Vitamin A & Measles

[Guest guest]

Vitamin A & Measles

Its amazing how they do it in the 3rd world, but never did it in the US and

why don't they give it in the US/UK/Canada/Europe/Australia/NZ with MMR -

could make a huge difference............but then they'd have to admit MMR

causes problems. Also should be given routinely for other issues and

deficiency.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=2194128 & dopt=Abstract

A Randomized, Controlled Trial of Vitamin A in Children with Severe Measles

N Engl J Med. 1990 Dec 20;323(25):1774-5.

A randomized, controlled trial of vitamin A in children with severe measles.

Hussey GD, Klein M.

Department of Paediatrics and Child Health, University of Cape Town, South

Africa.

BACKGROUND. Measles kills about 2 million children annually, and there is

no specific therapy for the disease. It has been suggested that vitamin A

may be of benefit in the treatment of measles. METHODS. We conducted a

randomized, double-blind trial involving 189 children who were hospitalized

at a regional center in South Africa because of measles complicated by

pneumonia, diarrhea, or croup. The children (median age, 10 months) were

assigned to receive either vitamin A (total dose, 400,000 IU of retinyl

palmitate, given orally; n = 92) or placebo (n = 97), beginning within five

days of the onset of the rash. At base line, the characteristics of the two

groups were similar. RESULTS. Although clinically apparent vitamin A

deficiency is rare in this population, the children's serum retinol levels

were markedly depressed (mean [+/- SEM], 0.405 +/- 0.021 mumols per liter

[11.6 +/- 0.6 micrograms per deciliter]), and 92 percent of them had

hyporetinemia (serum retinol level less than 0.7 mumols per liter [20

micrograms per deciliter]). Serum concentrations of retinol-binding protein

(mean, 30.1 +/- 2.0 mg per liter) and albumin (mean, 33.4 +/- 0.5 g per

liter) were also low. As compared with the placebo group, the children who

received vitamin A recovered more rapidly from pneumonia (mean, 6.3 vs.

12.4 days, respectively; P less than 0.001) and diarrhea (mean, 5.6 vs. 8.5

days; P less than 0.001), had less croup (13 vs. 27 cases; P = 0.03), and

spent fewer days in the hospital (mean, 10.6 vs. 14.8 days; P = 0.01). Of

the 12 children who died, 10 were among those given placebo (P = 0.05). For

the group treated with vitamin A, the risk of death or a major complication

during the hospital stay was half that of the control group (relative risk,

0.51; 95 percent confidence interval, 0.35 to 0.74). CONCLUSIONS. Treatment

with vitamin A reduces morbidity and mortality in measles, and all children

with severe measles should be given vitamin A supplements, whether or not

they are thought to have a nutritional deficiency.

PMID: 2194128 [PubMed - indexed for MEDLINE]

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http://www.whale.to/vaccine/citations4.html

Vitamin A & child mortality citations

http://66.70.140.217/vaccines/autism35.html

New Study Vitamin A & Autism: " Toxin in DPT Vaccine [may] Cause Autism

" When the live viral measles vaccine is given, it depletes the children of

their existing supply of Vitamin A (13), which negatively impacts the

retinoid receptors "

http://www.danasview.net/vitamina.htm

High Dose Vitamin A Protocol [for measles virus]

[The first portion of this page was written by Dr. Jaquelyn McCandless - a

physician working extensively with autism - author of the excellent book

Children With Starving Brains - available from my webpage

http://www.nccn.net/~wwithin/bookstor.htm#vaccine ]

http://www.vaccinationnews.com/Literature_Searches/VitA & Measles.htm

Literature Search ­ Vitamin A and Measles

Scroll down a little way for beginning

tons more online

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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=1625097 & dopt=Abstract

Arrieta AC, Zaleska M, Stutman HR, Marks MI. Vitamin A levels in children

with measles in Long Beach, California. J Pediatr 1992;121:75-78.

Department of Pediatrics, Children's Hospital of Orange County, Orange,

California 92668.

