{"id":81754,"date":"2025-04-03T10:31:04","date_gmt":"2025-04-03T16:31:04","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=81754"},"modified":"2025-06-25T13:43:29","modified_gmt":"2025-06-25T19:43:29","slug":"vitamin-a-and-cod-liver-oil-ineffective-against-measles-in-us","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/vitamin-a-and-cod-liver-oil-ineffective-against-measles-in-us\/","title":{"rendered":"Vitamin A and cod liver oil don’t prevent measles. So, what treatments work? And how sick are kids with measles?"},"content":{"rendered":"
<\/div>
\"Measles
Measles typically presents with a rash that starts at the hairline and forehead, then spreads to the chest and arms. Vitamin A and cod liver oil won’t prevent measles; vaccination is the best protection against this dangerous disease. Photo: Getty Images.<\/figcaption><\/figure>\n

Cod liver oil and Vitamin A will not prevent measles cases in the U.S.<\/p>\n

Take it from a doctor who has cared for patients with measles and sadly had to watch as some children died from the most infectious disease in the world.<\/p>\n

Dr. Edward Janoff<\/a> studied complications associated with measles back when he was an infectious disease fellow in the late 1980s. As part of his research, he helped care for hundreds of patients in the Philippines and Thailand who suffered from measles. Some experienced challenging and heartbreaking complications ranging from breathing difficulties to diarrhea to death.<\/p>\n

Janoff\u2019s guidance about measles is utterly clear:<\/p>\n

\u201cThe best treatment for measles is not to get measles. And the best way not to get measles is to get the vaccine,\u201d said Janoff.<\/p>\n

He\u2019s an infectious disease expert at UCHealth University of Colorado Hospital<\/a> and the Rocky Mountain Regional VA Medical Center <\/span><\/a>and a professor<\/a> of medicine, infectious diseases, microbiology and immunology at the University of Colorado School of Medicine<\/a> on the Anschutz Medical Campus<\/a>.<\/p>\n

Unlike Janoff, most doctors in the U.S. \u2014 even pediatricians and infectious disease experts \u2014 have never seen or cared for patients who are sick with measles. That\u2019s because this dangerous, highly infectious disease was largely eradicated in the U.S. in about 2000. But measles now is making a dangerous comeback<\/a>.<\/p>\n

And as measles cases continue to rise, misinformation about ways to prevent and treat measles is spreading too. Doctors in Texas \u2014 where the largest measles outbreak is taking place this year \u2014 now are seeing some children who are suffering from Vitamin A toxicity.<\/a> Too much Vitamin A in people who do not have Vitamin A deficiency, which is very uncommon in the U.S., can cause liver damage and other medical problems.<\/p>\n

Despite possible dangers of Vitamin A poisoning, the use of cod liver oil, a common source of Vitamin A, has been rising in parts of the U.S. because some health officials and parents have falsely claimed that doses of cod liver oil and Vitamin A are good substitutes for the safe and highly effective measles vaccine. Those claims are not true, and they are dangerous because \u2014 in addition to causing potential Vitamin A poisoning \u2014 people who don\u2019t get measles vaccines are highly vulnerable to getting sick with measles.<\/p>\n

So, what is the truth about measles? What are evidence-based treatments for people who get measles? What\u2019s it like to be sick with this dangerous disease? Is it ever appropriate to give children doses of Vitamin A or cod liver oil? How can doctors help people if they get measles? And what are some of the complications that people can experience if they get measles?<\/p>\n

Janoff answered many of the top questions people are asking about measles now. (For additional information, read about the current measles outbreaks<\/a> and why measles is so dangerous.)<\/p>\n

Do cod liver oil and Vitamin A work as cures or treatments to prevent measles?<\/strong><\/h2>\n

Cod liver oil and Vitamin A do not prevent measles, but the vaccine does.\u00a0 Cod liver oil is a type of fish oil that contains a lot of Vitamin A and Vitamin D. In parts of the world where children are undernourished, small doses of Vitamin A can be beneficial to treat some children with measles. But neither cod liver oil nor Vitamin A are necessary for children in the U.S. since nearly all kids here are well nourished, Janoff said<\/p>\n

\u201cCod liver oil is certainly not a miracle cure for measles,\u201d he said.<\/p>\n

Parents used to give children spoonfuls of cod liver oil or regularly fed them liver to try to boost Vitamin A and iron in attempts to stave off illnesses before groundbreaking vaccines prevented dangerous diseases like measles.<\/p>\n

