Measles (Rubeola) (cont.)
Edmond Hooker, MD, DrPH
Dr. Eddie Hooker is currently an Assistant Professor in the Department of Health Services Administration at Xavier University in Cincinnati, Ohio. He is also an Associate Clinical Professor in the Department of Emergency Medicine at the University of Louisville and at Wright State University. His areas of expertise include emergency medicine, epidemiology, health-services management, and public health.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
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Is there any treatment for measles after symptoms and signs develop?
The treatment of patients with measles is mostly focused upon symptom relief. Specific complications like pneumonia may require antibiotics. Home remedies are simply symptomatic treatment with acetaminophen (Tylenol), lots of rest, and fluids. Patients should be on bed rest until the fever has resolved and should remain well hydrated. In malnourished patients, vitamin A supplementation is recommended. Patients should be isolated to prevent spread of the disease.
What are complications seen with measles?
Some cases of measles have an associated complication. These complications can include diarrhea, middle ear infections, pneumonia, blindness, acute brain inflammation (encephalitis, which is very rare), and persistent brain inflammation (subacute sclerosing panencephalitis or SSPE, which is extremely rare).
Blindness associated with measles is due to a combination of poor nutrition (specifically vitamin A deficiency) and the measles infection. Prevention is the most effective treatment. In third-world countries, post-measles blindness is the leading cause of blindness.
Acute encephalitis, although rare, is extremely dangerous and results in death in a significant percentage of patients who develop it. When it occurs, acute encephalitis generally starts six days after onset of the rash. Symptoms can include fever, headache, vomiting, stiff neck, drowsiness, seizures, and coma.
Subacute sclerosing panencephalitis (SSPE) is an extremely rare degenerative condition of the brain and spinal cord (central nervous system). It is believed to be caused by a chronic infection of the central nervous system with the measles virus. Typically, symptoms start years after the patient had measles (average seven years, range one month to 27 years). The patient has a slow and progressive loss of brain function, seizures, and eventually death results. There is no known treatment for SSPE.
Most deaths from measles are due to pneumonia in children and encephalitis in adults. The people most likely to have complications (including death) are those who are malnourished or who have weakened immune systems (for example, people with AIDS or other conditions that weaken the immune system).
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