Host: Dr. Elizabeth Mumper | Guests: Dr. Joseph Varon & Matthew Halma, M.Sc.
Measles is back in the news, and beyond fear and soundbites, a critical question remains: what does the evidence actually say about how to treat it in children and adults?
In this week’s show, our host is IMA Senior Fellow in Pediatrics Dr. Elizabeth Mumper. She’ll walk through a new peer-reviewed paper published in Antiviral Research on the acute management of measles. And, she’ll be joined by two of the paper’s co-authors: IMA President, Dr. Joseph Varon, and IMA Director of Research Matthew Halma.
Together, they walk through the actual data on measles care and what it means for families and clinicians.
Measles is back in the news, and for most families the public conversation starts and ends in the same place: get vaccinated. But what about the people who do get vaccinated and still get measles? And what about the families worldwide who are already dealing with an active infection? Treatment has to be part of the conversation no matter where you land on the vaccine debate.
In this episode, IMA Senior Fellow in Pediatrics Dr. Elizabeth Mumper sits down with Dr. Joseph Varon and Matthew Halma, two co-authors of a new peer-reviewed paper published in Antiviral Research. Together, they’ll walk through what the evidence actually says about treating measles in children and adults. The study, “Acute Management of Measles: A Systematic Review of Therapeutic Strategies,” screened 1,571 records across five major databases and analyzed 10 studies on acute measles management.
The takeaway: therapeutic options exist, and clinicians and families deserve to know about them.
Meet the Experts
Dr. Elizabeth Mumper
IMA Senior Fellow, Pediatric Education. MD, FAAP, IFMCP. Dr. Mumper is a practicing pediatrician with several decades of clinical experience helping families navigate childhood illness and immunization decisions. She is the originator of IMA’s I-CARE: For Kids treatment guide and host of the Kid’s Corner educational series.
Dr. Joseph Varon
President, Independent Medical Alliance. Professor, University of Houston College of Medicine. Dr. Varon is one of the most widely published physicians in critical care medicine, with more than 1,000 peer-reviewed articles and decades of experience caring for seriously ill patients. He is a co-author of the systematic review discussed in this episode.
Matthew Halma, M.Sc.
Director of Scientific Research, IMA. PhD Candidate in Biophysics, Vrije Universiteit Amsterdam. Halma’s work focuses on evidence synthesis, molecular biology, and translating complex scientific literature into practical clinical insight. He is a co-author of the systematic review discussed in this episode.
1. Why This Paper Exists
Vaccination rates are declining globally, and families are asking a question that should have been easy to answer all along: if someone gets measles, what can actually be done? This review was built to fill that gap using the published clinical evidence.
What the authors found was not a lack of research. It was a lack of awareness. The data has been sitting in plain sight for years.
“I remember when I went to med school, they would just talk to you about vaccination as the only way to take care of measles. When I was a resident, I saw several adult patients with measles and even some of this information was kind of difficult to find, and the fact is that it’s in plain sight.” — Dr. Joseph Varon
And here is the point that reframes the entire conversation: vaccination does not guarantee protection.
Dr. Varon has seen vaccinated patients develop measles throughout his career. Dr. Mumper reinforced this with data from the Disneyland measles outbreak several years ago, where serotyping revealed that as many as 45 percent of patients were vaccinated. She also cited college outbreaks where MMR vaccination rates hit 98 to 99 percent and measles still spread.
When the go-to solution fails for a meaningful percentage of people, treatment is no longer optional.
“We did this not as an anti-vaccine article. We did it as a solutions-oriented article. Like, what can we do given that this is the case?” — Matthew Halma
The review screened 1,571 records, excluded over 1,400, and ultimately analyzed 10 peer-reviewed studies on acute measles treatment, including six clinical trials. Read a detailed breakdown of the paper’s findings here.
2. What the Evidence Shows
Everything starts with the basics: hydration, nutrition, and monitoring.
From there, the strongest evidence points to vitamin A supplementation, which is already recommended by the WHO. The paper cites a dosing protocol of 200,000 international units per day for two days in children.
Dr. Mumper noted she has seen recommendations as high as 400,000 IU for two days, and emphasized that some vitamin A is better than none.
“Instead of being so freaked out about measles, why don’t we just take care of making sure that all of us have enough vitamin A around in our systems? Because that would be one of our number one lines of defense against this illness.” — Dr. Joseph Varon
Dr. Mumper agreed, adding that based on the current evidence, vitamin A likely outperforms the antivirals. For more severe cases, the review identifies additional therapeutic candidates:
- Ribavirin, a broad-spectrum antiviral used off-label in severe or immunocompromised cases
- Interferon-alpha, which has shown reductions in severity and complications in small clinical trials
- IVIG (intravenous immunoglobulin) for high-risk patients
- Investigational options still in the preclinical pipeline, including polymerase inhibitors and monoclonal antibodies
Dr. Varon’s clinical approach is severity-dependent. Mild cases at home get vitamin A and supportive care.
Hospitalized patients with complications get everything available. As he put it, that’s when you throw “the whole enchilada” at it.
