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DESCRIPTION
Measles, known to health care providers as Rubeola, is a viral infection that attacks the respiratory tract, eyes, and skin. Although typically a childhood disease, adults are also susceptible. This is not the same disease as Rubella, also known as German Measles, and is caused by a different virus and can be dangerous in that it causes birth defects and can cause miscarriage and fetal death. Rubeola is also called morbilli, hard measles, red measles, 7-day measles, 8-day measles, 9-day measles and 10-day measles.
Measles is a highly contagious viral disease that can kill you. Although an uncommon disease in the United States of America, in 2006, measles killed 242,000 children worldwide. In most people, the disease produces fever, a generalized rash that last greater than three days, cough, runny nose (coryza), and red eyes (conjunctivitis). The complications of measles that result in most deaths include pneumonia and inflammation of the brain (encephalitis).
Measles has been called the greatest killer of children in history. Despite the availability of an effective vaccine that was developed more than 30 years ago, the measles virus still affects 50 million people annually and causes more than 1 million deaths. The highest incidence of measles and its associated morbidity and mortality is observed in developing countries. However, it still occurs infrequently in the United States and other industrialized nations.
FREQUENCY OF INCIDENCE - UNITED STATES
The US Centers for Disease Control and Prevention (CDC) support strict surveillance of measles both in the United States and abroad. The CDC defines a case of measles as one that is confirmed by (1) serologic laboratory tests, such as enzyme immunoassays for measles IgM antibodies; (2) cases epidemiologically linked to a laboratory confirmed case; or (3) clinically confirmed cases (ie, cases of measles suspected clinically but neither confirmed by serologic laboratory tests nor epidemiologically linked to a laboratory confirmed case). In countries that are trying to eliminate measles, the category of clinically confirmed cases represents a failure of the surveillance system because all cases ideally should be confirmed serologically or epidemiologically linked to a laboratory confirmed case.
According to an epidemiologic report by the CDC in 1993, the measles virus is no longer indigenous to the United States. Most reported measles cases are importation associated, meaning that they are linked to a strain of the measles virus outside of the United States.
In 2005, the CDC reported that 66 cases of measles were confirmed in the United States. Fifty of these cases were in unvaccinated individuals and 17 were contracted while traveling abroad. A large outbreak in Indiana in 2005 infected 34 people, the largest outbreak since 1999. This outbreak was linked to a young woman who acquired the infection while on a brief trip (2 week) to Romania. As recently as June 2006, a measles outbreak occurred in Boston, Mass and was linked to a recent immigrant from India. Thirteen cases of measles were confirmed in this outbreak, and they were linked to a common Indian strain of this virus.
More concerning was the report of 2 infected individuals who worked at the Christian Science Center in downtown Boston. Many members of this church are unvaccinated, which raised concern that the virus would spread further.
Importation-associated strains of measles may be acquired outside of the United States (internationally imported), have a known chain of transmission from an internationally imported source (epi-linked), or have a genotype that matches a known international strain without a clear chain of transmission or individual source (imported).
The number of non-importation-associated measles cases has significantly decreased since 1995, when 85 percent of all reported cases of measles in the United States were considered indigenous and not linked to importation. In addition, only 6 measles outbreaks were reported in 1998, the lowest ever recorded. The data collected by the CDC suggest that indigenous measles has been eliminated in the United States. Despite this, cases of measles will continue to arise, as it is not as well controlled in other parts of the world.
INTERNATIONAL INCIDENCE
Cases of measles will continue to arise even in developed nations with a high percentage of vaccinated individuals because of the millions of people still infected worldwide. Vaccination campaigns in many developing nations have fallen short, making measles deaths the most common cause of childhood death from vaccine-preventable disease. In the World Health Report in 2002, the World Health Organization (WHO) reported 30-40 million cases of measles annually, with 745,000 deaths attributable to the virus. In Africa in the 1990s, an estimated 400,000 children died annually from complications related to measles.
MORBIDITY & MORTALITY
The acute child fatality rate in industrialized nations is only 0.1-0.2 percent, compared with a 2-10 percent fatality rate in children in the developing world. The larger incidence of measles in developing nations combined with the higher fatality rate contributes to close to 1 million childhood deaths per year. Conditions possibly (unproven) associated with measles include multiple sclerosis, osteosclerosis (hearing loss), and some autoimmune disorders. Infection with measles has no race predilection. Prevalence is linked to inadequate vaccination in developing countries. Measles infection has no sex predilection. Historically, measles is a disease of childhood and continues to affect children in developing countries. In industrialized nations, infection is seen in unvaccinated individuals of any age or those with waned immunity.
SIGNS & SYMPTOMS
Measles is very contagious and is easily spread through the nose, mouth, or throat; secretions on articles or surfaces; or by coughing and sneezing. It is communicable just before the beginning of the prodromal symptoms, until approximately 4 days following the onset of the exanthem (red rash that appears on the face and behind the ears).
Illness usually sets in between 7 and 14 days (average is 10 to 11 days) after exposure to the virus. The first symptoms include:
- Fever (temperature of 103°F or higher). The fever that occurs with measles is called a stepwise fever. The patient starts with a mild fever that progressively gets higher. Fevers often reach temperatures greater than 103°F (39.5°C).
- Cough.
- Sneezing.
- Runny nose.
- Red eyes that may be sensitive to light.
These symptoms increase in severity up to 3-4 days prior to these symptoms:
- Koplik's spots, also referred to as enanthem, (tiny red spots with white centers) appear in the mouth and throat. These blue-white spots are about the size of kosher salt grains, about the size as a grain of sand and surrounded by a red halo. They appear on the inside of the cheek toward the back of the mouth (buccal mucosa opposite the premolar [first and second upper molar] teeth.
- The throat becomes sore. Although not as common as other symptoms, some patients may have a sore throat.
- A raised red rash (also known as exanthem or exanthema / morbilliform rash) appears 3-5 days after the onset of the initial symptoms (fever, runny nose, cough, and red eyes. These eruptions are seen on the forehead, face and behind the ears. This rash appears as flat to slightly elevated (maculopapular) red rash 0.1-1 cm in diameter that usually last 5 to 6 days. It begins at the hairline and progresses to the face and upper neck.
- Within 24 to 36 hours following the onset of the rash, it spreads and over a period of 5-7 days, the rash spreads to all parts of the body (the trunk and extremities, hands and feet). The rash has mostly distinct lesions, but some may overlap (become confluent). Initially, the color is dark red and reaches its maximum intensity in approximately 3 days. Initially, these lesions will turn white when you press on them (blanch). After 3-4 days, they no longer will blanch. It slowly fades to an purplish hue and then to yellow-brown lesions with a fine scale over the following 5-10 days. As the rash begins to fade, there will often be a fine flaking of the skin (desquamation). The rash fades in the same order that it appears.
The quick summary is an appearance of the signs and symptoms of measles are as follows:Days 0-1: Prodrome begins (initial signs and symptoms).
Days 2-3: Koplik spots appear.
Days 4-5: Morbilliform rash appears.
Day 6: Koplik spots regress.
Days 7-8: Rash is most intense.
Day 10: Rash begins to resolve.
In previously healthy children, measles usually runs its course in about 10 days. However, it can be followed by a number of complications, some of them potentially serious. These include:
- Middle ear infection (especially in children with a history of repeated ear infections).
- Bronchitis.
- Croup.
- Pneumonia.
- Strep throat.
- Encephalitis (in rare cases).
- Meningitis (in rare cases).
Adults who develop measles tend to suffer more serious cases of the disease than children do.
COMPLICATIONS OF RUBEOLA MEASLES
Approximately 30 percent of cases of measles have an associated complication. These complications include diarrhea (8 percent), ear infections (7 percent), pneumonia (6 percent), blindness (1 percent), acute brain inflammation (encephalitis) (0.1 percent), and persistent brain inflammation (subacute sclerosing panencephalitis) (0.0001 percent).
