Vitamin A

Mumps

In vitro inhibition of mumps by retinoids. 2013, Soye, Virol J

Vitamin A inhibits the replication of mumps virus in vitro.
Klenner used vitamin C to treat mumps and its complications.

Measles

Here is a short video containing parts of TV broadcasts from the 50's and the 60's, where you can see how the measles had been perceived prior to the vaccine era. Roughly the way we perceived the chickenpox 20 years ago. Nowadays, with the vaccine available, the chickenpox becomes progressively more dangerous and, according to some sources, even lethal disease. The same happened with measles. Here is another interesting video, analyzing changes in perception of measles.

Measles is indeed very dangerous in case of malnutrition and vitamin A deficiency, that is why it was often lethal in the 19th and early 20th century, and still is lethal in the third-world countries. In the developed countries, on the contrary, measles is much less dangerous than flu. The recovery is usually uncomplicated, provides lifelong immunity, and, as we will see, protects against much more dangerous diseases.

Measles

Intensive vitamin therapy in measles. 1932, Ellison, BMJ

In the 1920s, studies began to emerge proving that vitamin A protects against infections. Rats with vitamin A deficiency developed atrophies of the salivary glands and mucous membranes. Then these tissues were being infected by bacteria, and the rats died. In 1931, it turned out that vitamin A protects against postpartum sepsis. Back then, Vitamin A was being named anti-infective agent [1].
Measles virus attacks epithelial cells. With a deficiency of the vitamin A, these cells are atrophied, which allows bacteria to attack them. Those bacteria, which are usually harmless, manage to infect the lungs, skin, middle ear and gastrointestinal tract, causing complications.
In England, measles is dangerous mainly for children from the low income families, whose diet lacks fats (hence also vitamins A and D).
600 children with measles who were admitted to a London hospital were randomly divided into two groups. One group received vitamins A and D in form of fish oil (kindly provided by Glaxo Laboratories).
The mortality rate among those who did not receive the vitamins was 8.7% vs. 3.7% in the other group.
After this successful trial, vitamin A measles treatment was simply forgotten.

Measles

Vitamin A supplements and mortality related to measles: a randomised clinical trial. 1987, Barclay, BMJ

Vitamin A was discovered once again only 50 years later, when it turned out that children in Indonesia, even with a small vitamin A deficiency, die 4 times more often, and some age groups are 8-12 times more likely to die. Vitamin A supplementation also turned out to reduce mortality by 34%. A 1968 WHO report states that there is nothing else associated with infectious diseases more than vitamin A deficiency.
Measles reduces vitamin A levels even in children with good nutrition. Their vitamin levels even worse than in malnourished, but uninfected children.
The authors conducted a randomized trial among children with measles in Tanzania. A quarter of the children were severely malnourished, and only 30% weighted above 80% of the normal weight. Many suffered from anemia. In 91% of children, the level of vitamin A was below 0.56 umol/l (nowadays, 1.75 umol/l is considered the lower limit of the norm).
Among the children participating in the study, 14% were extremely malnourished, while in 58% the weight was below normal. Among those who did not receive vitamin A (400 thousand units), mortality was 13%, and among those who received the vitamin, mortality was 7%. Among children under two years of age, vitamin A reduced mortality by 87%. Malnourished children died from measles with several times higher likelihood than those with good nutrition, with no connection to vitamin A supplementation.
After this study, WHO recommended the use of vitamin A for children with measles, but only where mortality exceeds 1%. The dose recommended by WHO was 100-200 thousand IU (depending on age), despite the fact that a dose of 400 thousand IU was used in the study.

Measles

A randomized, controlled trial of vitamin A in children with severe measles. 1990, Hussey, N Engl J Med

A randomized, double-blind study in South Africa (189 children).
Unlike in Tanzania, where children had an obvious vitamin deficiency, in South Africa clinical vitamin deficiency is very rare. Nevertheless, it turned out that in children with measles, the level of vitamin A was very low (on average 0.4 umol/l). In 92% of the children it was below 0.7. They also had low levels of retinol binding protein and albumin. All the children lived in a poor region.
Children who received vitamin A (400 thousand IU) recovered from pneumonia and diarrhea 2 times faster, and they had respiratory croup 2 times less likely. Of the 12 children who died, 10 received a placebo. No one died among those children whose vitamin levels were above 0.7 umol/l.
The authors believe that vitamin A should be given to all children with complicated measles, and not only where the mortality rate is above 1%. Also, the dose needs to be increased to 400 thousand IU, since the effectiveness of a lower dose has not been proven.

Measles

Vitamin A levels in children with measles in Long Beach, California. 1991, Arrieta, J Pediatr

The authors tested vitamin A levels in 20 children with measles in California. To their surprise, half of them had low levels of vitamin A (less than 0.7), despite the fact that all of them had good nutrition. In the control group of uninfected children, all had normal vitamin levels. In the second control group (patients with other infectious diseases), 30% had a low level of vitamin A. All patients with measles also had a low level of retinol-binding protein and prealbumin. The authors conclude that it is impossible to further suggest that in well-fed American children, vitamin A levels during measles are not lowered. They also suggest that vitamin A levels decrease during other infectious diseases.

