Acute management of measles: A systematic review of therapeutic strategies.

Measles remains one of the most contagious viral infections, and its resurgence due to declining global vaccination coverage has renewed interest in therapeutic and preventive strategies. This systematic review analyzes current and emerging acute therapies and their relationship to measles virology and clinical outcomes. A systematic search of PubMed, Scopus, Web of Science, China National Knowledge Infrastructure and Google Scholar (1990-2025) was conducted using predefined inclusion and exclusion criteria to identify clinical studies on acute measles treatment. Despite being used off-label, ribavirin and interferon-α have demonstrated reductions in severity and complications in small clinical trials and case reports. Vitamin A supplementation remains the only widely recommended therapy with strong evidence for reducing morbidity and mortality, particularly in children with deficiency. Traditional Chinese medications such as Tanreqing and Xiyanping show symptomatic improvement but require mechanistic validation. Investigational therapeutics, including polymerase inhibitors such as ERDRP-0519, monoclonal antibodies targeting the fusion protein, and antiviral candidates such as remdesivir, offer promising future options. While vaccination remains essential, adjunctive therapies provide additional tools to reduce complications in under-vaccinated populations.