Studies from Africa suggest that vitamin A supplementation may reduce

morbidity and mortality rates associated with measles among poorly

nourished children. We studied 20 children with measles in Long Beach,

Calif., and found that 50% (95% confidence interval; 28% to 72%) were

vitamin A deficient. This frequency among presumably well nourished

American children supports evaluation of vitamin A status as a part of

acute management of measles in the United States.

PMID: 1625097 [PubMed - indexed for MEDLINE]

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http://www4.dr-rath-foundation.org/NHC/measles/study/study01.htm

Measles

Vitamin A for preventing secondary infections in children with measles--a

systematic review.

D'Souza RM; D'Souza R

J Trop Pediatr 2002 Apr;48(2):72-7

The objective of the present study was to determine whether vitamin A

prevents pneumonia, diarrhoea and other infections in children with

measles. A meta-analysis was carried out of randomized controlled trials

identified through a systematic search of the medical literature for

studies that used vitamin A to treat measles. A total of 492 children, aged

from 6 months to 13 years, were supplemented with vitamin A, and 536

children were given placebo in six trials, five of which were conducted in

hospitals and one in a community setting. The main outcome measures were:

incidence of pneumonia, diarrhoea, croup, and otitis media; and duration of

pneumonia, diarrhoea, fever and hospitalization. There was no significant

reduction in the incidence of pneumonia or diarrhoea but there was a 47 per

cent reduction in the incidence of croup (RR = 0.53; 95 per cent CI =

0.29-0.89) in children who were treated with 200 000 IU of vitamin A on 2

consecutive days. Only one study reported a 74 per cent reduction in the

incidence of otitis media (RR = 0.26 95 per cent CI = 0.05-0.92). There was

a statistically significant decrease in the duration of diarrhoea,

pneumonia, hospital stay and fever in individual studies. It was concluded

that vitamin A does have a beneficial effect on morbidity associated with

measles and should be used as a treatment for hospitalized measles cases.

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http://www4.dr-rath-foundation.org/NHC/measles/study/study16.htm

Vitamin A levels and severity of measles.

American journal of diseases of children / AMA; VOL: 146 (2); p. 182-6

Frieden TR; Sowell AL; Henning KJ; Huff DL; Gunn RA

Recent studies show that vitamin A levels decrease during measles and that

vitamin A therapy can improve measles outcome in children in the developing

world. Vitamin A levels of children with measles have not been studied in

developed countries. We therefore measured vitamin A levels in 89 children

with measles younger than 2 years and in a reference group in New York

City, NY. Vitamin A levels in children with measles ranged from 0.42 to 3.0

mumol/L; 20 (22%) were low. Children with low levels were more likely to

have fever at a temperature of 40 degrees C or higher (68% vs 44%), to have

fever for 7 days or more (54% vs 23%), and to be hospitalized (55% vs 30%).

Children with low vitamin A levels had lower measles-specific antibody

levels. No child in the reference group had a low vitamin A level. Our data

show that many children younger than 2 years in New York City have low

vitamin A levels when ill with measles, and that such children seem to have

lower measles-specific antibody levels and increased morbidity. Clinicians

may wish to consider vitamin A therapy for children younger than 2 years

with severe measles. Additional studies of vitamin A in measles and other

infectious diseases, and in vaccine efficacy trials, should be done.

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http://sprojects.mmi.mcgill.ca/tropmed/disease/measles/treatment.htm

How is measles treated?

Vitamin A administered to children acutely ill with measles has been shown

to reduce mortality. Results from a trial in South Africa showed children

treated with vitamin A had a reduced risk of dying, recovered more quickly

from pneumonia and diarrhoea and had less croup. In addition, symptomatic

treatment for cases requires antibiotics to combat bacterial complications,

and oral rehydratation salts for dehydration following diarrhoea.

Case-fatality rates can be lowered if cases reach health care facilities

early where appropriate care is offered. For uncomplicated cases,

supportive fluids, antipyretics and nutritional therapy may be required.

Many children need increased food intake for four to eight weeks to recover

their pre-measles nutritional status

Source : WHO's page about Measles

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http://www.who.int/nut/vad.htm

Micronutrient deficiencies

Combating vitamin A deficiency

A few salient facts

• Between 100 and 140 million children are vitamin A deficient. (I would

suggest that some of this is true in US, UK, Australia, Canada, Europe and

other non-3rd world countries)

• An estimated 250 000 to 500 000 vitamin A-deficient children become blind

every year, half of them dying within 12 months of losing their sight.