Blindness associated with measles is due to a combination of poor nutrition (specifically vitamin A deficiency) and the measles infection. Prevention is the most effective treatment. In third world countries, post-measles blindness is the leading cause of blindness, with up to 60,000 cases occurring annually.
Acute encephalitis, although rare, is extremely dangerous and results in death in approximately 15 percent of patients who develop it. When it occurs, acute encephalitis generally starts six days after onset of the rash. Symptoms can include fever, headache, vomiting, stiff neck, drowsiness, seizures, and coma.
Subacute sclerosing panencephalitis (SSP) is an extremely rare degenerative condition of the brain and spinal cord (central nervous system). It is believed to be caused by a chronic infection of the central nervous system with the measles virus. Typically, symptoms start years after the patient had measles (average seven years, range one month to 27 years). The patient has a slow and progressive loss of brain function, seizures, and eventually death results. There is no known treatment for SSP.
Most deaths from measles are due to pneumonia in children and encephalitis in adults. There are approximately 2.2 deaths per 1,000 people who get the measles. The people most likely to have complications (including death) are those who are malnourished or who have weakened immune systems (for example, people with AIDS or other conditions that weaken the immune system).
ATYPICAL MEASLES
Atypical measles occurs in people who received the killed measles vaccine (KMV; only used from 1963 until 1967) and who are exposed to wild-type measles virus. The KMV unfortunately sensitizes the patient to the measles virus but does not offer any protection. The disease is characterized by fever, pleural effusions, pneumonia, and swelling of the extremities. The rash of atypical measles is different from measles in that it may have an urticarial component (hives) and usually appears first on the ankles and wrists.
It is recommended by the U.S. Centers for Disease Control and Prevention (CDC) that people who may have received the KMV should receive re-vaccination with the live measles vaccine.
The virus can be isolated in tissue culture in the lab. Blood (serologic) tests are also available.
MODIFIED MEASLES
Modified measles is seen in patients who, because they were unimmunized, received immune globulin after being exposed to a patient with measles. It is also seen occasionally in young infants who have limited immunity from their mothers. The immune globulin prolongs the time from exposure to onset of symptoms (incubation period). When the symptoms do occur, they are much milder than those seen with normal measles and tend to last a shorter period of time.
CAUSES
Measles is caused by the measles virus (a paramyxovirus). Definition of paramyxovirus is it is one of a group of RNA viruses that are responsible predominantly for acute respiratory diseases and are usually transmitted in an airborne manner. The paramyxoviruses include the agents of mumps, measles (rubeola), RSV (respiratory syncytial virus, which mainly afflicts children), Newcastle disease, parainfluenza, Sendai virus and Hendra virus. Many of the paramyxoviruses cause disease in animals such as canine distemper and turkey rhinotracheitis. The genome of paramyxoviruses consists of single-stranded RNA that encodes 6 genes separated from each another by repeated sequences of RNA. The paramyxoviruses replicate, unlike the influenza virus, in the cytoplasm (not in the nucleus) of the host cell. The paramyxoviruses belong to the family Paramyxoviridae. The word "paramyxovirus" is a compound of "para-" + "-myxo-" + "virus. The "-myxo-" is derived from the Greek "myxa" meaning mucus, slime.
The measles virus initially infects the respiratory epithelium and is transmitted via respiratory droplets from the nose, throat, and mouth of someone who is infected with the virus. These droplets are sprayed out when the infected person coughs or sneezes.
It is highly transmissible. Among unimmunized people exposed to the virus, over 90 percent will contract the disease with a general infectivity rate of 76 percent, even greater than that of varicella. The infected person is highly contagious for four days before the rash appears until four days after the rash appears. The measles virus can remain in the air (and still be able to cause disease) for up to two hours after an infected person has left a room. Prior to the measles vaccine, infection with the measles virus was simply considered a part of life.
Anyone who has had measles is believed to be immune for life. People who have received two doses of vaccine after their first birthday have a 98 percent likelihood of being immune. Infants receive some immunity from their mother. Unfortunately, this immunity is not complete, and infants are at increased risk for infection until they receive the vaccination at 12 to 15 months.
PATHOPHYSIOLOGY
Instead of replicating in the respiratory epithelium, as was once thought, replication appears to occur in the regional lymph nodes. Replication in regional lymph nodes eventually leads to viremia. Infection of the endothelial cells ensues, causing an enanthem (Koplik spots). Epithelial cells are also infected, leading to the well-known cutaneous eruption of measles.
The measles virus is a single stranded RNA virus of the genus Morbillivirus and family Paramyxoviridae. Measles virus has 2 membrane glycoproteins called hemagglutinin and fusion. Both of these glycoproteins appear to be important for infection with the measles virus. Hemagglutinin appears to be involved with receptor binding and fusion, with fusion of the virus with host cells. Expression of hemagglutinin activates the alternative complement pathway.
The Edmonston strain of the measles virus and vaccines derived from this strain bind to the cell surface protein CD46, also known as membrane cofactor protein. CD46 is a regulator of the complement activation gene and inhibits activation of the alternative complement pathway. Four isoforms of CD46 exist in humans, and all are capable of binding measles virus.
An additional cellular receptor for the measles virus has recently been identified called SLAM (signaling lymphocyte-activation molecule) or CDw150 expressed on some T and B cells. SLAM is capable of binding strains of the measles virus that also bind CD46 (the Edmonston strain) as well as strains that do not bind CD46 such as the KA strain.
Infection with the measles virus leads to a prolonged immunosuppression, which accounts for much of the morbidity and mortality associated with this disease. Cell-mediated immunity decreases, clinically evidenced by the conversion of positive tuberculin skin test results to negative following infection or vaccination. The mechanism of this immunosuppression is being elucidated.
Following infection with the measles virus, a shift from cell-mediated immunity (a TH-1 response) to humoral immunity (a TH-2 response) occurs. Expression of the TH-2 cytokine interleukin (IL)-2 is increased, supporting antibody formation, and TH-1 cytokines IL-2, IL-12, interferon (IFN)-gamma decrease.
IL-12 is a crucial cytokine for the development of cell-mediated immunity. It is necessary for delayed-type hypersensitivity, induces production of IFN-gamma, and plays a role in activation of T cells and natural killer cells. Karp et al1 found that infection of monocytes, the primary producer of IL-12, with the measles virus via CD46 led to decreased production of this cytokine. Fugier-Vivier et al2 found that activated dendritic cells also had a significant decrease in production of IL-12, leading to proliferation of the measles virus and apoptosis of infected dendritic cells and T cells. These findings support the hypothesis that measles virus infection of antigen-presenting cells plays a critical role in the immunosuppression observed following infection with the measles virus.
Primates are the only hosts for measles virus, and no animal model exists that replicates the clinical findings of measles infection typical in children.
RISK FACTORS
Those people at high risk for measles include:
- Children less than 1 year of age (although they have some immunity passed from their mother, it is not 100% effective).
- People who have not received the proper vaccination series.
- People who received immunoglobulin at the time of measles vaccination.
- People immunized from 1963 until 1967 with an older ineffective killed measles vaccine.
PREGNANCY AND RUBEOLA MEASLES
If you contract measles while you are pregnant, you may have a miscarriage, a stillbirth, or a preterm delivery. There appears to be no risk of having birth defects (unlike an infection with the rubella virus, known as German measles).
DIAGNOSIS
The diagnosis of suspected measles is mostly clinical, meaning that the appearance and history of the patient suggest the diagnosis and historically does not require a diagnostic workup. In a person with known exposure to someone with measles or travel to a foreign country, measles should always be considered when faced with a patient who has high fever and characteristic rash. Given the rarity of measles in the United States, laboratory confirmation of the disease should be sought.