Janoff reiterated that the measles vaccine \u2014 which is called the MMR \u2014 is safe, highly effective and long-lasting. Getting the measles vaccine is the No. 1 way to stay safe from measles. The vaccine can give you a mild sore arm and, infrequently, can cause a short-lived fever and rash. But a real measles infection is much worse.<\/p>\n

Why is the measles vaccine called the MMR?<\/strong><\/h2>\n

The measles vaccine is called the MMR because people get vaccinated for the measles, mumps and rubella. Learn more about the recommended doses<\/a>.<\/p>\n

Why are the new measles outbreaks especially concerning?<\/strong><\/h2>\n

The new measles outbreaks are worrisome because measles is so contagious. Hundreds of people are getting infected, and so far, two children in Texas have died from measles this year.<\/a> If an unvaccinated person is exposed to someone with measles, the unvaccinated person is almost guaranteed to get it.<\/p>\n

\u201cIf you are not vaccinated, you are at risk. If you are unvaccinated and you are exposed to measles, there\u2019s more than 90% chance of getting infected,\u201d Janoff said.<\/p>\n

\u201cMeasles has a very high \u2018attack rate,\u2019 meaning it\u2019s very successful at spreading from one unvaccinated person to another. It\u2019s the most transmissible infectious disease in the world, more contagious than influenza, COVID-19, RSV and even Ebola. And everyone who gets measles gets sick,” Janoff said.<\/p>\n

What did you witness when you saw patients with measles? What\u2019s it like for children to be sick with this disease?<\/strong><\/h2>\n

\u201cWhen I worked in a very poor and crowded area in the Philippines, kids with measles were very sick. They had very high fevers. Their mouths were sore. They had a hard time eating and drinking. They had shortness of breath. Their eyes were red and itchy. The rash started by the hairline and the face, then it moves down to the chest and arms,\u201d Janoff said.<\/p>\n

Measles infections in the U.S. typically are not as severe as the illnesses Janoff saw in children abroad. Even so, the illness here often is much worse than a bad cold, he said.<\/p>\n

\u201cIt can last a week to 10 days or as long as three weeks,\u201d Janoff said.<\/p>\n

Unlike chicken pox, where the rash can be very itchy and uncomfortable, the rash in measles is a sign of the illness, but the rash that comes with measles is not generally itchy or painful. Other symptoms can be much more uncomfortable and scarier in people who suffer severe cases of measles.<\/p>\n

\u201cWith measles, you feel bad. You can be listless, very tired and short of breath with a lot of coughing. Some kids end up in the hospital because they can\u2019t eat or drink easily. With the children I saw, dehydration was the biggest problem. They needed fluids and some needed oxygen.<\/p>\n

\u201cWhen kids died, they had respiratory failure or profound dehydration,\u201d Janoff said. \u201cDealing with all of these phenomenally sick kids was really difficult and so sad, but not as difficult as it was for their parents and families.\u201d<\/p>\n

Are there any treatments or cures for measles?<\/strong><\/h2>\n

There are no cures for measles. For people who are sick, doctors can provide fluids, oxygen and comfort measures to try to ease the symptoms. Vitamin A has been used with variable success in Africa to lower mortality with measles. Vitamin A may be used, but it has not been studied for treatment in the U.S.<\/p>\n

For unvaccinated people who have been exposed to measles but do not yet have symptoms, doctors can give a dose of the measles vaccine within three-to-four days of exposure, and that vaccine dose can prevent the exposed person from getting sick, Janoff said.<\/p>\n

Similarly, a therapy called \u201cimmunoglobulins\u201d can stimulate a person\u2019s body to fight the infection better and faster and prevent some people from getting sick soon after exposure. These immunoglobulins are made from antibodies, which are like arrows targeting the measles virus.<\/p>\n

It\u2019s much wiser to get affordable, accessible measles vaccines to prevent the illness in the first place, Janoff said.<\/p>\n

How long is the incubation period for measles? How would I know if I was exposed?<\/strong><\/h2>\n

The incubation period is long: from a week to three weeks. So, it\u2019s possible for people to have been exposed to measles and not realize it.\u00a0 Measles is most easily spread to others from four days before to four days after the onset of the rash.<\/p>\n

What are some of the complications you witnessed when patients got severe cases of measles?<\/strong><\/h2>\n

Many children with measles got secondary illnesses, Janoff said.<\/p>\n

\u201cSome had pneumonia, and many had diarrhea. In that setting, among undernourished poor children living in crowded conditions, many died. There was at least a 5% mortality rate. These were sick, malnourished, underserved kids living in slums in Manila in the Philippines,\u201d Janoff said.<\/p>\n

