Signs and Symptoms

Measles is associated with the following signs and symptoms:

• Moderate-to-high fever
• Conjunctivitis (red, irritated eyes)
• Cough
• Sore throat, hoarseness
• Runny nose
• Red spots with bluish white centers (called Koplik spots) on the inside of the mouth
• Red, blotchy, itchy rash, which begins on the face and then spreads
• Enlarged lymph nodes
• Rarely (1 in 1,000 cases), extreme drowsiness, seizure, or coma, suggesting involvement of the central nervous system
• Gastrointestinal symptoms, including diarrhea, vomiting, and abdominal pain (these symptoms are less common)

What Causes It?

Measles is caused by a virus (paramyxovirus) that is spread through the air or by contact with infectious droplets from the nose, mouth, or throat. You can contract the disease just by being in the same room as an infected person. Most people get measles because they were never immunized. Once someone has measles, they are immune for life.

Who is Most At Risk?

People with the following conditions or characteristics are at risk for developing measles:

• Weakened immune system caused by a congenital immunodeficiency, the human immunodeficiency virus (HIV), or drugs that suppress the immune system (for example, chemotherapy medicines)
• Infants less than 1 year of age (too young to be immunized)
• Other children and adults who have not been immunized, or who have been insufficiently immunized
• Diminished immunity from vaccination in childhood (occurs rarely but with increasing frequency as adults get older)

What to Expect at Your Provider's Office

Anyone with a fever and unexplained rash should see a health care provider. Your health care provider will do a physical examination, checking for Koplik spots or the rash that usually appears several days after the spots have disappeared. To help confirm the diagnosis, your provider may order a blood test to detect the presence of antibodies against the measles virus.

Treatment Options

Prevention

Vaccination is the key to preventing measles. Since the 1980s, the live, weakened measles vaccine, has been available as the combination vaccine of measles-mumps-rubella (MMR). Health care staff administer the MMR vaccine in two doses, one at age 12 to 15 months, and the second at age 5 to 12 years. Of those who receive the vaccine, more than 95% have lifelong immunity.

Treatment Plan

Rest, drinking plenty of fluids, and treatment to relieve symptoms are adequate if there are no complications.

Drug Therapies

The following medications may be used to manage measles:

• Acetaminophen for high fevers. Children under 16 should not be given aspirin because of the danger of developing Reye syndrome.
• Antibiotics for bacterial complications, such as pneumonia and ear infection
• Immune gamma globulin followed by measles vaccination 5 to 6 months later

Complementary and Alternative Therapies

Following these nutritional tips may help reduce symptoms:

• Avoid refined foods, such as white breads, pastas, and sugar.
• Use healthy oils in cooking, such as olive oil or cocunut oil.
• Reduce or eliminate trans-fatty acids, found in commercially-baked goods such as cookies, crackers, cakes, and donuts. Also avoid French fries, onion rings, processed foods, and margarine.
• Avoid coffee and other stimulants, alcohol, and tobacco.
• Drink 6 to 8 glasses of filtered water daily.

You may address nutritional deficiencies with the following supplements:

• A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-vitamins and trace minerals, such as magnesium, calcium, zinc, and selenium.
• Omega-3 fatty acids, such as fish oil, 1 to 2 capsules or 1 to 2 tbsp. of oil, 1 to 2 times daily, to reduce inflammation and improve immunity. Omega-3 fatty acids can have a blood-thinning effect, and may increase the effect of blood-thinning medications, such as warfarin (Coumadin) and aspirin.
• Probiotic supplement (containing Lactobacillus acidophilus), 5 to 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. Some probiotic supplements need refrigeration. Check the label carefully. Some clinicians avoid giving probiotic supplements to severely immune-deficient patients. If using in children, make sure the supplement is specially formulated for use in children. DO NOT use a product for adults.

Herbs may help strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting treatment. Most herbs are not suitable for prenant or nursing women unless prescribed by a speciliast. You may use herbs as dried extracts (capsules, powders, or teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. You may use tinctures alone or in combination as noted. The herbs listed below are to help support immunity while providing antibacterial and antiviral support. DO NOT give herbs to children unless prescribed by their physician.

• Green tea (Camellia sinensis) standardized extract, 250 to 500 mg daily, for antioxidant, anti-inflammatory, and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb. Green tea may worsen anemia and potentially glaucoma.
• Reishi mushroom (Ganoderma lucidum). High doses of Reishi can have blood pressure-lowering and blood-thinning effects, and may dangerously increase the effect of blood-thinning medications, such as warfarin (Coumadin) and aspirin. Reishi is only suitable for short-term use. DO NOT take reishi for more than one month at a time. If you have any form of liver disease, check with your physician before taking reishi.
• Cat's claw (Uncaria tomentosa), for inflammation and antiviral activity. Cat's claw can interfere with a variety of medications. Speak with your doctor. Cat's claw can have deleterious effects in patients with Leukemia and autoimmune disease.
• Phyllanthus (Phyllanthus amarus) standardized extract, 200 mg, 2 to 4 times daily for antiviral effects. Phyllanthus can interact with lithium and diabetes medications. Phyllanthus may slow blood clotting and therefore can interact with blood-thinning medications, such as warfarin (Coumadin) and aspirin, among others. It may also lower blood sugar so check with your doctor if you have blood sugar abnormalities.