Until the rash appears, the presence of Koplik's spots should help to suggest the diagnosis. Most cases of suspected measles in the United States turn out not to be measles.
LABORATORY STUDIES
It is recommended that the diagnosis be confirmed using a blood test for IgM, a type of antibody against the virus. Although commercial antibody tests are available, any positive results obtained from these tests must be confirmed by the IgM enzyme immunoassay (EIA-IgM) developed by the CDC. This assay has been thoroughly evaluated and is both highly sensitive and highly specific for anti-measles IgM antibodies. The CDC EIA-IgM is the reference test for measles in North America and South America.
If the IgM test is positive, viral cultures should be obtained. The state and local health department should be contacted immediately for any suspected case in order to follow the correct procedures for viral culture and isolation of the patient. Further information on laboratory testing of suspected cases is available from the CDC ( http://www.cdc.gov/vaccines/pubs/surv-manual/downloads/chpt06_measles.pdf).
Other methods of detecting measles infection have also been developed. A radioimmunoassay technique that detects anti-measles IgM antibodies in oral fluids has been used in the United Kingdom. The CDC is currently trying to develop a similar EIA that can detect IgM antibodies in oral fluids rather than requiring blood samples. In addition to simply detecting measles infection, the particular strain of the measles virus can be identified by genotyping the viral RNA to determine its origin.
HISTOLOGIC FINDINGS
Skin biopsy of the fully evolved exanthem of measles is not specific, but the findings can be suggestive of the diagnosis. The histologic findings include psoriasiform epidermal hyperplasia, spongiosis, parakeratosis, and occasional dyskeratotic keratinocytes. Multinucleated keratinocytes (Warthin-Finkeldey giant cells) may be seen. A superficial, perivascular lymphocytic infiltrate associated with variable erythrocyte extravasation is present in the dermis. Multinucleated lymphoid cells containing intranuclear and cytoplasmic inclusions may be observed.
OTHER INFECTIOUS DISEASES THAT RESEMBLE MEASLES
There are a large number of infectious diseases that can cause some of the symptoms of measles. These include, but are not limited to, dengue, drug rashes, enteroviral infections, fifth disease, German measles (rubella), Kawasaki disease, Rocky Mountain spotted fever, roseola, and toxic shock syndrome. It is important that suspected cases be seen by a medical expert and appropriate laboratory tests be ordered.
MoonDragon's Health & Wellness: Hives
CONVENTIONAL MEDICAL TREATMENT
CONVENTIONAL MEDICAL GUIDELINES AFTER EXPOSURE TO RUBEOLA MEASLES
People who have been appropriately vaccinated (or who have had the disease) and who are exposed to a patient with measles do not need to do anything. If an unimmunized person is exposed to a patient with measles, they should receive the vaccine as soon as possible. This may prevent the disease if given within 72 hours of exposure. Immune globulin may have some benefit if given within six days of exposure. The CDC recommends that immune globulin be utilized for household contacts of infected people, immunocompromised people, and pregnant women. It is not recommended that immune globulin be utilized to control a measles outbreak.
CONVENTIONAL MEDICAL TREATMENT GUIDELINES
Treatment for measles generally consists of only supportive care, with particular attention to maintaining good hydration, especially in the developing world. The treatment of patients with measles is mostly focused upon symptom relief. Specific complications like pneumonia may require antibiotics. Patients should be on bed rest until the fever has resolved and should remain well hydrated. Patients should be isolated to prevent spread of the disease. Infected individuals or those suspected to have infection with the live measles virus should be quarantined until they are no longer contagious to prevent spread of the disease to other non-immunized individuals. Consultations can be arranged with a dermatologist or an infectious disease specialist, if needed.
VITAMIN A SUPPLEMENTS
In malnourished patients, vitamin A supplementation is recommended because of the higher rate of blindness following measles. Recently, however, the WHO has also recommended that vitamin A supplementation be given with measles vaccination in the developing world. The impetus behind this recommendation stems from the fact that a precipitous decrease occurs in vitamin A levels, which may already be low in children who are malnourished, at the onset of the exanthem. By giving a bolus of vitamin A with the vaccine, the WHO hopes to attenuate some of the complications (eg, blindness) associated with vitamin A deficiency. Antibiotics are indicated with diagnosed or suspected secondary bacterial infection but are not empirically indicated.
THE VACCINATION - CONVENTIONAL MEDICINE OVERVIEW
Although measles only rarely occurs in the United States, it still does occur and can be fatal. In the year 2000, almost 1 million children died of the disease. Through a very intensive effort by the World Health Organization, this was decreased by 68 percent to only 245,000 in 2006. When the number of vaccinated individuals starts to decrease, we see the disease start to occur more frequently. This occurred from 1989 until 1991 in the U.S. During that period, there were 55,000 cases and 123 deaths from measles in the U.S. Due to a massive public-health effort, almost all children in the U.S. now receive measles vaccine before they are allowed to enter school. The number of cases of measles in the U.S. dropped to only 37 in 2004. Most cases are now from outside the U.S. (commonly from adopted children from China), although some cases occur as people in this country are exposed to the infected international traveler.
The only way to prevent measles is by receiving measles immunization: This is commonly given as a shot containing measles, mumps, and rubella vaccine (MMR) or a shot containing measles, mumps, rubella, and varicella vaccine (MMRV). The MMRV is not recommended for anyone older than age 12 years. The current recommendation is that everyone receives two doses of the vaccine after 1 year of age. If the vaccine is received before 1 year of age, the person should receive two additional doses.
The measles vaccine is also available as a single vaccine; however, in most cases, there is no reason to utilize the measles vaccine alone without mumps and rubella vaccine. The complete schedule of recommended vaccinations is available from the CDC ( http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm).
THE MEASLES VACCINE
HISTORY
Cases of measles were described as early as the seventh century. However, it was not until 1963 that researchers first developed a vaccine to prevent measles. Before the vaccine was made available, almost every child became infected with the virus because it is so easily spread. Before routine vaccination, there were approximately 3-4 million cases of measles and 500 deaths due to measles each year in the United States of America.
There were initially two types of vaccines developed against measles. One was developed from a virus that had been killed, and the other was developed using a live measles virus that was weakened (attenuated) and could no longer cause the disease. Unfortunately, the killed measles virus (KMV) vaccine was not effective in preventing people from getting the disease, and its use was discontinued in 1967. The live virus vaccine has been modified a number of times to make it safer (further attenuated) and today is extremely effective in preventing the disease. The currently used vaccine is a live attenuated vaccine.
PREPARATION
In the United States, the measles vaccine is given in suite with mumps and rubella. Grown in chick fibroblast cell culture, the vaccine contains neomycin, sorbitol, and gelatin. Measles vaccine is both heat sensitive and light sensitive. Once reconstituted, its potency decreases each hour by 50 percent at 22-25°C, and it is completely inactivated at 37°C. This characteristic of the measles vaccine is important to consider both in the United States and abroad and may be responsible for decreased effectiveness of vaccine programs in developing countries with hot climates, particularly in areas where refrigeration may not be available. The measles vaccine should be stored at 2-8°C (35.6-46.4°F) and protected from light exposure. Once it has been reconstituted, the vaccine should be discarded after 8 hours.
VACCINE-RELATED EPIDEMIOLOGY
In the pre-immunization era, approximately 130 million cases of measles and 7-8 million measles-related deaths occurred around the world each year (child mortality rate, 7 percent). However, by 1991, 80 percent of the world's children were immunized by age 1 year, and an estimated 1 million lives are saved annually with immunization. Despite this marked improvement, the WHO estimated that, in 1994, 45 million cases of measles and 1.19 million measles-related deaths still occurred, primarily in the developing world. Before the advent of the vaccine, measles primarily affected preschool-aged and young school-aged children. In the postvaccine era in industrialized nations, the age of children affected by measles has increased. By 1980, 60 percent of all cases of measles occurred in children older than 10 years. In developing countries, a different trend has been observed. The age of children infected has decreased, likely because the passive immunity from the mother wanes earlier in these countries.
