Has Measles Become a Binary Choice Between Trying to Treat the Disease Vs Prevention?

Health and Human Services Secretary Robert F Kennedy Jr is reported to have asked the Centers for Disease Control and Prevention (CDC) to develop new guidance for treating measles with therapies and vitamins.

Paul Offit, MD, the director of the Vaccine Education Center and an attending physician in the Division of Infectious Diseases at Children's Hospital of Philadelphia (CHOP), says this idea creates a binary choice for parents who may believe it is better to treat for measles than to prevent the respiratory disease altogether.

“I think what RFK Jr did—maybe inadvertently—but he set it up as a binary choice. I mean, it's for people who are thinking about their child with measles or someone who might get measles…vitamin A sounds like a safer alternative than injecting yourself with a vaccine that contains 3 live, attenuated viruses. Vitamin A sounds far more benign,” Offit said. “The problem is by creating that or setting it up as a potential binary choice, then people may forego measles vaccination, thinking I'll just treat it with vitamin A. And then the child continues to do worse, and they give them more vitamin A and more vitamin A—and that’s what’s being seen.”

And Offit warns that this overdosing of vitamin A could lead to a dangerous toxicity and more serious health problems.

“That's what's being seen in West Texas; there have been a number of children admitted to the hospital with hypervitaminosis A, which can cause blurred vision, bone pain, and most significantly, liver damage. And that's what they're seeing—children with liver damage from hypervitaminosis A. So I think the whole story about vitamin A has been one of doing far more harm than good.”

He says the exception for vitamin A treatment is in countries where malnutrition is an issue.

“The World Health Organization says that vitamin A should be used in countries where vitamin A deficiency is common, and in that setting, for children less than 12 months of age, you would give 100,000 international units per day for 2 consecutive days. For those over 12 months of age, it would be 200,000 international units per day for 2 consecutive days,” Offit said.

It is important to point out there is no treatment regimen for measles to alleviate the disease, and that needs to be said, especially as there are those in the public who are saying otherwise, and allowing people to believe there are treatment options.

“There is no specific treatment for measles other than supportive therapy,” Offit said. “So when measles causes pneumonia, then you support it with respiratory therapies like face mask, oxygen, or ventilation. If it's dehydration, then you support it with intravenous fluids.”

This is the first segment of a 2-part interview with Offit. In the next segment, he discusses measles breakthrough infections and where we are with herd immunity.