Interventions for Measles

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Age Cohort: Pregnancy and newborn

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Health education on measles Information and health education to women,families and community on measles Information and health education to women,families and community on immunization Educate mothers on well baby clinics Good nutrition for the mother knowledge of vaccination schedule Importance of timely uptake of vaccine dose Community health workers training on measles including prevention and recognition of measles in pregnant women	Timely attendance to ANC clinic		Recognition of features of measles in pregnant women i.e. fever,fatigue,cough,runny nose,itchy or red eyes, white lesions on the inner cheek) and a raised rash Home based care for pregnant women with measles Supportive management for pregnant women with measles including;- Provision of plenty of fluids to the pregnant women with measles Plenty of rest for the pregnant women with measles Proper nutrition for the pregnant women with measles Monitoring and recognition for any features of worsening of measles in pregnant women including:- shortness of breath coughing up blood drowsiness confusion Referral to health facilities of pregnant women with features of worsening of measles
Primary Care
Information and health education to women/mothers,families and community on measles and prevention measures Provide Information on Good nutrition Educate mothers on well baby clinics Strengthen community based awareness on knowledge of vaccination schedule Importance of timely uptake of vaccine dose Training/sensitizing health workforce on measles and its management in pregnant women and newborn	ANC services Post-natal care services Contact tracing Quarantine for contacts Isolation for the mothers with measles to contain the spread		Clinical examination and diagnosis of measles in pregnant women whose features include, fever fatigue cough runny nose itchy or red eyes, white lesions on the inner cheek) and a raised rash. Supportive management for pregnant women with measles including;- Provision of plenty of fluids to the pregnant women with measles Plenty of rest for the pregnant women with measles Proper nutrition for the pregnant women with measles Relieve of fever and aches with paracetamol or ibuprofen Fetal monitoring Monitoring, recognition and management for any features of worsening of measles in pregnant women including; Shortness of breath Coughing up blood Drowsiness Confusion Referral to hospitals for mothers with complications due to measles		Psycho social support
Referral Facility: General
Guidance to mothers on measles prevention Guidance to pregnant women on proper nutrition Health workers training on management of measles in pregnant women			Immunoglobulin/measles antibodies administration for post exposure for Pregnant women Fetal monitoring Follow up of the newborns and manage any complications e.g. Low birth weight, babies born prematurely
Referral Facility: Specialist
Guidance to mothers on measles prevention Guidance to pregnant women on proper nutrition Health workers training on management of measles in pregnant women			Fetal monitoring Follow up of the newborns and manage any complications e.g. Low birth weight; babies born prematurely Immunoglobulin /measles antibodies administration for post exposure for Pregnant women

Age Cohort: < 5 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
community-based awareness on VPDs including transmission and prevention measures * Community education on proper nutrition for young children	Routine on schedule vaccination Good hygiene practices including hand hygiene Stay at home if any symptoms of measles Avoiding close contact with measles cases	Recognition of measles signs and symptoms	Psychological and emotional support for meningitis sequel	Home-based physical rehabilitation	Psycho social support/counseling to the parents/families of young children with complications of measles e.g. deafness, blindness.
Primary Care
Information and health education on VPDs and immunization	Routine on schedule vaccination Vitamin A supplementation	History Physical examination	Antipyretics Hydration Proper nutrition Vitamin A Immediate transfer of unresponsive or sever cases to a higher-level health care facility	Physical therapy Linkage with rehabilitation centres for deafness, learning impairment or behavioural problems	Psychological and emotional support for meningitis sequel
Referral Facility: General
Information and health education on VPDs and immunization	Routine on schedule vaccination Vitamin A supplementation	History Physical examination Serologic test Complete blood count Chest radiography	Antibiotics when indicated Antipyretics Vitamin A Hydration	Linkage with rehabilitation centres for deafness, learning impairment or behavioural problems	Psychological and emotional support for meningitis sequel
Referral Facility: Specialist
Information and health education on VPDs and immunization	Isolation of patients with measles to prevent spread Measles vaccination according to the national schedule	History Physical examination Complete blood count Serologic test PCR test Blood culture Chest radiography	Antibiotics Vitamin A Hydration Intensive care for severely ill	Linkage with rehabilitation centres for deafness, learning impairment or behavioural problems	Psychological and emotional support for meningitis sequel