VACCINE SCHEDULE
The difference in the age of children at risk for measles in the developed world versus the developing world has led to unique vaccination schedules aimed at serving the needs of these different communities. Although the best time for vaccination is debated, the following schedules are generally used: 2 doses in industrialized nations at age 12-15 months and age 11-12 years and 3 doses in developing countries starting at age 6-9 months, then at age 15 months, and repeated again upon entry into kindergarten.
One of the major complications with giving the vaccine at such an early age in the developing world is that the child may still have circulating antibodies from the mother. These antibodies can bind vaccine antigen prior to stimulating the child's own immune response and result in primary vaccine failure. Once this passive immunity wanes completely, the child has no protection against infection. This complication led health officials to recommend repeating the injection at age 15 months. Nonetheless, infection can occur within this window.
In industrialized nations, this schedule should be changed in some instances. For example, during outbreaks of measles in the United States or if an infant is traveling to an area where measles is endemic, the child should be vaccinated as young as age 6 months and then the regular schedule for industrialized nations should be followed.
Another indication for the vaccine is post-exposure prophylaxis. Some evidence suggests that the vaccine may provide protection in susceptible persons exposed to the virus if the vaccine is given within the first 72 hours of known exposure. The measles vaccine, although live, is not communicable. Therefore, vaccination in all persons in contact with individuals who are immunocompromised is important in preventing the spread of natural disease to these patients.
VACCINE EFFICACY
Antibody titers following vaccination are lower than those following natural disease. However, 93 percent of children vaccinated at age 12 months and 98% of those vaccinated at age 15 months develop immunity to measles. Furthermore, more than 99 percent of children who receive 2 doses of the vaccine at least 1 month apart and after 12 months develop an appropriate response. Protective titers can last as long as 16 years.
DRUG CATEGORY: VACCINES, VIRAL
The greatest advance against measles in the last 30 years has certainly been in prevention rather than treatment. The measles virus was first isolated in 1954 by Enders and Peebles, and the first live-attenuated vaccine, the Edmonston B strain, became available in the mid-to-late 1960s. The Moraten strain is the attenuated measles virus used in the United States today.
Drug Name Measles virus vaccine, live attenuated (Attenuvax) Description For anyone born in or after 1957 without documentation of live vaccine immunization on or after his or her first birthday. Adult Dose 0.5 mL SC in outer aspect of upper arm. Pediatric Dose Less Than 15 months: Not established
More than 15 months: Administer as in adults.Contraindications Documented hypersensitivity (contraindicated in individuals with life-threatening allergic reactions to neomycin and gelatin; patients who are immunocompromised; within 3 months of cessation of immunosuppressive drugs; thrombocytopenia purpura with previous measles vaccine; tuberculin skin test (PPD results can be falsely negative up to 6 weeks following measles vaccination); children who are allergic to eggs (generally considered safe even in individuals with egg allergy [discuss with your health care provider]); not recommended during or 3 months prior to pregnancy, although no evidence of harm to fetus or mother has been documented. Interactions Corticosteroids and other drugs that suppress immune system may diminish response to immunization. Pregnancy X - Contraindicated in pregnancy. Precautions Contraception in females is advised for 3 months following immunization; not indicated for patients who are immunocompromised; skin testing of children allergic to eggs prior to vaccination is unreliable.
Adverse reactions include fever more than 103°F (39.4°C) 5-10 days following vaccine (10 percent), transient rash (5-15 percent), thrombocytopenia (occurs in 1 per 30,000-40,000 persons and is usually subclinical but may cause purpuric lesions), and encephalitis/encephalopathy (rare, less than 1 case per 1 million vaccinations).
Defer vaccination for at least 3 months following blood or plasma transfusions or the administration of immune globulin; caution in history of cerebral injury, individual or family history of convulsions, or any condition in which stress due to fever should be avoided; should ensure that injection does not enter blood vessel; recent review of available data suggest that subacute sclerosing encephalopathy can be seen with measles infection, but not seen with vaccine.
Before deciding to use any vaccine for immunization, do your research and explore the pros and cons of using vaccinations. Become an informed consumer and investigate all your options.
COMPLICATIONS OF MEASLES
The complications of measles are generally more common and more severe in developing countries. The most common fatal complication of measles is dehydration secondary to diarrhea. Other complications associated with measles include pneumonia, malnutrition, gangrenous stomatitis (noma), vitamin A deficiency (leading to corneal ulceration and blindness), and immunosuppression (increasing children's susceptibility to other diseases).
Acute complications include diarrhea, pneumonia, laryngotracheal bronchitis, otitis media, malnutrition, gangrenous stomatitis (noma), vitamin A deficiency (leading to corneal ulceration and blindness), and acute encephalitis.
Late complications include immunosuppression and subacute sclerosing panencephalitis.
MEDICAL & LEGAL PITFALLS
Failure to report suspected cases of measles to local and/or state health departments is a pitfall. All suspected cases of measles should be reported to the local and/or state health departments, and a blood sample from the patient should be obtained for confirmatory testing for measles EIA-IgM antibodies.
Failure to report any adverse reactions to vaccination is a pitfall. Any adverse reactions to vaccination should be reported to the CDC. A Vaccine Adverse Event Report Form can be obtained by calling 1-800-822-7967.
SPECIAL CONCERNS
Complications in pregnancy include premature delivery, fetal loss, and increased risk of maternal death. No apparent association exists between MMR (measles, mumps, and rubella) vaccination and autism or other autistic disorders. No well-established association exists between MMR vaccination and the incidence of inflammatory bowel disease.
According to the CDC, there is no valid scientific evidence that the measles vaccine, or any other vaccine, is the cause of autism. The possibility of an association between the measles vaccine and autism was proposed by Andrew Wakefield and colleagues in 1998. The research published by Wakefield was found to be flawed, and the results have not been able to be repeated by other researchers. Since 1998, there have been numerous studies that have examined for such an association. None of these studies have shown any risk of autism associated with the use of the vaccine. A recent study performed in Japan after the MMR vaccine was removed from the market showed that autism continued to increase after the vaccine was no longer being utilized. Although autism is a very serious disease that warrants good research to find out its many causes, not obtaining vaccinations is potentially dangerous and not supported by the best scientific data available today.
VACCINE CONTRAINDICATIONS
The following groups of people should not receive measles vaccinations:
- People who have suffered a severe allergic reaction to either the measles vaccine or its components (gelatin or neomycin) should not receive the vaccine.
- Women known to be pregnant should not receive the vaccine. Pregnancy should be avoided for four weeks after vaccination.
- Severely immunocompromised patients (cancer patients or patients who are receiving large doses of corticosteroids) should not receive the vaccine. However, those leukemia patients who have been in remission for three months may receive the MMR.
- Patients with severe human immunodeficiency virus (HIV) infections should not receive the vaccine. However, asymptomatic patients with HIV are considered to be safe for vaccination. The CDC has issued guidelines for vaccination based on the CD4+ T-lymphocyte counts.
- People with a moderate to severe acute illness should wait until their illness resolves before receiving the vaccine.
- Patients with history of thrombocytopenic purpura or thrombocytopenia (low platelets) may be at increased risk, and immunization should be decided on a case-by-case basis.
EGG ALLERGIES & THE MEASLES VACCINE
Although the measles vaccine is made using chick embryos, there is no evidence of increased reactions in people with an egg allergy. Therefore the CDC recommends giving MMR vaccine to egg-allergic children without any prior skin testing or the use of special protocols.
VACCINATION ADVERSE REACTIONS
Adverse reactions to measles vaccination (as part of the MMR) include fever (5-15 percent), rash (5 percent), joint aches (5 percent), and low platelet count (thrombocytopenia; one instance per 30,000 doses). In adult women, up to 25 percent will suffer joint pain that is due to the rubella component of the vaccine. The fever usually occurs seven to 12 days after the vaccination, and the rash occurs seven to 10 days after vaccination.
CDC RE-VACCINATION RECOMMENDATIONS
The following group of people should be considered unvaccinated and should receive at least one dose of vaccine:
- People vaccinated before their first birthday should be re-vaccinated.
- Anyone known to have been vaccinated with the killed measles vaccine (KMV) should be re-vaccinated.
- Anyone vaccinated with KMV who received their dose of live measles vaccine with four months of their last dose of vaccine should be re-vaccinated.
- Anyone vaccinated before 1968 in whom it is not known if the vaccine was KMV or not should be re-vaccinated.
RESOURCES
1. http://wwwn.cdc.gov/travel/yellowBookCh4-Measles.aspx
2. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/meas.pdf
3. http://www.cdc.gov/vaccines/pubs/surv-manual/downloads/chpt06_measles.pdf
4. http://www.who.int/mediacentre/factsheets/fs286/en/
5. http://www.who.int/vaccines-documents/GlobalSummary/GlobalSummary.pdf
6. http://www.immunize.org/catg.d/p2065.pdf (autism)
CONSIDERATIONS
Health care providers recommend that children receive two measles vaccinations, the first at the age of about 15 months and the second either before entering school or at approximately 12 years of age. A second vaccination is now considered necessary because there have been outbreaks of measles among college students who received a single immunization in childhood. However, certain individuals should not be immunized against measles, including pregnant women and anyone who has cancer or a weakened immune system, is on cortisone or anticancer drugs, is undergoing radiation therapy, or has any type of illness with fever. People who are allergic to eggs should mention this to their health care provider prior to having the vaccine. A person who has had and recovered from measles does not require immunization; a single attack of measles gives lifelong immunity to the disease.
Short-term, high doses of Vitamin A have been used to lessen the severity and complications of measles. Since high doses of Vitamin A can be toxic, high dosages of this vitamin should be taken only for brief periods (2 weeks or less) and should be monitored very carefully.
Antibiotics are useless against viruses, so they are not called for unless complications occur.
DIETARY & LIFESTYLE RECOMMENDATIONS
DIETARY
If you suspect that you or a family member has measles, see your health care provider. This is important for a correct diagnosis and to prevent serious complications.
Drink plenty of fluids such as water, juice, herbal teas and vegetable broths to prevent dehydration.
Avoid processed foods.
To help relieve coughing, mix 1 tablespoon lemon juice and 2 tablespoons honey with 1/4 cup water. Take as needed. Note: Do not give raw honey to children under 1 year old.
To alleviate itching, place 1/2 cup of baking soda in a bathtub filled with lukewarm water and soak in the bath until the itching decreases. Gently applying witch hazel to the affected area also will help to ease the discomfort and itching associated with the rash.
Try using homeopathic remedies to ease symptoms.
Aconitum Napellus (homeopathic Monkshood) is the homeopathic version of Vitamin C in that it is helpful in the initial stage of measles.
Herbal Remedies: Aconite Homeopathic Clikpak, 30C, 84 Pellets
Ferrum Phosphoricum (homeopathic phosphate of iron) is beneficial for mild infections.
Herbal Remedies: Ferrum Phos, Hyland's Homeopathic Cell Salts, 6X #4, 500 Tabs
Rest until the rash and fever have disappeared.
Keep the lights dim. Do not read or watch television while your eyes are sensitive to light.
Do not send a child who has measles to school until 7-9 days after the fever and rash have disappeared.
HELPFUL VITAMINS & OTHER NUTRITIONAL SUPPLEMENTS
VITAMIN A: Vitamin A is the anti-infection vitamin and helps prevent blindness associated with measles in malnourished children. If used properly and in moderate doses, Vitamin A is rarely toxic and is very important in the body's defense system. See Nutrition Basics - Vitamin A for more information and Nutrients (below) for dosage recommendations.
Herbal Remedies: Vitamin A, 10,000 IU, 100% Natural, Nature's Way, 100 Softgels
Herbal Remedies: Beta Carotene (Natural Dunaliella Salina), Nature's Way, 100% Natural, 25,000 IU, 100 Softgels
Herbal Remedies: Multi-Carotene Antioxidant, Nature's Way, 60 Softgels
VITAMIN C: Vitamin C may be the single most important vitamin for the immune system. It is essential for the formation of adrenal hormones and the production of lymphocytes. It also has a direct effect on bacteria and viruses. Vitamin C should be taken with bioflavonoids, natural plant substances that enhance absorption and reinforce the action of this vitamin. See Nutrition Basics - Vitamin C for more information and see Nutrients (below) for dosage recommendations.
Herbal Remedies: Vitamin C Liquid w/ Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, Dynamic Health, 1000 mg, 16 fl. oz.
Herbal Remedies: Ester C With Bioflavonoids, Nature's Way, 1000 mg, 90 Tabs
Herbal Remedies: Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 VCaps
Herbal Remedies: The Right C, Nature's Way, 1000 mg, 120 Tabs
VITAMIN E: Vitamin E interacts with Vitamins A and C and the mineral Selenium, acting as a primary antioxidant and scavenger of toxic free radicals. Vitamin e activity is an integral part of the body's defense system. See Nutrition Basics - Vitamin E for more information and see Nutrients (below) for dosage recommendations.
Herbal Remedies: Ester E Natural Vitamin E, California Natural, 400 IU, 60 Softgels
Herbal Remedies: Vitamin E, 400 IU, 100% Natural, NOW Foods, 100 Gels
Herbal Remedies: Vitamin E-1000, NOW Foods, 1000 IU, 100 Gels
Herbal Remedies: Vitamin E, d-alpha-tocopherol, 400 IU, 100 Softgels
ZINC: Zinc boosts the immune response and promotes the healing of wounds when used in appropriate doses 100 milligrams (mg) or less daily). It also helps to protect the liver. Doses over 100 mg per day may actually depress immune function, however. See Nutrition Basics - Zinc for more information and see Nutrients (Below) for dosage information.
Herbal Remedies: Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz.
Herbal Remedies: Colloidal Silver & Zinc Lozenges, Silva Solution, 90 Lozenges
Herbal Remedies: Zinc Lozenges W/ Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges
Herbal Remedies: Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz.
Herbal Remedies: Zinc (Chelated), 100% Natural, Nature's Way, 30 mg, 100 Caps
Include in your diet chlorella, garlic, and pearl barley. These foods contain germanium, a trace element beneficial for the immune system. Also add kelp to the diet, in the form of giant red kelp or brown kelp. Kelp contains iodine, calcium, iron, carotene, protein, riboflavin, and vitamin C, which are necessary for the immune system's functional integrity.
Herbal Remedies: Kelp Supplement, Nature's Way, Certified, 650 mg, 100 Caps
Herbal Remedies: Kelp Seaweed, Norwegian, NOW Foods, 100% Natural, 550 mg, 250 Caps
Herbal Remedies: Kelp Seaweed, Norwegian Powder, 4 oz. Bulk
Herbal Remedies: Garlic Information & Products
Herbal Remedies: Chlorella Information
Herbal Remedies: Chlorella Products & Supplements
Consume "green drinks" daily. Invest in a juicing machine and make your own fresh, live juices every day. Drink beet juice (from roots and greens), carrot juice (a source of beta-carotene), fresh cabbage juice, and asparagus juice often. Grape, black cherry, and all dark-colored juices are good, as are black currants. Also beneficial is apple juice, if it is fresh. Fruit juices are best taken in the morning, vegetable juices in the afternoon.
HERBAL RECOMMENDATIONS
Catnip tea or Garlic enema can be used to help lower fever if necessary.
