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Pediatrics658 papers

Measles

Last edited: 4/14/2026

Overview

Measles is a highly contagious viral infection caused by the measles virus, leading to significant morbidity and mortality, particularly in unvaccinated populations 1414. Despite global vaccination efforts, outbreaks persist due to suboptimal coverage and disruptions in immunization programs 41324.

Diagnosis

  • Clinical Presentation: Fever, cough, coryza, conjunctivitis, and a characteristic rash progressing from head to trunk 124.
  • Recommended Tests: Serological tests (IgM antibodies) and viral detection methods (PCR) for confirmation 124.
  • Grading: Severity assessed based on complications such as pneumonia, encephalitis, and subacute sclerosing panencephalitis 118.

    • Management

  • First-Line Treatment: Supportive care including hydration, fever control, and monitoring for complications 124.
  • Vitamin A Supplementation: Essential for reducing mortality, especially in children 2033.
  • Antibiotics: Used prophylactically or therapeutically for secondary bacterial infections 2529.
  • Isolation: Patients should be isolated to prevent further transmission 124.

    • Special Populations

  • Pediatrics: Early vaccination (≥12 months) is crucial; early administration in high-risk areas may be considered 716.
  • Immunocompromised: Higher risk of severe disease; close monitoring and possibly additional prophylaxis needed 1737.
  • Pregnancy: Limited data; vaccination is generally avoided during pregnancy; post-partum vaccination recommended 11.

    • Key Recommendations

  • Ensure High Vaccination Coverage: Implement strategies to improve and sustain measles vaccination rates, especially in low-income and middle-income countries 313 (Evidence: Strong).
  • Vitamin A Supplementation: Administer vitamin A to children with measles to reduce mortality 2033 (Evidence: Strong).
  • Monitor and Respond to Outbreaks: Utilize outbreak investigations to identify gaps in vaccination and implement targeted interventions 58 (Evidence: Moderate).
  • Screen Healthcare Workers: Evaluate and vaccinate healthcare workers who lack measles immunity to protect vulnerable populations 11 (Evidence: Moderate).
  • Public Education: Enhance public awareness about measles symptoms, complications, and the importance of vaccination 46 (Evidence: Expert opinion).

