Medication Summary
Medications used in the treatment or prevention of measles include vitamin A, antivirals (eg, ribavirin), measles virus vaccine, and human immunoglobulin (Ig).
Vitamins
Class Summary
Vitamin A treatment for children with measles in developing countries has been associated with a marked reduction in morbidity and mortality. The World Health Organization (WHO) recommends vitamin A administration to all children with acute measles, regardless of their country of residence.
Of note, low serum concentrations of vitamin A are found in children with severe measles in the United States. Thus, two doses of vitamin A given 24 hours apart are recommended. A third age-specific dose should be given 2 to 4 weeks later to children with clinical signs and symptoms of vitamin A deficiency.
Vitamin A (Aquasol A, A-25, Gordons-Vite A)
Vitamin A is a fat-soluble vitamin needed for growth of skin, bones, and male and female reproductive organs.
Antivirals
Class Summary
Measles virus is susceptible to ribavirin in vitro. Although ribavirin (either IV or aerosolized) has been used to treat severely affected and immunocompromised adults with acute measles or SSPE (IV plus intrathecal high-dose interferon alfa), no controlled trials have been conducted; ribavirin is not approved by the US Food and Drug Administration (FDA) for this indication, and such use should be considered experimental.
Ribavirin (Virazole, Rebetol, Ribasphere, Copegus)
Ribavirin, a guanosine analogue, is for experimental use only. Its mechanism of action is not fully defined but relates to alteration of cellular nucleotide pools and of viral messenger RNA information.
Vaccines
Class Summary
In the United States, measles virus vaccine is usually given along with attenuated rubella and mumps viruses as the measles-mumps-rubella (MMR) vaccine. The following measles vaccines are available in the United States:
- Live measles mumps, and rubella virus vaccine (M-M-R II)
- Live measles, mumps, rubella, and varicella virus vaccine (ProQuad)
Measles mumps and rubella vaccine, live (M-M-R II)
The live MMR vaccine is used to induce active immunity against viruses that cause measles, mumps, and rubella.
Measles, mumps, rubella, and varicella virus vaccine (ProQuad)
This is a live vaccine that induces active immunity against viruses that cause measles, mumps, rubella, and varicella.
Immunoglobulins
Class Summary
Human Ig prevents or modifies measles in susceptible individuals if administered within 6 days of exposure.
Immune globulin IM (IGIM) GamaSTAN, Gammaked, Hizentra, Gamunex-C)
Immune globulin IM (IGIM) is a transient source of IgG. It is indicated for all susceptible contacts of patients with measles who reside in the same household who are pregnant, immunocompromised, or aged 6-12 months; it is also indicated for infants younger than 6 months who were born to mothers without measles immunity and also all children and adolescents with HIV infection who are exposed to measles, regardless of measles immunization status, unless they have received IV Ig (400 mg/kg as part of routine immunoprophylaxis) within 3 weeks of exposure.
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Koplik spots in measles. Photograph courtesy of World Health Organization.
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Enanthem of measles (Koplik spots).
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Measles conjunctivitis.
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Face of boy with measles.
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Morbilliform rash.
