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Estimating the Risk of Subacute Sclerosing Panencephalitis After Measles in Okinawa, Japan, 1986-2007

Yusuke Kobayashi1,2, Takuri Takahashi1, Kyomi Hirayasu3

  • 1Department of Infectious Disease Surveillance, National Institute of Infectious Diseases, Japan Institute for Health Security, Tokyo, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|July 13, 2026
PubMed
Abstract

Insights

Subacute sclerosing panencephalitis (SSPE) risk is higher in infants following measles infection. Maintaining high measles vaccination coverage is crucial to prevent this rare but fatal neurological complication.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • Subacute sclerosing panencephalitis (SSPE) is a rare, fatal neurological complication of measles, particularly following childhood infection.
  • While measles incidence has decreased due to vaccination, recent SSPE epidemiology requires further characterization.

Purpose of the Study:

  • To quantify the risk of SSPE following measles infection in Okinawa.
  • To assess the impact of measles infection timing on SSPE risk.

Main Methods:

  • Identified SSPE cases from national research projects and local publications.
  • Estimated measles-related outpatient visits using pediatric sentinel surveillance and medical institution data (1986-2007).
  • Applied ratio estimation with finite population correction to calculate SSPE risk.

Main Results:

  • Seventeen SSPE cases were identified, predominantly in males, with onset between 1994-2009.
  • The estimated overall SSPE risk was 1 per 3944 measles-related outpatient visits.
  • Infants under one year old faced a significantly higher risk (1 per 910 outpatient visits).

Conclusions:

  • Quantifying SSPE risk is feasible using sentinel surveillance data for medically attended measles cases.
  • The elevated risk in infants highlights the severe long-term consequences of measles.
  • Sustaining high measles vaccination coverage is essential to mitigate SSPE incidence.
Keywords:
incidence estimationmeaslessentinel surveillancesubacute sclerosing panencephalitisvaccine coverage

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