    • References

    1 Salloum M, Vandermosten L, Maseko T, Milolo S, Lariviere Y, Matuvanga TZ et al.. Assessing vaccination coverage and antibody levels for measles, pertussis, and tetanus in Boende, DR Congo: Implications for maternal and child health. Vaccine 2026. link 2 Vittrup DM, Charabi S, Jensen A, Stensballe LG. A systematic review and meta-analysis of adverse events following measles-containing vaccines in infants less than 12 months of age. Vaccine 2025. link 3 Yitbarek K, Mahimbo A, Bobo FT, Woldie M, Sheel M, Frawley J et al.. Impact of measles vaccination strategies on vaccination rates in low-income and middle-income countries: a systematic review and meta-analysis. BMJ global health 2025. link 4 Roush K. Measles Cases Surge Across the Globe. The American journal of nursing 2025. link 5 Durrheim DN. Never waste a measles outbreak. Communicable diseases intelligence (2018) 2024. link 6 Paiva BL, Lima IB, Nogueira LMV, Rodrigues ILA, Caldas SP, Andrade ML et al.. Use of an application on the measles vaccine for Warao indigenous refugees in Brazil. Revista brasileira de enfermagem 2024. link 7 Xu J, Doyon-Plourde P, Tunis M, Quach C. Effect of early measles vaccination on long-term protection: A systematic review. Vaccine 2021. link 8 Jean Baptiste AE, Wagai J, Luce R, Masresha B, Klinkenberg D, Veldhuijzen I et al.. Measles outbreak in complex emergency: estimating vaccine effectiveness and evaluation of the vaccination campaign in Borno State, Nigeria, 2019. BMC public health 2021. link 9 Zhong Y, Clapham HE, Aishworiya R, Chua YX, Mathews J, Ong M et al.. Childhood vaccinations: Hidden impact of COVID-19 on children in Singapore. Vaccine 2021. link 10 Gbenewei E, Nomhwange T, Taiwo L, Ayodeji I, Yusuf K, Jean Baptiste AE et al.. Adverse events following immunization: Findings from 2017/2018 measles vaccination campaign, Nigeria AEFI reporting in 2017/2018 measles vaccination campaign. Vaccine 2021. link 11 Bianchi FP, Mascipinto S, Stefanizzi P, de Nitto S, Germinario CA, Lopalco P et al.. Prevalence and management of measles susceptibility in healthcare workers in Italy: a systematic review and meta-analysis. Expert review of vaccines 2020. link 12 Ochani RK, Yasmin F, Tariq A, Shaikh A. Philippines hit by deadly Measles outbreak - a wakeup call?. Le infezioni in medicina 2019. link 13 Bose AS. Reducing measles mortality in India. eLife 2019. link 14 Price S. Talk to Patients About: Measles. Texas medicine 2018. link 15 Chladná Z. Optimal time to intervene: The case of measles child immunization. Mathematical biosciences and engineering : MBE 2018. link 16 Shoho Y, Kimura T, Yanagawa Y, Saito A, Inoue T, Suto C et al.. Vaccination Status and Antibody Titers against Rubella and Measles among Japanese Female College Students Majoring in Childcare between 2015 and 2018. The Tohoku journal of experimental medicine 2018. link 17 Archer Kelser E. A Moral Imperative to Eradicate Measles, Rubella. Health progress (Saint Louis, Mo.) 2017. link 18 Huang JG, Yeoh AE, Tambyah PA, Suhaila MI. The Conundrum in the Diagnosis and Management of Atypical Fulminant Measles in a Leukemia Survivor on Maintenance Chemotherapy. Journal of pediatric hematology/oncology 2017. link 19 Garon J, Orenstein W. Improving the Science of Measles Prevention-Will It Make for a Better Immunization Program?. PLoS medicine 2016. link 20 Bello S, Meremikwu MM, Ejemot-Nwadiaro RI, Oduwole O. Routine vitamin A supplementation for the prevention of blindness due to measles infection in children. The Cochrane database of systematic reviews 2016. link 21 Rozovsky FA. Of consent, informed refusal, and measles vaccination. Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management 2015. link 22 Warraich HJ. The measles outbreak coming near you. Missouri medicine 2015. link 23 Bello S, Meremikwu MM, Ejemot-Nwadiaro RI, Oduwole O. Routine vitamin A supplementation for the prevention of blindness due to measles infection in children. The Cochrane database of systematic reviews 2014. link 24 Burnett M. Measles (rubeola): an ongoing series on infectious diseases of importance to the deployed special forces. Journal of special operations medicine : a peer reviewed journal for SOF medical professionals 2013. link 25 Kabra SK, Lodha R. Antibiotics for preventing complications in children with measles. The Cochrane database of systematic reviews 2013. link 26 Benn CS. Combining vitamin A and vaccines: convenience or conflict?. Danish medical journal 2012. link 27 Bello S, Meremikwu MM, Ejemot-Nwadiaro RI, Oduwole O. Routine vitamin A supplementation for the prevention of blindness due to measles infection in children. The Cochrane database of systematic reviews 2011. link 28 Finerty EA. Did you say 'measles'?. The American journal of nursing 2008. link 29 Kabra SK, Lodha R, Hilton DJ. Antibiotics for preventing complications in children with measles. The Cochrane database of systematic reviews 2008. link 30 Moss WJ. Measles still has a devastating impact in unvaccinated populations. PLoS medicine 2007. link 31 Hainsworth T. Practice implications of the increase in measles infections. Nursing times 2006. link 32 Liu X, Zhou W, Zhang P, Xu Q, Hu C, Chen X et al.. Expression of SLAM (CDw150) on Sf9 cell surface using recombinant baculovirus mediates measles virus infection in the nonpermissive cells. Microbes and infection 2005. link 33 Huiming Y, Chaomin W, Meng M. Vitamin A for treating measles in children. The Cochrane database of systematic reviews 2005. link 34 Ali M, Canh GD, Clemens JD, Park JK, von Seidlein L, Minh TT et al.. The use of a computerized database to monitor vaccine safety in Viet Nam. Bulletin of the World Health Organization 2005. link 35 Bedford H. Measles: the disease and its prevention. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2003. link 36 Khalil MK, Al-Mazrou YY, Al-Ghamdi YS, Tumsah S, Al-Jeffri M, Meshkhas A. Effect of gender on reporting of MMR adverse events in Saudi Arabia. Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit 2003. link 37 Kalman S, Bakkaloglu SA, Ozkaya O, Buyan N, Söylemezoglu O. Measles: a rare communicable disease in a child with renal transplantation. Pediatric transplantation 2002. link 38 D'Souza RM, Campbell-Lloyd S, Isaacs D, Gold M, Burgess M, Turnbull F et al.. Adverse events following immunisation associated with the 1998 Australian Measles Control Campaign. Communicable diseases intelligence 2000. link 39 . Epidemiology of measles--United States, 1998. MMWR. Morbidity and mortality weekly report 1999. link 40 Traviss M. Cooperative effort leads to success. Nursing BC 1997. link 41 Weingarten CT, Gomberg SM. Measles: again an epidemic. Pediatric nursing 1992. link 42 Wiederhorn N. Far above rubies: the founders of Every Child By Two. Pediatric nursing 1992. link 43 Searle A, Owen WJ. Measles appendicitis. The British journal of clinical practice 1990. link 44 Bannon MJ. Measles giant cell pneumonia in children with malignant disease: a plea for immunisation. Irish medical journal 1989. link 45 Varsanyi TM, Lundquist G, Norrby E, Jörnvall H. Measles virus hemagglutinin. Removal of the initiator methionine in the mature protein, and evidence for further processing to produce a 'ragged' end. FEBS letters 1986. link80668-8) 46 Blair S, Shave N, McKay J. Measles matters, but do parents know?. British medical journal (Clinical research ed.) 1985. link 47 Tishler M, Abramov AL. Liver involvement in measles infection of young adults. Israel journal of medical sciences 1983. link 48 Munro JG. Measles. The GP view. Australian family physician 1982. link 49 Knightley MJ, Mayon-White RT. A measles epidemic in a circumscribed community. The Journal of the Royal College of General Practitioners 1982. link 50 Delforge JL, Zygraich N. Nontransmissibility of measles virus from vaccinated dogs to seronegative monkeys. Modern veterinary practice 1980. link 51 Weiss HB, Wise HS. Early control of a community measles outbreak. Virginia medical 1979. link 52 Kańtoch M, Falecka W, Litwińska B, Lityńska J, Sadowski W. Leucocyte migration inhibition test as an index of immunological response to measles virus II. Immunogenic activity of measles virus. Acta microbiologica Polonica 1977. link

