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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
PubMed

Insights

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.

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