Doctors treating patients hospitalized due to a measles outbreak in Texas and New Mexico are facing an alarming issue: vitamin A toxicity. At Covenant Children’s Hospital in Lubbock, located near the outbreak's epicenter, several children have exhibited abnormal liver function in routine lab tests, indicating a possible overdose of vitamin A. Dr. Lara Johnson, a pediatric hospitalist and chief medical officer for Covenant Health-Lubbock Service Area, reported that all affected children were unvaccinated.
U.S. Health and Human Services Secretary Robert F. Kennedy has emphasized the role of vitamin A in responding to the outbreak, even suggesting in a Fox News interview that it could serve as a “prophylaxis” against measles. However, experts caution that the overuse of vitamin A can lead to serious health complications, and there is no scientific evidence supporting its effectiveness in preventing measles infection. The only proven method to prevent infection with the measles virus is through the measles-mumps-rubella (MMR) vaccine, which boasts a 97% effectiveness rate after two doses.
Dr. Peter Hotez, co-director of the Texas Children’s Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at the Baylor College of Medicine, expressed concern over the public perception that individuals can choose between the MMR vaccine and vitamin A. “This misunderstanding could lead to many children becoming unnecessarily infected with measles, especially during an epidemic,” he warned. Furthermore, the unregulated nature of vitamin A dosing poses additional risks, with potential toxicities complicating patient outcomes.
While vitamin A can play a therapeutic role in treating severe measles cases when administered in specific doses under medical supervision, the patients experiencing toxicity likely did not receive the vitamin from healthcare professionals, according to Dr. Johnson. The World Health Organization and the U.S. Centers for Disease Control and Prevention recommend vitamin A for serious cases, particularly in populations where vitamin A deficiency is prevalent. However, the children in West Texas are generally well-nourished, which raises questions about the vitamin's efficacy in this context.
Vitamin A is crucial for maintaining both immunity and vision, but it's fat-soluble, meaning excess amounts can accumulate in organs like the liver. Symptoms of vitamin A toxicity include dry skin and eyes, blurry vision, bone thinning, skin irritation, liver damage, and more severe complications. For pregnant women, excessive vitamin A can lead to birth defects. Patients suffering from toxicity may require supportive care, including fluids to manage low blood pressure and moisturizers for skin and eyes. “Recovery can be swift for patients with acute toxicity once the vitamin is discontinued,” said Dr. Lesley Motheral, a pediatrician in Lubbock. However, chronic toxicity poses risks to bones, the brain, and the liver, with some complications potentially being irreversible.
The Council for Responsible Nutrition, a trade association representing dietary supplement and functional food manufacturers, issued a statement cautioning parents against the misuse of high doses of vitamin A to prevent measles. “While vitamin A is vital for overall immune function, research has not confirmed its effectiveness in preventing measles infection,” the statement read, highlighting concerns about inappropriate high-dose usage, particularly in children.
Dr. Johnson noted that she has encountered patients who mistakenly believed that high doses of vitamin A could either treat or prevent measles. The origins of these misconceptions are often traced back to discussions within the health and wellness influencer community, which frequently downplays the significance of vaccines while promoting various unproven treatments.
In his Fox News interview, Kennedy endorsed an unconventional treatment regimen for measles that includes a steroid, an antibiotic, and cod liver oil, which is rich in vitamin A. He praised two West Texas physicians who claimed to have witnessed “almost miraculous and instantaneous recovery” in their patients using this approach. However, the effectiveness of clarithromycin, the antibiotic mentioned, in preventing secondary bacterial infections like pneumonia remains limited, and the role of budesonide, a steroid, is still unclear regarding its potential benefits for measles patients.
The ongoing measles outbreak has now affected at least 379 individuals across Texas, New Mexico, and Oklahoma. Additionally, Kansas has reported 23 measles cases, with officials indicating that these may also be connected to the current outbreak.
