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Measles Virus and the Central Nervous System: An Update
1Atrium Health Levine Children's Hospital, Charlotte, NC.
Insights
Measles virus can cause severe central nervous system (CNS) diseases, including encephalitis and panencephalitis, years after infection. Despite advances, effective treatments for these measles-related brain injuries remain elusive.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Measles is a deadly, vaccine-preventable disease globally.
- Vaccination has eliminated endemic measles in the US, but outbreaks occur due to imported cases and undervaccination.
- Measles virus can lead to severe, long-term central nervous system (CNS) complications.
Purpose of the Study:
- To review the sequelae of measles virus infection, focusing on CNS complications.
- To discuss the pathogenesis, clinical presentations, and treatment challenges of measles-associated neurological diseases.
Main Methods:
- Literature review of measles virus and associated CNS diseases.
- Analysis of pathogenesis and pathological effects of different measles-related encephalitides.
- Synthesis of current understanding of clinical presentations and treatment.
Main Results:
- Measles-associated CNS diseases include primary measles encephalitis, acute postinfectious measles encephalomyelitis, measles inclusion body encephalitis, and subacute sclerosing panencephalitis.
- These conditions arise from complex brain-virus-immune interactions.
- All forms can result in severe, permanent brain injury.
Conclusions:
- Effective treatments for measles-associated CNS diseases are currently lacking.
- Understanding the pathogenesis is crucial for developing future therapies.
- Continued vigilance against measles importation and promotion of vaccination are essential.
Measles Virus And Associated Central Nervous System:
Sequelae Renee Buchanan, Daniel J. Bonthius Seminars in Pediatric Neurology Volume 19, Issue 3, September 2012, Pages 107-114 Worldwide, measles remains one of the most deadly vaccine-preventable diseases. In the United States, enrollment in the public schools requires that each child receives 2 doses of measles-containing vaccine before entry, essentially eliminating this once endemic disease. Recent outbreaks of measles in the United States have been associated with importation of measles virus from other countries and subsequent transmission to intentionally undervaccinated children. The central nervous system complications of measles can occur within days or years of acute infection and are often severe. These include primary measles encephalitis, acute postinfectious measles encephalomyelitis, measles inclusion body encephalitis, and subacute sclerosing panencephalitis. These measles associated central nervous system diseases differ in their pathogenesis and pathologic effects. However, all involve complex brain-virus-immune system interactions, and all can lead to severe and permanent brain injury. Despite better understanding of the clinical presentations and pathogenesis of these illnesses, effective treatments remain elusive.
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