There is a rare but cruel complication of measles: subacute sclerosing panencephalitis (SSPE), a progressive neurological disorder of children and young adults that affects the central nervous system (CNS).
Mischa, a 14 year old German boy, has just died of SSPE. He was infected with measles in 2000, at the age of 5 months, by an 11 year old boy whose parents had refused vaccination. The infection was passed at a pediatrian's office. The older child also infected five other children; one of them, a girl named Natalie, also developed SSPE and died in 2011.
Thanks to relatively high vaccination uptake of the Measles-Mumps-Rubella (MMR) vaccine, SSPE has become rare in the US, with fewer than 10 cases reported annually.
Analysis of data from an outbreak of measles in the United States during 1989-1991 suggests a rate of 4-11 cases of SSPE per 100,000 cases of measles. A risk factor for developing this disease is measles infection at an early age. Studies in the United Kingdom indicate that 18 out of every 100,000 people who get measles when they are less than a year old will develop SSPE. This is compared to 1.1 per 100,000 in those infected after 5 years of age. On average, the symptoms of SSPE begin 7 to 10 years after measles infection, but they can appear anytime from 1 month to 27 years after infection.
Most youngsters with SSPE have a history of measles infection at an early age, usually younger than 2 years, followed by a latent period of 6 to 8 years before neurological symptoms begin. Despite the long interval between the measles infection and the onset of SSPE, researchers think that the infection of the brain occurs soon after the primary bout with measles and progresses slowly.....There is progressive deterioration to a comatose state, and then to a persistent vegetative state. Death is usually the result of fever, heart failure, or the brain's inability to continue controlling the autonomic nervous system.
The blogging duo at Just the Vax have been covering SSPE for years:
Just the Vax's Coverage of SSPE cases in Europe
- April 23 2009 Medical Care for Unvaccinated Children
- January 28 2010 GMC ruling on Andrew Wakefield in and a reminder why MMR is important
- October 20, 2011 So predictable - so sad, Natalie dies of SSPE
- November 7 2011 And another SSPE case: Angelina is dying
- May 23 2012 Measles in Europe: personal stories about coma, SSPE
- September 12 2012 Olmsted Can't Find SSPE Either
- June 13 2013 Mischa is Dead