Prevention and treatment of measles
- Jorge L Barinaga, MD, MS
Jorge L Barinaga, MD, MS
- Assistant Professor of Medicine
- Tufts University School of Medicine
- Paul R Skolnik, MD, FACP, FIDSA
Paul R Skolnik, MD, FACP, FIDSA
- Professor of Medicine
- University of Connecticut School of Medicine
Measles is a highly contagious viral infection . Mathematical models have estimated that the average number of secondary infections that follow a single introduction of measles into a susceptible population ranges from 12 to 18 . Infection with measles is highly preventable.
Control measures for the prevention and spread of measles and treatment modalities for the virus will be reviewed here. The epidemiology, aims for global eradication, clinical manifestations, and diagnosis are discussed separately. (See "Epidemiology and transmission of measles" and "Clinical manifestations and diagnosis of measles".)
PREVENTION OF MEASLES
Vaccination — Measles vaccination has markedly reduced the incidence of measles throughout the developed world. However, measles cases still occur in low-incidence countries via importation by travelers. Therefore, maintenance of herd immunity is important even in countries with a low incidence of measles, since a single imported case can result in large measles outbreaks in the setting of waning immunity. (See "Epidemiology and transmission of measles".)
Measles vaccine is recommended for all children and for certain high-risk adolescents and adults. Factors to be considered when determining the need for measles vaccination include the age of the recipient, the date of administration of the first dose of vaccine (if any), and local measles epidemiology, including the potential risk of exposure, the type of measles vaccine administered previously, contraindications to vaccination, travel plans, and evidence of prior measles infection. (See "Measles-mumps-rubella vaccination in high risk adults".)
The importance of maintenance of immunity was underscored by a United States Centers for Disease Control and Prevention (CDC) analysis of United States measles cases reported in 2011, which found that the majority of cases could have been prevented by vaccination; 89 percent of 118 measles cases occurred in unvaccinated individuals . Immunization is also important for preventing severe sequelae of measles infection, including subacute sclerosing panencephalitis . (See "Clinical manifestations and diagnosis of measles".)
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- PREVENTION OF MEASLES
- - Types of vaccines
- - Vaccine effectiveness
- - General approach
- Approach in high-risk areas
- - Timing
- - Contraindications
- - Precautions
- - Adverse events
- - Lack of association with autism
- Evidence of measles immunity
- - Documentation of vaccination
- - Laboratory evidence of immunity
- - Laboratory confirmation of disease
- - Birth before 1957
- Controlling spread
- - Postexposure prophylaxis
- Immune globulin
- - Infants aged <12 months
- - Pregnant women without evidence of immunity
- - Immunocompromised patients
- - Outbreak control measures
- Case definitions
- Healthcare facilities
- - Healthcare personnel
- - Infection control
- TREATMENT OF MEASLES
- Vitamin A
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS