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Subacute sclerosing panencephalitis in Bulgaria (1978-2002)
Veneta Bojinova1, Petia Dimova, Liliana Belopitova
1Child Neurology Clinic, University Hospital of Neurology and Psychiatry, BG-1113 Sofia, Bulgaria. tchaniv@bulinfo.net
Neuroepidemiology
|August 19, 2004
Summary
Subacute sclerosing panencephalitis (SSPE) incidence decreased with measles vaccination. Early measles infection, particularly during epidemics, remains a significant risk factor for SSPE development in unvaccinated children.
Area of Science:
- Neurology
- Epidemiology
- Immunology
Background:
- Subacute sclerosing panencephalitis (SSPE) is a rare, progressive neurological disease.
- Measles infection is a known precursor to SSPE.
- The introduction of measles vaccination has impacted SSPE epidemiology.
Purpose of the Study:
- To analyze the incidence of SSPE in Bulgaria from 1978 to 2002.
- To investigate the relationship between measles vaccination status, age at measles infection, and SSPE onset.
- To assess changes in SSPE epidemiology following the introduction of routine measles immunization.
Main Methods:
- Retrospective study of SSPE cases admitted to a tertiary pediatric neurology clinic.
- Analysis of patient data including age at measles infection, age at SSPE onset, and vaccination status.
- Comparison of SSPE incidence rates before and during the period of routine measles immunization.
Main Results:
- 40 SSPE cases were diagnosed over 25 years (1978-2002).
- Incidence decreased from 4 patients/year (1978-1984) to 1.7 patients/year (1995-2002).
- 95% of cases were unvaccinated with early measles infection (mean age 11 months in 1995-2002 vs. 18 months in 1978-1984).
Conclusions:
- Early measles infection is a critical risk factor for SSPE.
- Routine measles immunization plays a crucial role in SSPE prevention.
- Despite vaccination, SSPE remains a concern, particularly following measles outbreaks in unvaccinated populations.