What is the management of a child with measles?

  1. The child should be kept away from other children until 5 days after the rash first appears. By this time the child is no longer infectious to others. Measles is most infectious during the 4 days of illness before the rash appears.
  2. Paracetamol for fever
  3. Adequate oral fluids to prevent dehydration
  4. Vitamin A for all children with measles: 100 000 IU orally daily for 2 days (50 000 IU daily for 2 days in children under 1 year)
  5. Look out for and treat complications (acyclovir for herpes stomatitis and stridor; antibiotics for otitis media and pneumonia).
  6. Measles is a notifiable disease in South Africa.

Other viral infections may have a rash similar to measles: rubella (German measles), erythema infectiosum (slapped cheek disease) due to parvovirus, roseola infantum (‘baby measles’) due to herpes virus 6, infectious mononucleosis (glandular fever) due to Epstein-Barr virus and common viral infections of the bowel, e.g coxsackie and ECHO.

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