    Original source

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      Assessing vaccination coverage and antibody levels for measles, pertussis, and tetanus in Boende, DR Congo: Implications for maternal and child health. — Salloum M, Vandermosten L, Maseko T, Milolo S, Lariviere Y, Matuvanga TZ et al. Vaccine (2026)
    2. [2]
      A systematic review and meta-analysis of adverse events following measles-containing vaccines in infants less than 12 months of age. — Vittrup DM, Charabi S, Jensen A, Stensballe LG Vaccine (2025)
    3. [3]
      Impact of measles vaccination strategies on vaccination rates in low-income and middle-income countries: a systematic review and meta-analysis. — Yitbarek K, Mahimbo A, Bobo FT, Woldie M, Sheel M, Frawley J et al. BMJ global health (2025)
    4. [4]
      Measles Cases Surge Across the Globe. — Roush K The American journal of nursing (2025)
    5. [5]
      Never waste a measles outbreak. — Durrheim DN Communicable diseases intelligence (2018) (2024)
    6. [6]
      Use of an application on the measles vaccine for Warao indigenous refugees in Brazil. — Paiva BL, Lima IB, Nogueira LMV, Rodrigues ILA, Caldas SP, Andrade ML et al. Revista brasileira de enfermagem (2024)
    7. [7]
      Effect of early measles vaccination on long-term protection: A systematic review. — Xu J, Doyon-Plourde P, Tunis M, Quach C Vaccine (2021)
    8. [8]
      Measles outbreak in complex emergency: estimating vaccine effectiveness and evaluation of the vaccination campaign in Borno State, Nigeria, 2019. — Jean Baptiste AE, Wagai J, Luce R, Masresha B, Klinkenberg D, Veldhuijzen I et al. BMC public health (2021)
    9. [9]
      Childhood vaccinations: Hidden impact of COVID-19 on children in Singapore. — Zhong Y, Clapham HE, Aishworiya R, Chua YX, Mathews J, Ong M et al. Vaccine (2021)
    10. [10]
      Adverse events following immunization: Findings from 2017/2018 measles vaccination campaign, Nigeria AEFI reporting in 2017/2018 measles vaccination campaign. — Gbenewei E, Nomhwange T, Taiwo L, Ayodeji I, Yusuf K, Jean Baptiste AE et al. Vaccine (2021)
    11. [11]
      Prevalence and management of measles susceptibility in healthcare workers in Italy: a systematic review and meta-analysis. — Bianchi FP, Mascipinto S, Stefanizzi P, de Nitto S, Germinario CA, Lopalco P et al. Expert review of vaccines (2020)
    12. [12]
      Philippines hit by deadly Measles outbreak - a wakeup call? — Ochani RK, Yasmin F, Tariq A, Shaikh A Le infezioni in medicina (2019)
    13. [13]
      Reducing measles mortality in India. — Bose AS eLife (2019)
    14. [14]
      Talk to Patients About: Measles. — Price S Texas medicine (2018)
    15. [15]
      Optimal time to intervene: The case of measles child immunization. — Chladná Z Mathematical biosciences and engineering : MBE (2018)
    16. [16]
      Vaccination Status and Antibody Titers against Rubella and Measles among Japanese Female College Students Majoring in Childcare between 2015 and 2018. — Shoho Y, Kimura T, Yanagawa Y, Saito A, Inoue T, Suto C et al. The Tohoku journal of experimental medicine (2018)
    17. [17]
      A Moral Imperative to Eradicate Measles, Rubella. — Archer Kelser E Health progress (Saint Louis, Mo.) (2017)
    18. [18]
      The Conundrum in the Diagnosis and Management of Atypical Fulminant Measles in a Leukemia Survivor on Maintenance Chemotherapy. — Huang JG, Yeoh AE, Tambyah PA, Suhaila MI Journal of pediatric hematology/oncology (2017)
    19. [19]
      Improving the Science of Measles Prevention-Will It Make for a Better Immunization Program? — Garon J, Orenstein W PLoS medicine (2016)
    20. [20]
      Routine vitamin A supplementation for the prevention of blindness due to measles infection in children. — Bello S, Meremikwu MM, Ejemot-Nwadiaro RI, Oduwole O The Cochrane database of systematic reviews (2016)
    21. [21]
      Of consent, informed refusal, and measles vaccination. — Rozovsky FA Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management (2015)
    22. [22]
      The measles outbreak coming near you. — Warraich HJ Missouri medicine (2015)
    23. [23]
      Routine vitamin A supplementation for the prevention of blindness due to measles infection in children. — Bello S, Meremikwu MM, Ejemot-Nwadiaro RI, Oduwole O The Cochrane database of systematic reviews (2014)
    24. [24]
      Measles (rubeola): an ongoing series on infectious diseases of importance to the deployed special forces. — Burnett M Journal of special operations medicine : a peer reviewed journal for SOF medical professionals (2013)
