[Epidemiological aspects of SSPE]
1Tokyo Nishi Tokushukai Hospital.
Abstract:
SSPE is neurodegenerative complication of slow measles infection in young children. In developing countries, SSPE has become rare disease because of widespread immunization for measles. However, in under developing countries, it is not rare disease. In Japan, widespread measles vaccination started in 1978. From 1981 SSPE cases declined to about 5 patients per year. We studied 114 cases with SSPE who were still alive in 2003. Incidence of SSPE elevated to near 10 cases per year in 1993-1998 coincident with decline of the rate of immunization for measles. After 1999, the incidence is under 5 cases per year. The immunization rate of young children increased to over 90%, SSPE will become rare disease near future. Future problem will be adult or infant onset of SSPE because of decreasing of anti measles virus titer, SSPE in immunosuppressive state including AIDS or post measles vaccination SSPE.
Insights
Subacute sclerosing panencephalitis (SSPE) is a rare neurological complication of measles. While vaccination has reduced SSPE incidence in developed nations, fluctuations in immunization rates can cause temporary increases, highlighting the need for sustained high vaccination coverage.
Area of Science:
- Neurology
- Pediatrics
- Infectious Diseases
Context:
- Subacute sclerosing panencephalitis (SSPE) is a rare, fatal neurodegenerative disease caused by persistent measles virus infection.
- Widespread measles vaccination has significantly reduced SSPE incidence globally, particularly in developed countries since the late 20th century.
- However, fluctuations in vaccination rates can lead to resurgence, as observed in Japan between 1993-1998.
Purpose:
- To analyze the long-term incidence of SSPE in Japan in relation to measles vaccination coverage.
- To identify trends and potential future challenges for SSPE management and prevention.
Summary:
- This study examined 114 living SSPE cases in Japan as of 2003.
- SSPE incidence declined sharply after measles vaccination began in 1978, but a rise was noted during 1993-1998, coinciding with a dip in immunization rates.
- With vaccination rates exceeding 90% post-1999, SSPE incidence has fallen again, suggesting it will become rare.
Impact:
- Sustained high measles vaccination rates are crucial for eradicating SSPE.
- Future challenges may include adult-onset SSPE, infant cases, and SSPE in immunocompromised individuals or following vaccination.
- Understanding these trends is vital for public health strategies aimed at preventing SSPE globally.
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