Herbal Remedies: Catnip Information
Herbal Remedies: Catnip Supplements & Products
Herbal Remedies: Garlic Information
Herbal Remedies: Garlic Supplements & Products
Lobelia as an extract (tincture) helps to relieve pain. Take 1/2 teaspoon of lobelia extract every 4 to 5 hours (be sure to adjust dosage for age of child - see Nutrients (below) for dosage instructions).
Herbal Remedies: Lobelia Information
Herbal Remedies: Lobelia Supplements & Products
Spirulina is helpful for bolstering the immune system and can help slow replication of the virus.
Herbal Remedies: Spirulina, 100% Organic, NOW Foods, 500 mg, 120 VCaps
Herbal Remedies: Spirulina Powder, 100% Natural, NOW Foods, 1 lb.
Herbal Remedies: Spirulina Natural, Earth Rise, 500 mg, 180 Tabs
Herbal Remedies: Spirulina Natural Green Super Food For Longevity, Earth Rise, 500 mg, 360 Tabs
NUTRITIONAL SUPPLEMENT RECOMMENDATIONS
The following nutrients are important for healing once appropriate local treatment has been administered. Unless otherwise specified, the following recommended doses are for those over the age of 18. For a child between 12 and 17 years old, reduce the dose to 3/4 the recommended amount. For a child between 6 and 12 years old, use 1/2 the recommended dose, and for a child under 6, use 1/4 the recommended amount.
NUTRIENTS Supplement Suggested Dosage Comments Helpful Bio-Strath As directed on label. Acts as a tonic. Contains the Vitamin B complex. Use the liquid form. Calcium As directed on label. Needed for tissue repair.
Calcium Ionic Mineral Supplement, Fully Absorbable, 700 +/- ppm, 16 fl. oz.,
Liquid Calcium W/ConcenTrace, Orange Vanilla, Trace Minerals, 1000 mg, 32 fl. oz.,
Cal-Mag Pre-Chelated Calcium & Magnesium, Vital Earth, 240 GelcapsMagnesium As directed on label. Needed for tissue repair and to balance calcium.
Magnesium Ionic Mineral Supplement, Fully Absorbable, 350 +/- ppm, 16 fl. oz.,
Just An Ounce Calcium & Magnesium Liquid, Almond Flavor, 16 fl. oz.,
Calcium & Magnesium Mineral Complex, 100% Natural, Nature's Way, 500 mg / 250 mg, 250 CapsOr
Micellized Vitamin A Emulsion
(American Biologics)As directed on label. If you are pregnant, do not exceed 10,000 IU daily. For adults. Needed to reduce infection and to repair tissues. Or
Vitamin A10,000 IU twice daily for 1 week, then reduce to 10,000 IU once daily. Do not exceed this dosage for children. If you are pregnant, do not exceed 10,000 IU daily. Needed for tissue repair and proper immune function and prevent blindness in children with rubeola measles.
Vitamin A, 10,000 IU, 100% Natural, Nature's Way, 100 SoftgelsPlus
Natural Beta-Carotene
In With
Carotenoid ComplexAs directed on label. Powerful antioxidants, free radical scavengers, and immune enhancers.
Beta Carotene (Natural Dunaliella Salina), Nature's Way, 100% Natural, 25,000 IU, 100 Softgels,
Multi-Carotene Antioxidant, Nature's Way, 60 SoftgelsOr
Cod Liver OilAs directed on label. For children or adults unable to swallow tablets or capsules.
Barlean's Fishery's Cod Liver Oil, Fresh Catch, Lemonade Flavor, 8 fl. oz.,
Cod Liver Oil, Great Tasting Strawberry Flavor, 8 fl. oz.Proteolytic Enzymes As directed on label 2-3 times daily, between meals. Reduces infection and aids digestion. Powerful free radical scavengers. To aid in proper breakdown of proteins, fats, and carbohydrates for better absorption of nutrients.
MetabolicZyme (Hypoallergenic), Allergy Research Group / Nutricology, 900 Tabs,
Plant Enzymes, NOW Foods, Vegetarian, 120 VCaps,
Enzymes, All Complete, 250 mg, 90 CapsGarlic (Kyolic) 2 capsules 3 times daily. Stimulates the immune system.
Garlic Oil Tincture, Alcohol Free, Nature's Way, 1 fl. oz.,
Garlic Bulb Cloves, Garlic Supplement, Nature's Way, 580 mg, 100 Caps,
Odorless Garlic Supplement, NOW Foods, 50 mg, 250 SoftGels,
Garlic Supplement, Kwai, Triple Concentrated, 180 Tabs,
Every Day Garlic Supplement, Kwai, 30 Tabs,
Garlic Tincture, 100% Organic, 2 fl. oz.,
Aged Garlic Extract, Cardiovascular Formula 100, Wakunaga Kyolic Supplements, 300 Caps,
Kyolic Liquid Aged Garlic Extract, Cardiovascular, Vegetarian, Wakunaga Kyolic, 4 fl. oz.,
Kyolic Aged Garlic Extract, One-A-Day, Vegetarian, 1000 mg, Wakunaga Kyolic, 30 Caps,
Aged Garlic Extract, Cholesterol Formula 104, Wakunaga Kyolic, 200 CapsOr
"Green Drinks"
Fresh Wheatgrass Juice
Such as Kyo-Green from WakunagaAs directed on label. To supply chlorophyll and important nutrients needed for tissue repair, and cleanses the blood. Important in immune response. Wheatgrass is used to for the treatment of cancer in many cancer clinics.
Wheatgrass Supplements & ProductsRaw Thymus Glandular 500 mg twice daily. Stimulates the immune system. See Gland Therapy.
Thymus Organic Glandular (Hypoallergenic), Allergy Research Group/Nutricology, 75 CapsVitamin B Complex 100 mg of each B vitamin daily, with meals 3 times daily (amounts of individual vitamins in a complex will vary). Important in all body functions, including immune response and proper healing. For a child under 8, use a formula designed for children.
Vitamin B-12 Complex Liquid, NOW Foods, 2 fl. oz.,
Ultimate B (Vitamin B Complex), Nature's Secret, 60 Tabs,
Vitamin B-100 Complex, w/ Coenzyme B-2, Nature's Way, 631 mg, 100 CapsPlus
Raw Liver ExtractAs directed on label. A good source of B vitamins and iron. Consider injections (under a health care provider's supervision). Vitamin C With Bioflavonoids Adults: 3,000-10,000 mg daily, in divided doses.
Children: 1,000-3,000 mg daily in divided doses.Very important for immune function. Fights fever and infection. Has antiviral properties. Use an ascorbate or esterified form.
Vitamin C Liquid w/ Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, Dynamic Health, 1000 mg, 16 fl. oz.,
Ester C With Bioflavonoids, Nature's Way, 1000 mg, 90 Tabs,
Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 VCaps,
The Right C, Nature's Way, 1000 mg, 120 TabsVitamin E 200 IU daily or 400 IU every other day. Children's dosage should not exceed 200 IU daily. Neutralizes harmful free radicals, which can destroy cell membrane. Use d-alpha-tocopherol form.
Ester E Natural Vitamin E, California Natural, 400 IU, 60 Softgels,
Vitamin E, 400 IU, 100% Natural, NOW Foods, 100 Gels,
Vitamin E-1000, NOW Foods, 1000 IU, 100 Gels,
Vitamin E, d-alpha-tocopherol, 400 IU, 100 Softgels
Zinc 1 15-mg lozenge 3 times daily for 4 days. Then reduce to 1 lozenge daily. For immune response and tissue repair. Reduces symptoms and speeds healing. Also relieves itchy throat and coughing.