Measles

Vitamin A levels and severity of measles. New York City. 1992, Frieden, Am J Dis Child

In New York, vitamin A levels were measured in 89 children under 2 years old with measles, and were compared with a control group. Almost all the children were Latin and African Americans. 22% had a low vitamin level (less than 0.7). 26% had a borderline level (0.7-0.87). Children with vitamin deficiency had fever (above 40) more often, for longer time, and they were hospitalized 2 times more often. Children with borderline vitamin levels were also hospitalized more often. Children in the control group did not have vitamin A deficiency, and their average vitamin level was 2 times higher than in the group of measles patients (0.92 vs. 1.9 umol/l).
6 of the children with measles had proof of vaccination. Measles symptoms, vitamin levels and the antibodies levels were exactly the same as in those with no vaccination record.
Vitamin A deficiency weakens cellular immunity and reduces antibody production.
The authors conclude that half of children with measles in New York have low or borderline vitamin A levels, which leads to more severe symptoms. They suggest supplementing vitamin A to children in the United States, and not just in third world countries.
A similar study conducted in Milwaukee.

Measles

Vitamin A for treating measles in children. 2005, Huiming, Cochrane Database Syst Rev

A Cochrane systematic review on treating measles with vitamin A.
Two doses of vitamin A (200,000 IU each) reduce measles mortality by 82%. The risk of otitis media is reduced by 74%, the risk of laryngitis – by 47%. Water-based vitamin A is more effective than fat-based vitamin A.
A single dose of vitamin A does not reduce mortality.
Could it be that three doses of vitamin A, or higher doses, will reduce mortality even more? For some reason, no one ever studied this possibility.

Measles

Reduced mortality among children in southern India receiving a small weekly dose of vitamin A. 1990, Rahmathullah, N Engl J Med

A randomized controlled study on vitamin A impact on mortality in India. Fifteen thousand children were divided into two groups. One received vitamin E once a week, and the second were also supplemented with vitamin A (8000 IU). The study continued for one year. Among children who received vitamin A, mortality was 54% lower. In children under one year of age, mortality was 4 times lower than in children who did not receive vitamin A. Among those who were malnourished (72% of the study population), vitamin A reduced mortality 9-fold.
The authors did not expect such a significant reduction in mortality, since a similar trial in Indonesia led to a decrease in mortality of 11-45% only. But in Indonesia, vitamin A was added to monosodium glutamate, whereas in India it was added to peanut butter.

Measles

Vitamin A supplementation and child mortality. A meta-analysis. 1993, Fawzi, JAMA

A meta-analysis of the vitamin A impact on infant mortality. Vitamin A reduced measles-related mortality by 60%, and by 90% among infants. Pneumonia-related mortality decreased by 70%.

Measles

Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age. 2017, Imdad, Cochrane Database Syst Rev.

A Cochrane systematic review of the overall vitamin A impact on morbidity and mortality. Vitamin A prophylactic supplementation in children reduces mortality by 12-24%. The risk of diarrhea is reduced by 15%, the risk of measles is reduced by 50%.

Measles

Severe measles: some unanswered questions. 1983, Morley, Rev Infect Dis

In developed countries, measles is a mild illness. The authors suggest this is "unfortunate", since measles vaccination may not be a priority as a public health measure for the decision makers in our world – parents of children who contract this mild form of measles.
But in Africa, measles is 400 times more deadly, thus vaccination is very important there. The authors also claim that a malnourished child with severe measles probably secretes the virus three times longer than does a child with normal nutrition, and that malnutrition, especially in children, leads to a more severe infection, and a lack of vitamin A can lead to blindness

Measles

The effect of live measles vaccines on serum vitamin A levels in healthy children. 1998, Yalçin, Acta Paediatr Jpn

Similar to measles, the MMR vaccine also depletes the vitamin A levels. [1]

Measles

Vitamin A and Measles. 2000, West, Nutr Rev

A review article about vitamin A and measles. In England measles-related mortality had dropped 200-fold from 1908 to 1960, before the vaccine was even available.
The authors write that the tradition of daily supplementing children with cod liver oil (which has high vitamin A content) has virtually disappeared in Europe, remaining only in Norway. They recommend giving vitamin A along with the vaccine.

Measles

As opposed to vitamin A, there is not a single study proving that measles vaccination in developed countries reduces measles-related mortality.
Now please recall how much you heard in the media about vitamin A, and how much about vaccinations in light of the recent measles “epidemics”.

Measles

Severe Measles, Vitamin A Deficiency, and the Roma Community in Europe. 2012, Melenotte, Emerg Infect Dis

Romany have low vitamin A level, and therefore they suffer from measles more severely. Most often, children under one-year-old and adults contract the disease. Gypsies live in difficult, crowded conditions, and are generally malnourished.
Another study showing that Romany have low levels of vitamins A, C, and E. (It also turns out that 78% of Romany mothers smoke).
It also turns out that in Europe even a malnourished child with low vitamin A level cannot die of measles. To do this, they must also have a weakened immune system (usually this refers to patients with cancer or rare genetic diseases), but vaccination is contraindicated for such children.

Measles

Measles are dangerous in case of malnutrition and vitamin A deficiency. Personally, I have a bottle of vitamin A just in case. And, of course, some vitamin C, to prevent bacterial complications. (Vitamin A is toxic in large doses and should not be taken thoughtlessly, especially during pregnancy).
Measles in childhood protects against cancer, neurological, cardiovascular and atopic diseases in adulthood.
Measles vaccine is quite effective (90% for period of 10 to 20 years for two MMR doses, while additional doses have little to no effect), but in the case of measles it is rather a disadvantage. Measles is a useful disease, it is preferable to contract it in childhood rather than not to have it at all, or to get sick in adulthood or during pregnancy, when the vaccination no longer offers protection and measles is more dangerous.

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