Recent headlines will spur questions about managing measles.
Stay alert for symptoms including fever...cough...runny nose...red, itchy eyes...and a delayed maculopapular rash that starts on the face.
If you suspect a patient may have measles, give them a mask...get them into a private area...and notify the local health department ASAP.
What’s the role of vitamin A or cod liver oil? Explain that most evidence for vitamin A and measles is from resource-limited countries...where vitamin A deficiency from severe malnutrition is more common.
Advise against using vitamin A or cod liver oil, which is high in vitamin A, to PREVENT measles. Warn that improper dosing or prolonged use of vitamin A can lead to toxicity...vomiting, eye or liver damage, etc.
But vitamin A may decrease complications in children for measles TREATMENT, along with supportive care, under the care of their prescriber.
Vitamin A is given once daily for 2 days, and the dose varies by age. It’s 50,000 IU for infants under 6 months, 100,000 IU for infants 6 through 11 months, and 200,000 IU for children 12 months or older.
Who should get post-exposure prophylaxis? Giving NONimmune contacts an MMR vaccine within 72 hours of initial exposure OR immune globulin within 6 days of exposure may help prevent measles or limit severity.
But don’t give live MMR vaccine to severely immunocompromised or pregnant patients...or kids under 6 months. Instead, recommend immune globulin within 6 days of exposure...and vaccinate household contacts.
How can you prevent measles? Vaccinate. About 97% of people develop lifelong immunity after 2 doses of a measles vaccine.
Continue to give 2 doses of MMR or MMRV to kids...at 12 to 15 months, then again at 18 months or later, up until school entry. But the second MMR dose can be given 4 weeks after the first, especially in outbreak areas or if travelling.
And MMR can be given to infants as young as 6 months if they’re at higher risk of exposure during an outbreak or travel. But infants who get MMR before age 1 year still need 2 MORE doses per the usual schedule.
Ensure adults have had at least 1 dose of MMR if born in 1970 or later. Or give 2 doses at least 4 weeks apart for higher-risk adults, such as postsecondary students, healthcare workers, military, etc.
Watch for patients who were born before 1970 and travelling outside of Canada. If they don’t have a record of getting at least one dose of MMR or confirmed immunity by a lab test, vaccinate with one dose.
Use our resource, Vaccine Adherence: Addressing Myths and Hesitancy, to support your discussions about autism, fears, etc.
- Health Canada. Measles vaccines: Canadian Immunization Guide. https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-12-measles-vaccine.html#vsp (Accessed March 12, 2025).
- American Academy of Pediatrics. Measles Resources. March 7, 2025. https://publications.aap.org/redbook/resources/31510 (Accessed March 10, 2025).
- TRC Healthcare. Vitamin A. [Natural Medicines website]. March 21, 2025. Available at: https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=964 (Accessed March 25, 2025).