To reduce itching from the rash, use witch hazel (Hamamelis virginia) topically or add oatmeal to a bath.

Few studies have examined the effectiveness of specific homeopathic remedies. A professional homeopath, however, may recommend one or more of the following treatments for measles based on his or her knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type, includes your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

• Aconitum, for symptoms that come on suddenly including fever, conjunctivitis, dry cough, and restlessness. It is best used very early in the course of the disease.
• Apis mellifica, for individuals with swollen lips and eyes and a rash that is not fully developed. Warmth increases itchiness as well as swelling.
• Belladonna, can be used either during early stages of measles or after the rash has erupted. It is useful for those who have difficulty sleeping and symptoms that include fever, headache, and drowsiness.
• Bryonia, for individuals with a delayed rash who have a dry, painful cough, headaches, and muscle pain that worsens with movement and warmth. This remedy is most appropriate for people with a rash primarily on the chest, a dry mouth, and a desire for cold drinks.
• Euphrasia, for nasal discharge, red eyes, and tears associated with measles. This remedy is most appropriate for people who have a strong sensitivity to light.
• Gelsemium, for the early stages of measles when there is a slow onset of fever and chilliness, cough, headache, weakness, and a watery nasal discharge that burns the upper lip. This remedy is most appropriate for people who are apathetic and have little or no thirst.
• Pulsatilla, can be used at any stage of the measles but often used after fever has resolved. This remedy is most appropriate for people who may have thick, yellow nasal discharge, a dry cough at night, a productive cough in the daytime, and mild ear pain. Symptoms are frequently mild.
• Sulphur, for measles in which the skin has a purplish appearance. The individual for whom this remedy is appropriate may have red mucus membranes with a cough and diarrhea that is worse in the mornings.

Prognosis/Possible Complications

Measles is most often an uncomplicated childhood illness. The most common complication of measles in children is acute otitis media, which occurs in 7 to 9% of cases. However, infants and adults, especially those who are malnourished or whose immune system is weak, may develop complications that involve the respiratory system, central nervous system, or digestive system, and may need to be hospitalized. In a small percentage of cases, measles can be fatal.

Measles in a pregnant woman can result in premature birth, miscarriage, stillbirth, or low birth weight babies. Infants of mothers with active measles should receive immune globulin at birth. Pregnant women should not be vaccinated.

Supporting Research

Bhat KPL, Kosmeder JW 2nd, Pezzuto JM. Biological effects of resveratrol. Antioxid Redox Signal. 2001;3(6):1041-64.

Beers MH, Porter RS, et al. The Merck Manual of Diagnosis and Therapy. 18th ed. Whitehouse Station, NJ: Merck Research Laboratories; 2006:1642-1644.

Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea -- a review. J Am Coll Nutr. 2006;25(2):79-99.

fazilli A, Mir AA, Shah, RJ, Bhat IA, Fomda BA, Bhat MA. Effect of second dose of measles vaccine on measles antibody status: a randomized controlled trial. Indian Pediatr. 2013;50(5):473-6.

Ferri: Ferri's Clinical Advisor 2015. Philadelphia, PA: Elsevier Mosby; 2014.

Levin A, Burgess C, Garrison LP, et al. Global eradication of measles: an epidemiologic and economic evaluation. J Infect Dis. 2011; 204(1)S98-106.

Long: Principles and Practice of Pediatric Infectious Diseases. 4th ed. Philadelphia, PA: Elsevier Saunders; 2012.

Measles - United States, 2011. MMWR Morb Mortal Wkly Rep. 2012;61:253-7.

Parker AA, Staggs W, Dayan GH, et al. Implications of a 2005 measles outbreak in Indiana for sustained elimination of measles in the United States. N Engl J Med. 2006 Aug 3;355(5):447-55.

Rotsein OD. Oxidants and antioxidant therapy. Crit Care Clin. 2001;17(1):239-47. Shi J, Yu J, Pohorly JE, Kakuda Y. Polyphenolics in grape seeds-biochemistry and functionality. J MedFood. 2003;6(4):291-9.

Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.

Williams JE. Review of antiviral and immunomodulating properties of plants of the Peruvian rainforest with a particular emphasis on Una de Gato and Sangre de Grado. Altern Med Rev. 2001;6(6):567-79.