    25. [25]
      Antibiotics for preventing complications in children with measles. — Kabra SK, Lodha R The Cochrane database of systematic reviews (2013)
    26. [26]
      Combining vitamin A and vaccines: convenience or conflict? — Benn CS Danish medical journal (2012)
    27. [27]
      Routine vitamin A supplementation for the prevention of blindness due to measles infection in children. — Bello S, Meremikwu MM, Ejemot-Nwadiaro RI, Oduwole O The Cochrane database of systematic reviews (2011)
    28. [28]
      Did you say 'measles'? — Finerty EA The American journal of nursing (2008)
    29. [29]
      Antibiotics for preventing complications in children with measles. — Kabra SK, Lodha R, Hilton DJ The Cochrane database of systematic reviews (2008)
    30. [30]
      Measles still has a devastating impact in unvaccinated populations. — Moss WJ PLoS medicine (2007)
    31. [31]
      Practice implications of the increase in measles infections. — Hainsworth T Nursing times (2006)
    32. [32]
      Expression of SLAM (CDw150) on Sf9 cell surface using recombinant baculovirus mediates measles virus infection in the nonpermissive cells. — Liu X, Zhou W, Zhang P, Xu Q, Hu C, Chen X et al. Microbes and infection (2005)
    33. [33]
      Vitamin A for treating measles in children. — Huiming Y, Chaomin W, Meng M The Cochrane database of systematic reviews (2005)
    34. [34]
      The use of a computerized database to monitor vaccine safety in Viet Nam. — Ali M, Canh GD, Clemens JD, Park JK, von Seidlein L, Minh TT et al. Bulletin of the World Health Organization (2005)
    35. [35]
      Measles: the disease and its prevention. — Bedford H Nursing standard (Royal College of Nursing (Great Britain) : 1987) (2003)
    36. [36]
      Effect of gender on reporting of MMR adverse events in Saudi Arabia. — Khalil MK, Al-Mazrou YY, Al-Ghamdi YS, Tumsah S, Al-Jeffri M, Meshkhas A Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit (2003)
    37. [37]
      Measles: a rare communicable disease in a child with renal transplantation. — Kalman S, Bakkaloglu SA, Ozkaya O, Buyan N, Söylemezoglu O Pediatric transplantation (2002)
    38. [38]
      Adverse events following immunisation associated with the 1998 Australian Measles Control Campaign. — D'Souza RM, Campbell-Lloyd S, Isaacs D, Gold M, Burgess M, Turnbull F et al. Communicable diseases intelligence (2000)
    39. [39]
      Epidemiology of measles--United States, 1998. MMWR. Morbidity and mortality weekly report (1999)
    40. [40]
      Cooperative effort leads to success. — Traviss M Nursing BC (1997)
    41. [41]
      Measles: again an epidemic. — Weingarten CT, Gomberg SM Pediatric nursing (1992)
    42. [42]
      Far above rubies: the founders of Every Child By Two. — Wiederhorn N Pediatric nursing (1992)
    43. [43]
      Measles appendicitis. — Searle A, Owen WJ The British journal of clinical practice (1990)
    44. [44]
      Measles giant cell pneumonia in children with malignant disease: a plea for immunisation. — Bannon MJ Irish medical journal (1989)
    45. [45]
      Measles virus hemagglutinin. Removal of the initiator methionine in the mature protein, and evidence for further processing to produce a 'ragged' end. — Varsanyi TM, Lundquist G, Norrby E, Jörnvall H FEBS letters (1986)
    46. [46]
      Measles matters, but do parents know? — Blair S, Shave N, McKay J British medical journal (Clinical research ed.) (1985)
    47. [47]
      Liver involvement in measles infection of young adults. — Tishler M, Abramov AL Israel journal of medical sciences (1983)
    48. [48]
      Measles. The GP view. — Munro JG Australian family physician (1982)
    49. [49]
      A measles epidemic in a circumscribed community. — Knightley MJ, Mayon-White RT The Journal of the Royal College of General Practitioners (1982)
    50. [50]
      Nontransmissibility of measles virus from vaccinated dogs to seronegative monkeys. — Delforge JL, Zygraich N Modern veterinary practice (1980)
    51. [51]
      Early control of a community measles outbreak. — Weiss HB, Wise HS Virginia medical (1979)
    52. [52]
      Leucocyte migration inhibition test as an index of immunological response to measles virus II. Immunogenic activity of measles virus. — Kańtoch M, Falecka W, Litwińska B, Lityńska J, Sadowski W Acta microbiologica Polonica (1977)
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