High incidence of subacute sclerosing panencephalitis in South India

Abstract

During 1983-7 a clinical diagnosis of subacute sclerosing panencephalitis (SSPE) was confirmed by the detection of measles virus haemagglutination inhibiting antibody in the cerebrospinal fluid (CSF) in 81 subjects resident in Tamilnadu. The antibody titre (reciprocol of the end-point dilution) in the CSF ranged from 2 to 32 and in the sera from 8 to 2048. The CSF:serum ratios of titres were 1:4-1:64 in 80 cases and 1:128 in one case. The median age at onset of SSPE was 10 years and 97% of cases were diagnosed at stage 2 and beyond. Based on the geographic distribution of 72 cases in an estimated population of 8.4 million, the annual incidence of SSPE was calculated to be 2.14 per million population, or 4.3 cases per million children below 20 years. Assuming that only 10% of all cases would have reached the level of laboratory diagnosis, the incidence may be as high as 21 cases per million population.

Subacute sclerosing panencephalitis (SSPE) in Papua New Guinea: a high incidence in young children

“…The male: female ratio in our study was less than previously reported figures of 2-3:1 to 3-3:1 [1,16,17], although a recent report from Australia found no clear male predominance in the occurrence of SSPE [2]. A ratio of 1'8: 1 agrees with the male predominance usually observed in SSPE; however, the male: female ratio of positives was the same as the presentation ratio of all suspect cases, and therefore may be confounded partly by the sex ratio of patients admitted to hospital.…”

“…An epidemic in South India between 1983 and 1987 produced a calculated annual incidence rate of 4-3 cases per million under 20 [16]. The number of SSPE cases identified in the Indian study was thought to be as few as 10% of all cases occurring in that community [16], giving an estimated annual incidence of 43 cases per million under 20 years old.…”

“…In India the median age at diagnosis was 10 years, which is typical of SSPE [16]. In PNG the age at presentation is significantly lower, with a mean age of < 5 years.…”

“…In the USA an incidence of 0-35 cases per million below 20 years of age has been recorded [15], while in Queensland, Australia the reported frequency from 1978 to 1983 was 1-21 cases per million of Queensland residents per year [2]. An epidemic in South India between 1983 and 1987 produced a calculated annual incidence rate of 4-3 cases per million under 20 [16]. The number of SSPE cases identified in the Indian study was thought to be as few as 10% of all cases occurring in that community [16], giving an estimated annual incidence of 43 cases per million under 20 years old.…”

Subacute Sclerosing Panencephalitis: A Rare Neurological Disorder in Pregnancy

“…Saha et al reported an annual incidence of 21 per million population in India. 2 in comparison with 2.4 per million population in Middle East. 3,4 It is a slow virus infection caused by defective measles virus.…”