Measles (rubeola) is a highly contagious respiratory infection. In fact, 90% of people exposed to measles will develop the disease, unless they are immune. Measles is caused by a virus and can be a serious or even fatal illness for young children. However, since vaccinations were introduced in 1963, measles has become rare in developed countries, including the United States. There are still an estimated 30 million cases of measles worldwide each year, resulting in 750,000 deaths.
Signs and Symptoms
Measles is associated with the following signs and symptoms:
- Moderate-to-high fever
- Conjunctivitis (red, irritated eyes)
- Sore throat, hoarseness
- Runny nose
- Red spots with bluish white centers (called Koplik's 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. It is possible to contract it by merely being in the same room as an infected person. Most people get measles because they were never immunized. Once someone has had measles, that person has immunity for life.
Who's 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 certain 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's spots or the rash that usually appears several days after the spots have disappeared. To help confirm the diagnosis, your health care provider may order a blood test to detect the presence of antibodies against the measles virus.
Vaccination is the key to preventing measles. Since the 1980s, the live, weakened measles vaccine, available as the combination vaccine of measles-mumps-rubella (MMR), is administered in two doses -- one at age 12 - 15 months, and the second at age 5 - 12 years. Of those who receive the vaccine, more than 95% have lifelong immunity.
Rest, drinking plenty of fluids, and treatment to relieve symptoms are adequate if there are no complications.
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 - 6 months later
Complementary and Alternative Therapies
Nutrition and Supplements
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 vegetable 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 - 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 - 2 capsules or 1 - 2 tablespoonfuls oil 1 - 2 times daily, to help decrease 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 Coumadin (warfarin) and aspirin.
- Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. Some probiotic supplements may need refrigeration. Check the label carefully.
- Resveratrol (from red wine), 50 - 200 mg daily, for antioxidant and immune effects.
- Acetyl-L-carnitine, 500 mg daily, for antioxiant and antiviral activity.
Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting any treatment. You may use herbs as dried extracts (capsules, powders, 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 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 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.
- Green tea (Camellia sinensis) standardized extract, 250 - 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.
- Reishi mushroom (Ganoderma lucidum), 150 - 300 mg 2 - 3 times daily, for antiviral and immune activity. You may also take a tincture of this mushroom extract, 30 - 60 drops 2 - 3 times a day. High doses of Reishi can have a blood thinning effect and may increase the effect of blood thinning medications, such as Coumadin (warfarin) and aspirin.
- Cat's claw (Uncaria tomentosa) standardized extract, 20 mg 3 times a day, 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.
- Rhodiola (Rhodiola rosea) standardized extract, 150 - 300 mg 1 - 3 times daily, for immune support. Rhodiola is an "adaptogen" and helps the body adapt to various stresses.
- Phyllanthus (Phyllanthus amarus) standardized extract, 200 mg 2 - 4 times daily for antiviral effects. Phyllanthus can interact with lithium.
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 -- 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.
Measles is most often an uncomplicated childhood illness. The most common complication of measles in children is acute otitis media, which occurs in 7 - 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.
Anonymous. Global measles control and regional elimination, 1998-1999. MMWR Morb Mortal Wkly Rep. 1999;48(49):1124-1130.
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.
Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines. 3rd ed. New York, NY: Penguin Putnam; 1997: 108-109.
Eo SK, Kim YS, Lee CK, Han SS. Antiviral activities of various water and methanol soluble substances isolated from Ganoderma lucidum. J Ethnopharmacol. 1999;68(1-3):129-36.
Long: Principles and Practice of Pediatric Infectious Diseases, 3rd ed. Philadelphia, PA: Churchill Livingstone; 2008, Ch. 227.
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.