Zinc Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz.,
Colloidal Silver & Zinc Lozenges, Silva Solution, 90 Lozenges,
Zinc Lozenges W/ Echinacea & Vitamin C, Nature's Way, 23 mg, 60 Lozenges,
Zinc (Chelated), 100% Natural, Nature's Way, 30 mg, 100 Caps
MEASLES SUPPLEMENTS & PRODUCTS
Information, supplements and products for measles, a viral infection that attacks the respiratory system, eyes, and skin.
AHCC (Active Hexose Correlated Compound), NOW Foods, Vegetarian, 500 mg, 60 VCaps
NOW Foods AHCC is a rich source of polysaccharides such as beta glucan 1,3 and activated hemicellulose produced by enzymatic modification of organic medicinal mushrooms, including shiitake.AHCC (Active Hexose Correlated Compound), NOW Foods, Vegetarian, 750 mg, 60 Caps
AHCC (Active Hexose Correlated Compound) is a proprietary extract produced from specially cultivated and hybridized mushrooms. AHCC supports immune system function through its effects on macrophages and NK (Natural Killer) Cells. NK cells and the intercellular mediators they produce are critical for the maintenance of healthy cell cycle function. AHCC has also been shown to possess antioxidant properties, and supports healthy liver function.AHCC 100% Pure Powder, NOW Foods, 2 oz.
AHCC (Active Hexose Correlated Compound) is a proprietary extract produced from specially cultivated and hybridized mushrooms. According to extensive research in humans, as well as numerous non-clinical studies, AHCC supports immune system function through its effects on macrophages and NK (Natural Killer) Cells.Barley Grass Tincture, 2 fl. oz.
Super Greens like Barley Grass help with digestion, elimination, detoxification, internal cleansing, tissue repair, skin problems and healing.Bio Defender, Antibacterial, Antiviral & Antifungal Formula, Balanceuticals, 56 Caps
This unique antibacterial, antiviral and antifungal formula is a clinical nutritionist response to bio terrorism such as anthrax.Catnip Herb, Nature's Way, 380 mg, 100 Caps
Nature's Way Catnip Herb is certified organically grown by Trout Lake Farm, Washington.Chamomile Tincture, 100% Organic, 2 fl. oz.
Chamomile is a gentle relaxer that soothes upset stomaches and gas pain.Colloidal Silver Generator Kit, 1 Each
Colloidal Silver Generator is used to make your own colloidal silver, a natural suspended liquid silver supplement, at a low cost.Colloidal Silver, Liquid Silver Homeopathic Formula, SilvaSolution Advanced Immune System Activator For Colds and Flu, 8 fl. oz.
TriMedica SilvaSolution Advanced Liquid Silver Homeopathic Formula integrates the basic principles of homeopathy and is a profound healing system designed to increase the body's ability to respond to immune challenges and restore optimal health.Colloidal Silver Liquid, SilvaSolution Super Strength Pro 50, 8 fl. oz.
Colloidal Silver Super Strength Liquid provides for a strong immune system, ears, sinuses, throat and lung support for the winter season.Colloidal Silver Salve, SilvaSolution, 2 oz.
SilvaSolution Colloidal Silver Salve now contains added homeopathics that add a benefit that will enhance the SilvaSolutions effectiveness.Colloidal Silver, Trace Minerals, 8 fl. oz.
Trace Minerals Super Oxygenated Pure Colloidal Silver Supplement is in a Fast Absorbing Liquid Formula. Colloidal Silver is a dietary supplement with over 30 ppm per dose of pure Colloidal Silver.Colloidal Silver & Zinc Lozenges, SilvaSolution, 90 Lozenges
Now you can get powerful liquid silver in the most convenient form ever with new SilvaSolution Silver and Zinc Lozenges.Daily Maintenance Group (For Infants & Children), Children's Nutrition Supplement Kit (Multi-Vitamin & Mineral, Essential Fatty Acids, Colostrum With Probiotics, Vitamin C)
The Daily Maintenance Group provides all the essential nutrients needed on a daily basis for healthy growth and development.Effer-C Instant Fizzy Vitamin C Drink Mix Powder, Cranberry, NOW Foods, 1000 mg, 36 0.3 oz Packets
Effer-C Instant Fizzy Vitamin C Drink Mix Powder, Lemon Lime, NOW Foods, 1000 mg, 36 0.3 oz Packets
Effer-C Instant Fizzy Vitamin C Drink Mix Powder, Orange, NOW Foods, 1000 mg, 36 0.3 oz Packets
Effer-C Instant Fizzy Vitamin C Drink Mix Powder, Raspberry, NOW Foods, 1000 mg, 36 0.3 oz Packets
Effer-C Instant Fizzy Vitamin C Drink Mix Powder, Punch Flavor, NOW Foods, 1000 mg, 36 0.3 oz Packets
This excellent tasting fizzy Vitamin C drink mix is for Energy & Immune System Support, select orange, raspberry, punch or cranberry flavor.Elderberry Juice Concentrate, 12.5 fl. oz.
Elderberry Juice Concentrate is a Non-Alcoholic source for the health benefits of Elderberries. A medically proven strong anti-viral and immune system enhancer, elderberry is recommended as part of a health maintenance program.Enzymes, All Complete, 250 mg, 90 Caps
All Complete Enzymes, dietary supplement, is an important combination of critical enzymes that help support normal digestive function, cholesterol levels, fat metabolism and more, all in one convenient tablet.Every Day Garlic Supplement, Kwai, 30 Tabs
Kwai Every Day. Safety & Effectiveness. Kwai Every Day is recognized in the world's foremost medical journals because Kwai has the quality and the research to prove its effectiveness and safety. Kwai Every Day is the most scientifically proven and professionally recommended garlic supplement with allicin in the world.First Defense Homeopathic Formula For Children, 4 fl. oz.
A complete and effective natural broad spectrum anti-infective formula available for infants and children. Completely safe and non-toxic for infants and children of all ages. A homeopathic Formula.Ginger Root Tincture, 100% Organic, 2 fl. oz.
Ginger root has also been recommended as a treatment for atherosclerosis, migraine headaches, rheumatoid arthritis, high cholesterol, burns, ulcers, depression, impotence, and liver toxicity.Ginger Tea, Yogi Tea, Organic Digestive Aid, 16 Tea Bags
Our 100% Organic Ginger tea by Yogi Tea has something to offer to anyone who wants to get or stay healthy.Grapefruit Seed Extract Plus, 125 mg, 90 Caps
NutriBiotic Grapefruit Seed Extract Plus Capsules contain 125 mg of grapefruit seed extract, equivalent to 12-15 drops of NutriBiotic GSE liquid concentrate, combined with the extracts of echinacea and artemisia annua.Green Super Food Powder, 8 oz.
Green Super Food drink powder - mix Green Super Food powder with water, juice or your favorite smoothie. 25 Enzyme Rich Power Plant Super Foods Formulated in a Great Tasting Blend!Green Tea & Apple Blossom Daily Tea, Republic of Tea, 50 Tea Bags
Green Tea & Apple Blossom is enriched with the crisp tart-sweet flavor of apples and the floral note of fruit blossoms. This tea has traveled far to protect the body and mind.Green Tea & Kiwi Pear Daily Tea, Republic of Tea, 50 Tea Bags
This green herbal kiwi pear tea is luscious with the naturally sweet flavor of ripe pears and tropical tang of kiwi.Green Tea & Wild Berry Plum Tea, Republic of Tea, 50 Tea Bags
This deep flavored green tea is buoyant with the nectar of sweet wild berries and balanced with the tart flavor of ripe plums.Irwin Naturals Immuno Shield, Immune System Support, 100 GelCaps
Supports overall strength of the immune system. This potent multi-herb complex addresses two key areas, immune support and bacterial/viral control.Kids SuperFood Powder, Children's Supplement, Chocolate Flavor, 200 g
The SuperFood Children's Supplement has 33 fruits and vegetables with a healthy scoop of cocoa to bring a new and tasty way for kids to get the anti-oxidant power of 3 servings of fruits and vegetables in one glass.Lactobacillus Acidophilus, Kosher Liquid, All Natural, Vegetarian Medium, Lactose-Free, Apple Strawberry Flavor, Dynamic Health, 16 fl. oz.