• Nearly 600 000 women die from childbirth-related causes each year, the

vast majority of them from complications which could be reduced through

better nutrition, including provision of vitamin A.

The challenge

Vitamin A deficiency (VAD) is the leading cause of preventable blindness in

children and raises the risk of disease and death from severe infections.

In pregnant women VAD causes night blindness and may increase the risk of

maternal mortality.

Vitamin A deficiency is a public health problem in 118 countries,

especially in Africa and South-East Asia, once again hitting hardest young

children and pregnant women in low-income countries.

Crucial for maternal and child survival, supplying adequate vitamin A in

high-risk areas can signifcantly reduce mortality. Conversely, its absence

causes a needlessly high risk of disease and death.

For children, lack of vitamin A causes severe visual impairment and

blindness, and significantly increases the risk of severe illness, and even

death, from such common childhood infections as diarrhoeal disease and

measles.

For pregnant women in high-risk areas, vitamin A deficiency occurs

especially during the last trimester when demand by both the unborn child

and the mother is highest. The mother’s deficiency is demonstrated by the

high prevalence of night blindness during this period. VAD may also be

associated with elevated mother-to-child HIV transmission.

The response: planting the seeds, cultivating the garden

WHO’s goal is the worldwide elimination of Vitamin A Deficiency (VAD) and

its tragic consequences, including blindness, disease and premature death.

To successfully combat VAD, short-term interventions and proper feeding in

infancy must be backed up by long-term sustainable solutions. The arsenal

of nutritional “well-being weapons” includes a combination of breastfeeding

and vitamin A supplementation, coupled with enduring solutions, such as the

promotion of vitamin A-rich diets and food fortification.

© WHO/NHD

The impact of this single supplementation on childhood mortality is as

great or greater than that of any one vaccine ­ and it costs only a couple

of cents a dose.

Planting the seeds. The basis for lifelong health begins in childhood.

Vitamin A is a crucial component:

Breastfeeding. Breast milk is a natural source of vitamin A. Promoting

breastfeeding is the best way to protect babies from VAD.

Vitamin A supplementation. For deficient children, the periodic supply of

high-dose vitamin A in swift, simple, low-cost, high-benefit interventions

has also produced remarkable results, reducing mortality by 23% overall and

by up to 50% for acute measles sufferers.

“Planting these seeds” between 6 months and 6 years of age can reduce

overall child mortality by a quarter in areas with significant VAD.

However, because breastfeeding is time-limited and the effects of vitamin A

supplementation capsules last only 4-6 months, neither are long-term

solutions. Rather, they should be seen as initial steps towards better

overall nutrition.

Cultivating the garden. Both literally and figuratively, the next phase is

necessary for long-term results:

Food fortification. Taking over where supplementation leaves off, food

fortification (e.g. sugar in Guatemala) maintains vitamin A status,

especially for high-risk groups and needy families.

Home gardens. For vulnerable rural families (e.g. in Africa and South-East

Asia), growing fruits and vegetables in home gardens complements dietary

diversification and fortification and contributes to better lifelong health.

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http://www.who.int/vaccines-diseases/en/vitamina/PDF/08_JAMA_META.PDF

this one takes a long time to load but is very interesting

• Vitamin A Supplementation and Child Mortality: A Meta-Analysis. W Fawzi,

T Chalmers, G Herrerra, F Mosteller. IAMA, 1993

http://www.who.int/vaccines-diseases/en/vitamina/PDF/08_JAMA_META.PDF.

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" It is of interest to note that the 50% reduction in measles mortality is

the same if vitamin A supplementation is given preventively (i.e.

children's vitamin A levels are raised before they have measles) or as a

treatment for measles case management. Given that many children with

measles are never seen at health facilities the preventive strategy of

supplementation can have the biggest health impact. For maximum health

impact, programme managers should aim to reach at least 80% of children

6-59 months of age. "

http://www.who.int/vaccines-diseases/en/vitamina/science/sci02.shtml

Vitamin A

Globally, 3 million children suffer clinical VAD (exhibiting the signs and

symptoms of eye damage and xerophthalmia). However, the full magnitude of

VAD often remains hidden: an estimated 140-250 million children under five

years of age are at risk of sub-clinical VAD, mainly in Asia and Africa.