Age Cohort: 5 - 11 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community-based awareness on measles and other VPDs including transmission and prevention measures * Community education on proper nutrition for young children	Routine on schedule vaccination Good hygiene practices including hand hygiene Stay at home if any symptoms of measles Avoiding close contact with measles cases	Recognition of measles signs and symptoms	Antipyretics Hydration Proper nutrition Immediate transfer of unresponsive or sever cases to a higher-level health care facility	Linkage with rehabilitation centres for deafness, learning impairment or behavioural problems	Psychological and emotional support for meningitis sequel
Primary Care
Information and health education on VPDs and immunization	Routine on schedule vaccination Vitamin A supplementation	History Physical examination	Antipyretics Hydration Proper nutrition Vitamin A Immediate transfer of unresponsive or sever cases to a higher-level health care facility	Linkage with rehabilitation centres for deafness, learning impairment or behavioural problems	Psychological and emotional support for meningitis sequel
Referral Facility: General
Information and health education on VPDs and immunization	Routine on schedule vaccination Vitamin A supplementation	History Physical examination Serologic test Complete blood count Chest radiography	Antibiotics if indicated Antipyretics Hydration	Linkage with rehabilitation centres for deafness, learning impairment or behavioural problems	Psychological and emotional support for meningitis sequel
Referral Facility: Specialist
Information and health education on VPDs and immunization	Routine on schedule vaccination Vitamin A supplementation	History Physical examination Complete blood count Serologic test PCR test Blood culture Chest radiography	Antibiotics Oral Vitamin A IV fluid ICU services for severely ill	Linkage with rehabilitation centres for deafness, learning impairment or behavioural problems	Psychological and emotional support for meningitis sequel

Age Cohort: 12 - 24 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Adolescents and Families education on transmission and prevention of measles Community education on proper nutrition for adolescents Proper sanitation Promoting planning especially in urban areas to avoid over-crowding through multi sectoral approach Community health workers training on measles including prevention and recognition of signs of measles in adolescents	Contact tracing Quarantine for contacts		Recognition of features of measles in adolescents including cold-like symptoms such as;- a runny nose,sneezing and a cough Sore, red eyes that may be sensitive to light Fever Small greyish-white spots on the inside of the cheeks Watery eyes Swollen eyelids Body aches and pains Relieve Headcheas/pain with paracetamol or Ibuprofen Relieve fever-administer anti-pyretics when there is fever (paracetamol or brufen) Proper nutrition for the adolescents with measles Home based care Supportive management for adolescents with measles including; Provision of plenty of fluids to the adolescents Encourage the adolescents with measles to rest Monitoring and recniognition for any features indicating worsening of measles in adolescents and referral. The features include;- Shortness of breath Coughing up blood Drowsiness Confusion Fits (convulsions) Referral to the health facilities
Primary Care
Information to Families and community education on transmission and prevention Community education on proper nutrition Proper sanitation Provision of IEC materials Promoting proper planning especially in urban areas to avoid over-crowding Training/sensitizing health workforce on management of measles in adolescents	Contact tracing Quarantine for contacts Isolation for the patients with measles to contain the spread		Clinical examination and diagnosis of measles in adolescents based on features including cold-like symptoms,such as a runny nose,sneezing and a cough Sore,red eyes that may be sensitive to light Fever Small greyish-white spots on the inside of the cheeks Watery eyes Swollen eyelids Body aches and pains Investigations;collect samples for lab confirmation and viral detection Supportive management for adolescents with measles including;- Provision of plenty of fluids to the adolescents Proper nutrition for the adolescents with measles Encourage the adolescents with measles to rest Relieve fever-administer anti-pyretics when there is fever (paracetamol or brufen) Relieve aches/pain with paracetamol or Ibuprofen Monitoring and recognition for any features indicating worsening of measles in adolescents and referral. The features include; Shortness of breath Coughing up blood Drowsiness Confusion Fits (convulsions) Monitor /recognition of complications due to measles in adolescents which include; Diarrhea Ear infection Bronchitis Laryngitis (inflammation of the voice box) Pneumonia Encephalitis (swelling of the brain) Croup (inflammation of the airway) Emergency care with an aim of stabilizing the adolescents with complications due to measles before referral Post exposure vaccination for unvaccinated contacts Referral of the adolescents with worsening measles/complications to the hospital
Referral Facility: General
	Isolation of patients with measles to prevent spread		Post exposure vaccination for unvaccinated contacts (within 72 hours of exposure to measles virus) Relieve common symptoms of measles in adolescents Fever Cough Blocked nose Conjunctivitis Sore mouth Provide nutritional support Appropriate Antibiotics administration for any secondary infection e.g. pneumonia Responses for AEFI Identify and manage any complications as per guidelines e.g. pneumonia,croup,diarrhea,malnutrition, otitis media,mouth ulcers,eye complications (conjunctivitis),laryngitis,febrile seizures,encephalitis Intensive care services for adolescents with severe complications of measles Follow up N/B Investigations-carry out necessary confirmatory tests for measles if need be (blood tests,throat swab; urine sample)
Referral Facility: Specialist
	Isolation of patients with measles to prevent spread		Post exposure vaccination for unvaccinated contacts (within 72 hours of exposure to measles virus) Identify and manage any complications as per guidelines e.g. pneumonia,croup,diarrhea,malnutrition, otitis media,mouth ulcers,eye complications (conjunctivitis),laryngitis,febrile seizures,encephalitis Provide nutritional support Appropriate Antibiotics administration for any secondary infection e.g. pneumonia Responses for AEFI Intensive care services for adolescents with severe complications of measlesFollow up Relieve common symptoms of measles in adolescents ; Fever Cough Blocked nose Conjunctivitis sore mouth N/B Investigations-carry out necessary confirmatory tests for measles if need be (blood tests,throat swab; urine sample)

Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Families and community education on transmission and prevention of measles Education on proper nutrition for adults Health education on Proper sanitation Promoting proper planning especially in urban areas to avoid over-crowding Community health workers training on measles including prevention and recognition of measles in adults	Contact tracing Quarantine for contacts		Recognition of features of measles in adults including cold-like symptoms, such as;- a runny nose, sneezing and a cough Sore, red eyes that may be sensitive to light Fever Small greyish-white spots on the inside of the cheeks Watery eyes Swollen eyelids Body aches and pains Home based care Supportive management for adults with measles including;- Provision of plenty of fluids to the adults Encourage the adults with measles to rest Proper nutrition for the adults with measles Relieve fever-administer anti-pyretics when there is fever (paracetamol or brufen Relieve aches/pain with paracetamol or Ibuprofen Monitoring and recognition for any features indicating worsening of measles in adults and referral the features include;- Shortness of breath Coughing up blood drowsiness confusion Fits (convulsions) Referral to the health facilities
Primary Care
Information to Families and community education on transmission and prevention Community education on; proper nutrition Proper sanitation Promoting proper planning especially in urban areas to avoid over-crowding Provision of IEC materials Training/sensitizing health workforce on measles including its management	Contact tracing Quarantine for contacts Isolation for the patients with measles to contain the spread		Clinical examination and diagnosis of measles in adults based on key features (signs and symptoms) including cold-like symptoms,such as a runny nose,sneezing and a cough Sore, red eyes that may be sensitive to light Fever Small greyish-white spots on the inside of the cheeks Watery eyes Swollen eyelids Body aches and pains Supportive management for adults with measles including; Provision of plenty of fluids to the adults Proper nutrition for the adults with measles Encourage the adults with measles to rest Relieve fever-administer anti-pyretics when there is fever Relieve aches/pain with analgesics Monitoring and recognition for any complications/worsening of measles in adults and referral. The features include; shortness of breath coughing up blood drowsiness confusion fits (convulsions) Emergency care with an aim of stabilizing the adults with complications due to measles before referral Referral of adults with measles complications to a hospital post exposure vaccination for unvaccinated contacts
Referral Facility: General
	Isolation of patients with measles to prevent spread		Post exposure vaccination for unvaccinated contacts (within 72 hours of exposure to measles virus) Management of measles complications in adults including; otitis media,conjunctivitis, pneumonia, croup, seizures, encephalitis N/B Carry out necessary confirmatory tests for measles if need be (blood tests,throat swab, urine sample)
Referral Facility: Specialist
	Isolation of patients with measles to prevent spread		Management of measles complications in adults including;- otitis media conjunctivitis pneumonia croup seizures encephalitis N/B Carry out necessary confirmatory tests for measles if need be (blood tests,throat swab; urine sample) Post exposure vaccination for unvaccinated contacts (within 72 hours of exposure to measles virus)

Age Cohort: 60+ years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Information to Families and community education on transmission and prevention of measles Proper sanitation Promoting proper planning especially in urban areas to avoid over-crowding Community education on proper nutrition for the elderly Community health workers training on measles including prevention and recognition of measles in the elderly	Contact tracing Quarantine for close contacts		Recognition of features of measles in the elderly including cold-like symptoms, such as;- a runny nose, sneezing and a cough Sore, red eyes that may be sensitive to light Fever Small greyish-white spots on the inside of the cheeks Watery eyes swollen eyelids Body aches and pains Home based care Supportive management for elderly patients with measles:- Provision of plenty of fluids and Plenty of rest Proper nutrition Management of fever-administer anti-pyretics for fever Monitor for any worsening of measles in the elderly patient and refer Referral of elderly persons with severe measles to the health facilities
Primary Care
Information to Families and community education on transmission and prevention Community education on; proper nutrition Proper sanitation Provision of IEC materials Promoting proper planning especially in urban areas to avoid over-crowding Training/sensitizing health workforce on measles including its management	Contact tracing Quarantine for contacts Isolation for the patients with measles to contain the spread		Clinical examination and diagnosis of measles in the elderly based on key features (signs and symptoms) including cold-like symptoms, such as a; runny nose,sneezing and a cough Sore, red eyes that may be sensitive to light Fever Small greyish-white spots on the inside of the cheeks Watery eyes Swollen eyelids Body aches and pains Supportive management for elderly with measles including; Provision of plenty of fluids to the elder5ly Relieve fever-administer anti-pyretics when there is fever Relieve aches/pain with analgeith measlees Encourage the elderly with measles to rest Proper nutrition for the elderly with measles Monitoring and recognition for any complications/worsening of measles in adults and referral. The features include; shortness of breath coughing up blood drowsiness confusion fits (convulsions) Emergency care with an aim of stabilizing the elderly with complications due to measles before referral Referral of elderly with measles complications to a hospital post exposure vaccination for unvaccinated elderly persons
Referral Facility: General
	Isolation of patients with measles to prevent spread		Isolation of patients with measles to prevent spread
Referral Facility: Specialist
	Isolation of patients with measles to prevent spread		Isolation of patients with measles to prevent spread