Beneficial bacteria, such as Lactobacillus Acidophilus and Bifidobacterium bifidum, are called probiotics, available in a liquid Lactobacillus Acidophilus from Dynamic Health.Lung Formula, Supports Proper Lung Function, Banyan Botanical, 90 Tabs
Lung Formula is a rejuvenating tonic designed to strengthen and support the respiratory system. This synergistic blend of herbs nourishes the lung tissue and bolsters the body's natural defenses against allergies, infections, disorders caused by smoking, or the deleterious effects of air pollution.Meta C Vitamin C Supplement, 1000 mg, 100 Tabs
Meta C Vitamin C Supplement is a unique form of vitamin C that is absorbed faster than regular vitamin C and maintains higher serum levels for longer period of time with no intestinal discomfort.NutriBiotic Hand & Body Lotion, With Grapefruit Seed Extract & Aloe Vera, 8 fl. oz.
Hand & Body Lotion has been laboratory proven to kill up to 99.9% of bacteria within 1 minute after application.Ola Loa, All Natural Hydrating Sports Drink, Mango Tangerine, 30 Packets
Ola Loa, All Natural Hydrating Sports Drink, Mixed Berry, 30 Packets
Ola Loa Sport is an all natural thirst-quenching, hydrating drink created for people who want to lead healthy, active lives.Ola-Loa Children's Multi-Vitamin Drink Mix, Cran-Raspberry, 30 Packets
Better your kids health by introducing them to this Child Multi-Vitamin based upon the most up-to-date studies on nutrition and child development and is 100% all-natural.Peter Gillham's Liquid Organic Life Vitamins, 32 fl. oz.
Organic Life Vitamins is a power-packed premium formulation that supplies the body with the essential nutrients it requires-missing as a result of deficient diets and the stresses of today's busy lifestyles. It is easy to take and tastes great!Propolis Throat Spray, 1.05 fl. oz.
Propolis Throat Spray combines the antibacterial and anaesthetic properties of bee propolis with essential oils of aniseed, peppermint, clove and myrrh to provide a refreshing oral hygiene spray and breath freshener.Respiratory Support, Respiratory Supplement, TheraVeda Pavan, 60 VCaps
TheraVeda's Respiratory supplement provides the benefits of both supercritical extracts and whole herbs in an innovative, paten-pending technology that uses no harmful chemical solvents.Sambucol For Kids, Elderberry Formula, 4 fl. oz.
Sambucol for Kids supports the immune system, and is especially popular during the winter season. Sambucol black elderberry extract has been used by million of people with positive results being reported worldwide.Sambucol Immune System Formula, 30 Lozenges
Sambucol Immune System Formula Lozenges support your natural defenses, and are especially popular during the winter season. Sambucol black elderberry extract has been used by millions of people with positive results being reported worldwide.Sambucol Immune System Formula With Elderberry & Echinacea, 7.8 fl. oz.
Sambucol Immune System Elderberry Formula supports your natural defenses against the Flu, and Colds, and is especially popular during the winter season.Silver Ionic Mineral Supplement, Fully Absorbable, 100 +/- ppm, 16 fl. oz.
WaterOz Ionic Silver is a pure liquid Silver supplement. Silver is a food supplement that has a long history of use in health care. It is believed that silver may support the immune system as a systemic disinfectant.Spirulina Digest & Flora, 180 Caps
Provides an all-inclusive proprietary formula to support gastrointestinal function, antioxidant protection and immunity.Spirulina Green Blends Cleansing Formula Powder, 7.4 oz.
Earthrise Green Blends Cleansing Formula is a Spirulina-based green food that contains five key ingredients to help detoxify the body naturally.Spirulina, 100% Organic, NOW Foods, 500 mg, 120 VCaps
Spirulina helps protect the immune system, reduce cholesterol, aid in the absorption of minerals and has been used in the treatment of diabetes, glaucoma, liver pathologies, cancer, increasing neurotransmitter formation, and it acts as an appetite suppressant.Spirulina Immune System Modulator, Spirulina IL-4, 180 Caps
A human clinical study shows that Earthrise Spirulina IL-4 is high in Zinc, Vitamin C and Phycocyanin reduces IL-4 (Interleukin-4), the mediator of IgE (Immunoglobulin E) production.Spirulina Natural, 500 mg, 180 Tabs
Earthrise Spirulina Natural is a concentrated source of antioxidants and total carotenoids which help protect the body from damaging effects of free radicals.Spirulina Natural Powder, 6.3 oz.
Earthrise Spirulina Natural is a concentrated source of antioxidants and total carotenoids which help protect the body from damaging effects of free radicals.Spirulina Powder, 100% Natural, Vegetarian, NOW Foods, 1 lb.
Spirulina helps protect the immune system, reduce cholesterol, aid in the absorption of minerals and has been used in the treatment of diabetes, glaucoma, liver pathologies, cancer, increasing neurotransmitter formation, and it acts as an appetite suppressant.Super Strength FarmFresh Colostrum Chewables, Natural Vanilla Flavor, 480 mg, 60 Chews
Colostrum known for its powerful healing factors offers optimal health. Colostrum research proves a wide spectrum of immunoglobulins, antibodies, and accessory immune factors.Thymus Organic Glandular, Hypoallergenic, Allergy Research Group / Nutricology, 75 Caps
Thymus Organic Glandular supports the function of the thymus gland, the master gland of the immune system.Throat Spray GSE, 4 fl. oz.
This natural formulation is designed to promote healthy conditions in the mouth and throat. NutriBiotic Throat Spray provides protection from sore throat due to germs.Vital Yew (Pacific Yew) Salve, 1 oz.
Yew promotes healing of wounds, rashes, burns, bug bites, and problem skin.Vital Yew (Pacific Yew) Tea, 20 Tea Bags
Vital Yew has been analyzed for its remarkable anti-cancer properties, but has also been historically utilized in its natural form for promoting relief from a variety of health concerns including colds, viral, bacterial and fungal infections, flu, rheumatism, sciatica, kidney problems, lung problems and more.Vitamin C Complex Powder, NOW Foods, Vegetarian Formula, 8 oz.
This Vitamin C Complex Powder is formulated with buffered Calcium Ascorbate for acid-sensitive individuals.Vitamin C Liquid For Baby & Children, 4 fl. oz.
Vitamin C is known as a principal anti-oxidant, the need for which is greatly increased in infants and children due to today's elevated environmental stresses and pollution.Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 VCaps
Nature's Way Vitamin C with Bioflavonoids provides antioxidant protection for many of the body's important enzyme systems.Vitamin C 1000 With Rosehips, Nature's Way, 100% Natural, 500 mg, 250 Caps
Nature's Way Vitamin C with Rosehips offers a rich whole plant source of vitamin C.Yarrow Flowers Herbs, 325 mg, 100 Caps
Yarrow Flower Herb may be helpful for Nosebleeds, fevers, colds, sore throat, indigestion, heartburn, inflammation, menstruation, dysmenorrhea, high blood pressure, muscle spasms, urinary tract infections, and minor injuries.
FOR A COMPLETE LIST OF MEASLES SUPPLEMENTS & PRODUCTS:
Herbal Remedies: Measles Information
Herbal Remedies: Measles Supplements & Products
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HELPFUL PRODUCTS & FURTHER EDUCATION
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 2nd Edition
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 4th Edition
Prescription for Herbal Healing: The A-To-Z Reference To Common Disorders
-- by Phyllis A. Balch
The Complete Guide to Natural Healing
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