Though showing none of the ocular signs or symptoms these children suffer a

dramatically increased risk of death and illness, particuarly from measles

and diarrhoea, as a consequence of VAD.

Long known to be a principle cause of childhood blindness (250 000-500 000

children lose their sight each year), VAD is now recognized as a major

contributing factor in an estimated 1-3 million child deaths each year.

Benefits of Vitamin A Supplementation to Child Health

Vitamin A is essential for the functioning of the immune system and the

healthy growth and development of children.

The simple provision of high-dose vitamin A supplements every 4-6 months

not only protects against blindness but has been repeatedly shown to have a

dramatic and multiple impact on the health of young children (6-59 months):

• Overall, all-cause mortality is reduced by 23%

• Measles mortality is reduced by 50%

• Diarrhoeal mortality is reduced by 33%

• 85% coverage can result in a 90% reduction in the prevalence of severe

xerophthalmia

Note: coverage below 25% is unlikely to have an impact on xerophthalmia.

It is of interest to note that the 50% reduction in measles mortality is

the same if vitamin A supplementation is given preventively (i.e.

children's vitamin A levels are raised before they have measles) or as a

treatment for measles case management. Given that many children with

measles are never seen at health facilities the preventive strategy of

supplementation can have the biggest health impact. For maximum health

impact, programme managers should aim to reach at least 80% of children

6-59 months of age.

Vitamin A supplementation has been shown to have a positive impact on child

mortality, particularly with measles and diarrhoea:

Measles/Vitamin A studies have shown that supplementation:

• Enhances immune response

• Reduces the severity of measles

• Decreases the incidence and/or severity of major complications

(diarrhoea, pneumonia, croup or otitis media)

• Results in fewer days inhospital

• Leads to faster recovery and fewer post-measles complications

Diarrhoea/Vitamin A studies have shown that supplementation:

• Reduces the frequency of moderate and severe diarrhoea

• Results in fewer signs and symptoms of dehydration

• Lowers clinic attendance and the frequency of diarrhoea-related hospital

admissions

Recent findings:

Vitamin A and Malaria: A recent study in Papua New Guinea found that when

young children were given vitamin A supplements three times a year they had

30% fewer malaria attacks and the number of malaria parasites in their

blood dropped by 36%.

Vitamin A and HIV/AIDS: Trials are currently on-going to determine if

vitamin A supplementation can reduce the mother-to-child transmission of

HIV during lactation.

Reference Documents: (see website for the links to these articles)

Click to see or download key reference documents

• Vitamin A Supplementation and Child Mortality in Developing Countries. G

Beaton, R Martorell, K Aronson, B Edmonston, G McCabe, C Ross, and B

Harvey. Food and Nutrition Bulletin, 1994.

• Vitamin A Supplementation in Infectious Diseases: A Meta-Analysis. P

Glasziou, D Mackerras. BMI, 1993.

• Vitamin A Supplementation and Child Mortality: A Meta-Analysis. W Fawzi,

T Chalmers, G Herrerra, F Mosteller. IAMA, 1993

http://www.who.int/vaccines-diseases/en/vitamina/PDF/08_JAMA_META.PDF.

• Vitamin A Deficiency and Attributable Mortality Among Under-5-Year-Olds.

J Humphrey, K.P.West Jr., A Summer. Bulletin of the World Health

Organization, 1992.

• IVACG Policy Statement on Vitamin A Diarrhoea and Measles, 1998.

http://www.who.int/vaccines-diseases/en/vitamina/PDF/10_IVACG_Measles.PDF

• Vitamin A and Public Health: Challenges for the Next Decade. D Ross.

Proceedings of the Nutrition Society, 1998.

• Effect of Vitamin A Supplementation on Morbidity Due to Plasmodium

Flaciporum, A Shankar, et al, Lancet, 350: 203-09. 1999.

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http://www.emedicine.com/med/topic2381.htm