rates are high.[39]Yang HM, Mao M, Wan C. Vitamin A for treating measles in children. Cochrane Database Syst Rev. 2005;(4):CD001479. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001479.pub3/full http://www.ncbi.nlm.nih.gov/pubmed/16235283?tool=bestpractice.com
Primary options
vitamin A (retinol): children <6 months of age: 50,000 units orally once daily for 2 days, repeat in 4 weeks if eye disease present; children 6-11 months of age: 100,000 units orally once daily for 2 days, repeat in 4 weeks if eye disease present; children ≥12 months of age: 200,000 units orally once daily for 2 days, repeat in 4 weeks if eye disease present
Choose a patient group to see our recommendations
Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups. See disclaimer
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