Acute Measles Case Management
Measles treatment is supportive because no FDA-approved antiviral therapy exists for measles. [1]
Management should focus on symptom relief, rapid treatment of complications, vitamin A supplementation for indicated patients, and airborne isolation to prevent transmission. [1]
Supportive Care
Medical care is generally supportive and is directed at relieving symptoms. [1]
Fluid status should be assessed and supportive therapy should be provided, with prompt management of dehydration risk when present. [1]
Fever and discomfort should be treated with standard supportive measures under clinician supervision. [1]
Vitamin A Supplementation
Vitamin A does not prevent measles and is not a substitute for vaccination. [1]
Vitamin A may be administered to infants and children in the United States with measles under clinician supervision as part of supportive management. [1]
Children with severe measles, including hospitalized patients, should be managed with vitamin A. [1]
Vitamin A should be administered immediately upon diagnosis and repeated the next day for a total of 2 doses under clinician supervision. [1]
Recommended age-specific total daily doses are: [1]
- 50,000 IU for infants younger than 6 months of age. [1]
- 100,000 IU for infants 6–11 months of age. [1]
- 200,000 IU for children 12 months of age and older. [1]
Overuse of vitamin A can lead to toxicity. [1]
Pregnant women should avoid high levels of vitamin A because of teratogenic risk. [1]
Complication Recognition and Treatment
Secondary bacterial infections and pneumonia are common complications and should be promptly managed under clinician supervision. [1]
There is no evidence to support routine antibiotic use for measles treatment. [1]
Antibiotic therapy should be used only when secondary bacterial infection is suspected or confirmed based on clinical assessment. [1]
Antiviral Therapy Use
Ribavirin has no FDA approval for the treatment of measles. [1]
Clinical data are lacking regarding ribavirin efficacy for measles. [1]
Use of ribavirin has been reported for severe measles in select settings, including severely immunocompromised patients, but it is not recommended as routine therapy. [1]
Infection Prevention and Control
Patients who develop a rash should be isolated for 4 days after rash onset. [1]
Airborne precautions should be used in healthcare settings. [1]
The preferred setting for airborne precautions is a single-patient airborne infection isolation room. [1]
All healthcare staff entering the room should use respiratory protection consistent with airborne infection control precautions, including N95 respirators or respirators with similar effectiveness. [1]
Post-Exposure Prophylaxis for Contacts
Persons exposed to measles who do not have adequate presumptive evidence of immunity should be offered post-exposure prophylaxis (PEP). [2]
PEP options include measles-mumps-rubella (MMR) vaccine administered within 72 hours of initial exposure or immunoglobulin (IG) administered within 6 days of exposure. [2]
MMR vaccine and IG should not be administered simultaneously because this practice invalidates the vaccine. [2]
The recommended intramuscular IG dose is 0.5 mL/kg regardless of the contact’s immune status. [2]
Outbreak-Level Measures
During measles outbreaks, clinical case management and infection prevention and control measures should be implemented to reduce measles morbidity and mortality. [3]
Outbreak guidance emphasizes practical interventions for suspected and confirmed measles cases across care settings. [3]