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MEASLESVisit The Healthy Living Bookshelf:
Measles is a potentially serious, highly contagious infection caused by the measles virus. Infection is easily transmitted by kissing, or being coughed or sneezed upon by an infected person. The recent introduction of an effective vaccine against measles has greatly reduced the number of cases in many countries, though some developing nations continue to experience serious measles epidemics in children. Checklist for Measles
What are the symptoms of measles? Symptoms of measles begin with a runny nose, cough, muscle aches, fatigue, and a slight fever, often accompanied by redness of the eyes and sensitivity to light. Later, the fever rises and a mildly itchy red rash develops on the face and spreads to the lower body. In severe cases, there may be high fever, convulsions, pneumonia, or severe diarrhea, and some severe cases can result in death. How is it treated? People with measles are commonly advised to rest, drink plenty of fluids, and take vitamin A. Doctors may also recommend limiting contact with non-immunized people to prevent transmission of the disease. Antibiotics may also be recommended in some people to prevent or treat a bacterial infection. Aspirin-containing products are not given to children who have a fever and are under the age of 19, since their use in these circumstances has been linked to an increased risk of Reye’s syndrome, a potentially serious illness that can affect the liver and brain. Lifestyle changes that may be helpful: Treatment of measles is aimed at minimizing discomfort as the symptoms develop. Since people with measles tend to run a high fever, reducing the temperature with a lukewarm bath can reduce aches and other discomforts.1 Adding mineral salts or oatmeal to the bath water may reduce the itchiness of the skin.2 3 Because of their sensitivity to light, being in a room with dimmed lights will be soothing to the person with measles. Nutritional supplements that may be helpful: Measles appears to increase the body’s need for vitamin A.4 5 Studies in developing countries have shown that measles infection is more frequent and severe in people with low vitamin A blood levels,6 7 and preliminary research suggests this may also be true in the developed world.8 9 10 Repeatedly in controlled trials, preventive supplementation with vitamin A, at oral doses of up to 400,000 IU per day, reduced the risk of death in children with measles living in developing countries.11 12 13 Whether vitamin A supplementation would help people with measles in developed countries, where deficiency is uncommon, is less clear.14 However, the American Academy of Pediatrics recommends that all children with measles be given a short course of high-dose vitamin A. Two controlled studies of urban South African15 and Japanese16 children hospitalized with severe measles showed that supplementation with 100,000 to 400,000 IU of vitamin A resulted in faster recoveries, fewer complications, and fewer pneumonia-related deaths. An older study in England found one ounce per day of cod liver oil (containing about 40,000 IU of vitamin A, plus vitamin D and omega-3 fatty acids) reduced measles-related deaths in children hospitalized with severe cases of the disease.17 Such large doses of vitamin A should only be taken under a doctor’s supervision. Flavonoids are nutrients found in the white, pithy parts of fruits and vegetables. In preliminary laboratory research, certain flavonoids have been found to inhibit the infectivity of measles virus in the test tube.18 Whether flavonoid supplements could be effective in preventing or treating measles is unknown. References: 1. Boyle W, Saine A. Lectures in naturopathic hydrotherapy. East Palestine, Ohio: Buckeye Naturopathic Press, 1988. 2. Lust, J. The Herb Book. New York: Bantam Books, 1974. 3. Pigatto P, Bigardi A, Caputo R, et al. An evaluation of the allergic contact dermatitis potential of colloidal grain suspensions. Am J Contact Dermat 1997;8:207–9. 4. Rumore MM. Vitamin A as an immunomodulating agent. Clin Pharm 1993;12:506–14 [review]. 5. West CE. Vitamin A and measles. Nutr Rev 2000;58:S46–S54. 6. Glasziou PP, Mackerras DE. Vitamin A supplementation in infectious diseases: a meta-analysis. BMJ 1993;306:366–70. 7. Markowitz LE, Nzilambi N, Driskell WJ, et al. Vitamin A levels and mortality among hospitalized measles patients, Kinshasa, Zaire. J Trop Pediatr 1989;35:109–12. 8. Arrieta AC, Zaleska M, Stutman HR, Marks MI. Vitamin A levels in children with measles in Long Beach, California. J Pediatr 1992;121:75–8. 9. Butler JC, Havens PL, Sowell AL, et al. Measles severity and serum retinol (vitamin A) concentration among children in the United States. Pediatrics 1993;91:1176–81. 10. Frieden TR, Sowell AL, Henning KJ, et al. Vitamin A levels and severity of measles. New York City. Am J Dis Child 1992;146:182–6. 11. Glasziou PP, Mackerras DE. Vitamin A supplementation in infectious diseases: a meta-analysis. BMJ 1993;306:366–70. 12. Fawzi WW, Chalmers TC, Herrera MG, Mosteller F. Vitamin A supplementation and child mortality. A meta-analysis. JAMA 1993;269:898–903. 13. Barclay AJ, Foster A, Sommer A. Vitamin A supplements and mortality related to measles: a randomised clinical trial. BMJ 1987;294:294–6. 14. Glasziou PP, Mackerras DE. Vitamin A supplementation in infectious diseases: a meta-analysis. BMJ 1993;306:366–70. 15. Hussey GD, Klein M. A randomized, controlled trial of vitamin A in children with severe measles. N Engl J Med 1990;323:160–4. 16. Kawasaki Y, Hosoya M, Katayose M, Suzuki H. The efficacy of oral vitamin A supplementation for measles and respiratory syncytial virus (RSV) infection. Kansenshogaku Zasshi 1999;73:104–9 [in Japanese]. 17. Ellison JB. Intensive vitamin A therapy in measles. BMJ 1932;2:708–11. 18. Lin YM, Flavin MT, Schure R, et al. Antiviral activities of bioflavonoids. Planta Med 1999;65:120–5. |
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