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A Re-emergence of Subacute Sclerosing Panencephalitis in the United Kingdom

Helen Campbell1, Jamie Lopez Bernal1, Antoaneta Bukasa1

  • 1From the Immunisation and Vaccine Preventable Disease Division, UK Health Security agency, London, United Kingdom.

The Pediatric Infectious Disease Journal
|November 21, 2022
PubMed

Insights

Subacute sclerosing panencephalitis (SSPE) cases re-emerged in the UK after 2017, following a period of no reported pediatric cases. This resurgence aligns with increased measles activity, suggesting a potential link.

Area of Science:

  • Neurology
  • Epidemiology
  • Infectious Diseases

Background:

  • Subacute sclerosing panencephalitis (SSPE) is a rare, progressive neurological disorder of the central nervous system, typically fatal.
  • Historically, SSPE has been strongly associated with measles virus infection.
  • The United Kingdom had not reported pediatric SSPE cases for 15 years prior to 2017.

Purpose of the Study:

  • To report and analyze new pediatric and adult SSPE cases in the UK between 1996 and 2020.
  • To investigate the potential association between the re-emergence of SSPE cases and measles incidence.
  • To assess the ascertainment of SSPE cases using a UK registry and a pediatric surveillance system.

Main Methods:

  • Utilized an established UK SSPE registry to identify new pediatric and adult cases from 1996-2020.
  • Cross-referenced registry data with a separate pediatric surveillance system to ensure comprehensive case ascertainment.
  • Employed statistical modeling to correlate SSPE case emergence with measles notification data.

Main Results:

  • Three pediatric UK-acquired SSPE cases were identified between 2017 and 2020, following a 15-year absence.
  • The timing of these cases coincided with an observed increase in measles notifications.
  • Modeling indicated that the SSPE case increase was consistent with measles trends, potential underreporting of measles, or an elevated SSPE risk.

Conclusions:

  • The re-emergence of pediatric SSPE in the UK after 2017 is temporally associated with increased measles activity.
  • Findings suggest a potential link between measles resurgence and SSPE incidence, highlighting the importance of measles vaccination.
  • The study confirms robust ascertainment of SSPE cases through the UK registry and surveillance systems.

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