3. Recognizing Measles: What Parents Should Know
Early signs can look unremarkable:
- Low-grade fever
- A child who seems sluggish or “looks kind of sad,” as Dr. Varon put it
- Mild cough or runny nose
- Sometimes red or watery eyes
The telltale sign that few people know about is Koplik spots, small lesions inside the mouth across from the molars. Dr. Mumper noted that these are essentially a clinical confirmation of measles. If you see them alongside those early symptoms, you can make the diagnosis without lab testing.
Why measles spreads so easily: Children are contagious before the rash appears, during a high-replication phase lasting five to seven days. The rash itself actually signals that the body is beginning to clear the virus. Dr. Varon recalled the old teaching: four days before the rash, four days after.
Adults fare worse. Dr. Varon noted that adults are more prone to pulmonary complications, including acute respiratory distress syndrome, which carries a mortality rate of 40 to 50 percent if not managed appropriately.
It was a generation ago that measles parties were common practice. Dr. Mumper pointed out that there may actually be a benefit to having measles as a child, when the disease tends to be mild, rather than encountering it as an adult when complications are more likely.
Mortality in context: 0.1 to 0.3 percent in high-income countries, 3 to 6 percent in developing countries. Dr. Mumper noted these figures likely overstate the risk, since milder cases that never reach medical attention are not captured in the data.
4. Red Flags: When to Seek Medical Care
Most children with a healthy immune system can ride out measles at home. But there are clear warning signs that mean it’s time to go to the hospital. Dr. Varon offered a systems-based framework:
- Neurological: Confusion, seizures, or worsening lethargy
- Respiratory: Rapid breathing, bluish discoloration around the mouth, or dropping oxygen on a pulse oximeter
- Cardiovascular: Rapid heart rate or chest pain, particularly in adults
- Renal: The child or adult stops urinating, a sign of dehydration or kidney stress
- Gastrointestinal: Excessive diarrhea, which is common with measles and can quickly outpace fluid intake
His rule of thumb: any adult with measles should be seen in an emergency department because deterioration can happen fast. For children, stay vigilant and act immediately if any of these signs appear.
5. Your Home Medicine Cabinet
You do not need a pharmacy to care for a child with mild measles. You need a few basics and the confidence to use them.
What to have on hand:
- Electrolyte fluids: the number one priority. Stay ahead of fluid loss from sweating and diarrhea before it becomes a problem.
- Vitamin A supplements: cheap, available, and backed by strong evidence. Dr. Varon noted you can start supplementing even before illness hits.
- A thermometer: to monitor, not to panic over.
- Tepid bath supplies: Dr. Mumper’s preferred first-line approach to fever reduction, ahead of medication.
- Vitamin C and vitamin D: to support immune function alongside vitamin A. Foods that are yellow, red, and orange are high in both A and C.
On fever: both physicians were emphatic that fever is protective, not dangerous. The body produces heat shock proteins at elevated temperatures that actively help fight infection.
Dr. Varon does not treat fevers below 101.5°F. Dr. Mumper’s threshold is 102.5°F, and she sometimes lets fevers run even higher if the child is active and comfortable.
“I try to convince people that fever is their friend. It’s a signal that their kid is sick.” — Dr. Elizabeth Mumper
On Tylenol: use sparingly. Dr. Mumper cautioned that it depletes glutathione, the body’s primary intracellular antioxidant, which can increase oxidative stress in a child who is already fighting an infection.
On nutrition: Dr. Mumper urged parents to condition children toward savory and vegetable-rich diets early. Kids who start on bananas and applesauce tend to reject the very foods that build their defenses.
6. Don’t Believe the Panic
Measles has been around for thousands of years. The vast majority of healthy children recover with supportive care and good nutrition. The real danger for most families is not the virus itself. It’s the fear.
“You’ll hear about the kids that died. You’ll hear about the kids that are in the hospital. You won’t hear about the hundreds of children that got measles, stayed at home, maybe didn’t even go to the doctor. So try to get that balance.” — Dr. Elizabeth Mumper
Dr. Varon illustrated the point with a recent anecdote: a local TV station contacted him about a single measles case in a jail housing 7,000 inmates. Officials were discussing relocating the entire population over one case.
The panel’s closing message was consistent: treatment options exist, they are backed by published evidence, and families and clinicians should know about them. The goal is not to dismiss prevention but to ensure that when prevention falls short, nobody is left without a plan.
“We have to be honest with them and tell them the good, the bad and the ugly of both the disease entity as well as the therapeutic interventions. The patients can have the opportunity to do a truly informed consent on whatever therapeutic intervention you are going to do.” — Dr. Joseph Varon
Related Reading
IMA has created a wealth of resources on measles, all in one tidy location:
- Peer-Reviewed Study: Acute Management of Measles: A Systematic Review of Therapeutic Strategies
- Post: Major New Study: “Measles Is Highly Treatable”
- Post: New Study Reviews Therapeutic Candidates for Measles
- Video: Measles Treatment: New Study Shifts Focus to Recovery Options
- Guide: 9 Must-Know Measles Facts You Won’t Hear on the News
- Webinar: Measles and Childhood Vaccines: What You Need to Know
- Video: Dr. Liz Mumper Discusses Measles
- Course: Kid’s Corner 11: The MMR Vaccine Debate
- Course: Kid’s Corner 12: Treating Measles and Understanding Risks
