There is no specific antiviral therapy for measles, though supportive care can help relieve symptoms and address complications such as secondary bacterial infections. Rapid medical attention is crucial to head off serious complications. Treatment recommendations may vary depending on the patient’s age, health status, and local guidelines.

5.1 Diagnosing Measles

Rapid identification of measles is the key to containing an outbreak. This includes testing urine, blood, or samples from the nose and throat. Diagnosis also includes clinical symptoms, asking about a recent history of international travel, risk factors, and exposure to others with measles.

Two positive serum specimens are required for positive serologic testing by enzyme-linked immunoassay (ELISA). A blood test for measles IgM antibodies is necessary to confirm reportable cases.  A confirmed case must be reported to the local health department, in addition to the infectious disease departments of hospitals and healthcare facilities.

Lab test results may show decreased platelets, low white blood cells, specifically low T-cells, which puts those who are already immunocompromised at greater risk. A chest x-ray may show pneumonitis.

Rubella, erythema infectiosum, roseola infantum, and hand-foot-mouth disease can resemble measles. Many other childhood conditions present with fever and rash, and knowing the various clinical presentations can help with the differential diagnoses.

5.2 Acute Care

Loss of fluids due to diarrhea, vomiting, or sweating can be a concern during a bout with measles. Fluid replacement is important using juice, tea, or water. Rehydration fluids (not sugary sports drinks), which contain salts and electrolytes, are available without a prescription. A cool-mist humidifier or a saline nasal spray can relieve cough, sore throat, and irritated nasal passages. Gargling with salt water may provide some relief for sore throat. Reading and watching television may aggravate the eyes, so patients may have to forego these activities (Mayo Clinic, 2025).

There are some post-exposure measures that can protect people who are not already immune. A post-exposure vaccination can be administered, even to infants, within 72 hours of exposure. It may not prevent the disease entirely, but usually the infection is much milder and shorter than it would have been without the vaccine.

Human normal immunoglobulin (HNIG) or intravenous immunoglobulin (IVIG) may be administered to pregnant women, infants, or people with weakened immune systems up to six days after exposure. Do not offer both medications simultaneously, as this will invalidate the vaccine.

Over-the-counter fever medications can relieve fever, though aspirin should be avoided. Antibiotics may be prescribed for pneumonia or ear infections, both of which can be serious if they are left untreated.

Robert F. Kennedy Jr. has written that vitamin A is an effective tool in the fight against measles. During a measles outbreak in Texas in early 2025, vitamin A supplements were shipped to the epicenter of the crisis. During this outbreak, several hospitals confirmed they treated pediatric measles patients who were suffering from abnormal liver function due to overly high levels of vitamin A.

While judicious doses of vitamin A may reduce the deadliness of a measles infection, it does not hinder the development or the spread of the disease. Most of the studies on the efficacy of vitamin A were done in the 1980s and 1990s in sub-Saharan Africa, a time and a place where many children were deficient in vitamin A. Most American children do not need this form of support for their underlying health (Brownstein, 2025).

Without proper medical supervision, too much vitamin A can cause nausea, vomiting, headache, dizziness, irritability, blurred vision, and muscular incoordination. Prolonged overuse of the supplement can cause chronic vitamin A toxicity, with symptoms including dry, cracked skin, hair loss, brittle nails, fatigue, loss of appetite, bone and joint pain, and an enlarged liver, or hepatomegaly (Olson, et al, 2023).

As of 2024, the CDC’s recommendation is that vitamin A may be administered to infants and children with measles in the U.S. as part of supportive management. This should only be done under a physician's supervision.

If vitamin A is recommended, it should be administered immediately on diagnosis and repeated the next day for a total of 2 doses. Inappropriate dosing may lead to hypervitaminosis A. The recommended age-specific daily doses are:

• 50,000 IU for infants younger than 6 months of age
• 100,000 IU for infants 6–11 months of age
• 200,000 IU for children 12 months of age and older

5.3 Hospital Protocols

Hospital protocols for patients known or presumed to have measles are rigorous, starting with masking the patient and alerting healthcare professionals (including those who are not directly involved with patient care, such as volunteers, security, and service personnel) that someone with measles is arriving at the facility, and which entrance they will use. All personnel should be able to provide evidence of their immunity. This consists of being able to document that they have had two MMR shots; have had the measles; or were born before 1957.

Hand hygiene, masking, and cough etiquette must be emphasized. The patient should be placed alone in an airborne infection isolation room (AIIR); or, if none is available, in a private room with a closed door and high-efficiency particulate air filtration. An AIIR room must demonstrate at least 6 (if the facility is old) to 12 (for new construction) air changes per hour. Measles can exist in the air for up to 2 hours. Current public air sources have not been built to eliminate the small measles virus.

Healthcare personnel should use a respirator that is at least as protective as a fit-tested, NIOSH-certified disposable N95 filtering facepiece respirator, regardless of presumptive evidence of immunity, whenever they enter a room with a patient with known or suspected measles. Airborne precautions should remain in place for four days after the onset of the rash, or for the duration of the disease for immunocompromised patients due to prolonged virus shedding in these individuals.

If other patients without evidence of immunity are exposed to the measles patient, they should be placed on Airborne Precautions for 21 days and receive postexposure prophylaxis (CDC, 2024b).

Standard cleaning and disinfection procedures are required for medical waste and there is no additional management needed for waste, according to federal and local rules for regulated medical waste.

Assessment and management of exposure is defined as the time up to 2 hours in a shared air space after the measles patient was present. An example is requiring 2 hours for the necessary time to clean an ambulance after a patient with measles was present. The conservative margin of time is to wait 2 hours with air cycling before a 99% safety status is confirmed.

If there is an outbreak involving a large number of patients, consult your facility’s infection control specialist before a patient is placed, to determine the safety of alternative rooms if an AIIR room is unavailable.