The Upsurge of SSPE--A Reflection of National Measles Immunization Status in Pakistan

Abstract

Subacute sclerosing panencephalitis (SSPE) is a rare disorder in the developed world. However, an upsurge has been seen lately in our part of the world owing to inadequate measles immunization coverage. At the midst of our struggle against polio, we are struggling with the war against other vaccine-preventable childhood illnesses like measles. The increasing numbers of SSPE that we reported over the past half decade suggest an underlying periodic measles epidemic in Pakistan. In addition, children are now presenting with SSPE in early childhood, warranting a relook, reinforcement and strengthening of primary immunization and mandatory two-dose measles vaccination for all children nationwide. Previously undertaken Measles Supplementary Immunization Activity were a failure in terms of providing the expected cover against measles in young children. Intensive surveillance and establishment of SSPE registers at the district level is essential for eradication of this easily preventable disorder. Unless timely efforts are made to achieve global immunization, SSPE is bound to add to the national disability burden.

Subacute sclerosing panencephalitis

“…In the postmeasles vaccination era, another north Indian tertiary care center registered 458 serologically confirmed SSPE cases over a 10‐year period (1996 to 2005) . In Pakistan, from Karachi, 43 patients of SSPE were diagnosed between 2000 and 2012 . In both countries, a large number of SSPE cases are likely to remain unreported.…”

“…8 In Pakistan, from Karachi, 43 patients of SSPE were diagnosed between 2000 and 2012. 9 In both countries, a large number of SSPE cases are likely to remain unreported.…”

Subacute sclerosing panencephalitis – current perspectives

“…Subacute sclerosing panencephalitis, commonly known as SSPE, is a progressive neurodegenerative disease caused by the persistence of measles infection commonly seen in children and young adults. 1 SSPE was previously known as Dawson’s inclusion body encephalitis as Dawson in 1933 and 1934 reported cellular inclusions in the cerebral lesions of patients with SSPE, thus resulting in this disease being labeled as Dawson inclusion body encephalitis. 2 Ten years later, Brain et al 3 reported similar conditions with further case reports, and later, the term SSPE was coined.…”

Diagnostic Approaches and Management of Subacute Sclerosing Panencephalitis in Children

“…Most patients with SSPE have a history of primary measles infection at an early age (< 2 years), which continues with latent period of infection. 3,4 Most patients survive 1 to 3 years after diagnosed, with mean survival time is about 18 months. 2 The neurological manifestations that appear will be progressive, and causes the death.…”