\"Measles
Measles can be serious, especially for young children. This photo of a baby with measles was taken in 2014 in Manila, the capital city of the Philippines, where large measles outbreaks began after Typhoon Haiyan caused significant destruction. The rash on the infant’s face is typical of measles. Photo by Jim Goodson, courtesy of the U.S. Centers for Disease Control and Prevention’s Public Health Image Library.<\/figcaption><\/figure>\n

The children he saw in Thailand came from higher socioeconomic groups and were in better health before getting sick. Those children experienced fewer complications with measles, Janoff said.<\/p>\n

Janoff and other researchers learned that, in addition to making people sick acutely, measles also undermines people\u2019s immune systems, which can cause additional health problems. On top of measles, it\u2019s also common to get secondary infections like ear infections, bronchitis, pneumonia and diarrhea.<\/p>\n

\u201cIn Africa, diarrhea is a common complication and cause of death related to measles,\u201d Janoff said. \u201cMeasles is a profound immunosuppressant. Once you have measles, you are more likely to get other bacterial and viral infections.\u201d<\/p>\n

Influenza can cause similar complications. It harms the cells that line the lungs and makes it easier for bacteria to infect the lungs.<\/p>\n

\u201cIf you get influenza, a week or two later, you can get bacterial pneumonia,\u201d Janoff said.<\/p>\n

Measles can also cause progressive neurological deficits.<\/p>\n

\u201cSome patients get brain inflammation,\u201d Janoff said.<\/p>\n

Along with short-term side effects, can measles also cause long-term side effects?<\/strong><\/h2>\n

Measles can have long-term side effects. Along with an array of side effects at the time of infection \u2014 from pneumonia to diarrhea to brain inflammation, which is also called encephalitis \u2014 measles can also trigger a rare, terrible illness five to 20 years after the original infection.<\/p>\n

A small percentage of people can get a fatal condition called SSPE, which stands for Subacute Sclerosing Panencephalitis<\/a>.<\/p>\n

\u201cIt\u2019s a long-term complication that affects about 1 in 5,000 people who get measles. It causes confusion and seizures. It\u2019s progressive. There are no treatments, and you end up dying,\u201d Janoff said.<\/p>\n

For infectious disease experts who have witnessed the dangers of measles, how tough is it to see spikes in measles outbreaks?<\/strong><\/h2>\n

\u201cIt saddens me,\u201d Janoff said. \u201cIt\u2019s very clear that measles is a very bad infection. And any side effects from the vaccine are very minor compared to the effects you get from the disease.\u201d<\/p>\n

He said most people in the U.S. who are skipping vaccines have never seen the scary impacts of vaccine preventable diseases like measles, polio and diphtheria, which used to be common and routinely made millions of people sick every year.<\/p>\n

\u201cMost people don\u2019t know how bad these diseases are. Instead, they might hear about minor side effects with a vaccine,\u201d he said.<\/p>\n

In Janoff\u2019s own family, a disease that vaccines now prevent took a terrible toll.<\/p>\n

\u201cMy father had 11 kids in his family, and two of them died of diphtheria,\u201d Janoff said.<\/p>\n

When the vaccines for diphtheria, polio and measles came out, most people were overjoyed and relieved. Parents were thrilled when their children could receive vaccines in schools.<\/p>\n

\u201cWe went from every child in the country getting measles to fewer than 200 cases a year. That\u2019s pretty dramatic and an amazing success story,\u201d Janoff said.<\/p>\n

Now, misinformation is reversing years of progress, Janoff said.<\/p>\n

He cited declining child mortality rates as a public health victory that could erode over time.<\/p>\n

Global child mortality rates have declined dramatically in recent decades, dropping from nearly 13 million deaths a year in children under age 5 in 1990 to about 5 million deaths in young children in 2022, according to the World Health Organization<\/a>.<\/p>\n

And since the measles vaccine was developed in 1963, it has literally been a lifesaver.<\/p>\n

\u201cThe measles vaccine has prevented about 25 million deaths. It\u2019s been an effective and safe vaccine. Some people don\u2019t get it because they don\u2019t have access to it,\u201d Janoff said.<\/p>\n

But people who do have access to the measles vaccine should definitely get it, he said.<\/p>\n

\u201cMeasles selects vulnerable people. It can be mild or terrible or fatal. It\u2019s a very serious worldwide disease.\u201d<\/p>\n

Tell us more about the eradication of measles in the U.S.<\/strong><\/h2>\n

Prior to 1963, measles was extremely common in the U.S. and around the world.<\/p>\n

\u201cIt was a serious worldwide disease,\u201d Janoff said. \u201cEvery child in America got it.\u201d<\/p>\n

According to experts at the U.S. Centers for Disease Control and Prevention (CDC)<\/a>:<\/p>\n