Epidemiology of Subacute Sclerosing Panencephalitis (SSPE) in Germany from 2003 to 2009: A Risk Estimation

Tuesday, 19th of November 2013

[source]PLoS One[|source]

Calculation of the risk of developing Subacute sclerosing panencephalitis (SSPE) after measles infection is complex, because information on both measles and SSPE incidences is required. The calculation is additionally complicated by the long and variable latency period of SSPE. In the older literature, the risk of SSPE was reported to be about 1:100,000 cases of measles. Later in a study from the UK, the risk of SSPE was estimated as 1 of 5,500 following measles infection in the first year of life and 1 in 90,000 measles cases in children of 5 years and older. A more recent study from the USA reported a SSPE incidence of 6.5 to 11 cases per 100,000 acute measles infections translating into a SSPE risk of 1 in 9,100 to 15,400 cases of measles. 

In this article, the authors provide data on the SSPE epidemiology in Germany for the period 2003 to 2009, which suggests that the risk of developing SSPE after acute measles infection below 5 years of age is in the range of 1:1,700 to 1:3,300. The authors conclude that this considerable risk for a disastrous and yet preventable disease should be incorporated in every risk-benefit-education of measles vaccination and may constitute an important component of communication about the rationale for measles elimination. More details are available at:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3706451/

 

Abstract

Subacute sclerosing panencephalitis (SSPE) is a fatal long-term complication of measles infection. We performed an estimation of the total number of SSPE cases in Germany for the period 2003 to 2009 and calculated the risk of SSPE after an acute measles infection. SSPE cases were collected from the Surveillance Unit for Rare Paediatric Diseases in Germany and the Institute of Virology and Immunobiology at the University of Würzburg. The total number of SSPE cases was estimated by capture-recapture analysis. For the period 2003 to 2009, 31 children with SSPE who were treated at German hospitals were identified. The capture-recapture estimate was 39 cases (95% confidence interval: 29.2–48.0). The risk of developing SSPE for children contracting measles infection below 5 years of age was calculated as 1:1,700 to 1:3,300. This risk is in the same order of magnitude as the risk of a fatal acute measles infection.