MEASLES

Always-Fatal Measles Complication More Frequent Than Thought

November 3, 2016

Unvaccinated children who are infected with measles in infancy are at greater risk of a fatal neurological complication than the medical community previously thought. Researchers shared their findings in an oral abstract presentation at ID Week 2016 in New Orleans, Louisiana.

Previously published research had involved German children less than 5 years of age who were infected with measles. That study reported the risk of subacute sclerosing panencephalitis (SSPE), which always leads to death, as approximately 1 in 1,700. However, the new research, which examines cases of measles in California, reports a risk of 1 in 1,387 for children infected before age 5 years. For children infected with measles before 1 year of age, the risk was 1 in 600.

To understand risk factors for the complication, the investigators reviewed SSPE cases in California between 1998 and 2016. They identified cases through state medical records, reports from the Centers for Disease Control and Prevention, and through investigations involving undiagnosed neurological disease.

Based on their review, 17 cases of SSPE were identified—12 of those children (71%) had a clinical history of measles. All of the 12 children were infected before 15 months of age and measles vaccination. At the time of measles infection, 8 (67%) of children were living in the United States.

Diagnosis of SSPE occurred at a median age of 12 years, though range of diagnosis was from 3 to 35 years. The mean latency period was 9.5 years, with a range of 2.5 to 34 years, and many of the individuals had experienced cognitive or motor issues for years before receiving the SSPE diagnosis.

The new data highlight the importance of vaccines and using herd immunity and other measures to protect children too young to receive the vaccine. “Protection of infants younger than 12-15 months of age, when measles vaccine is routinely administered, requires avoidance of travel to endemic areas, or early vaccination prior to travel,” the researchers wrote. They added, “SSPE demonstrates the high human cost of ‘natural’ measles immunity.”

—Lauren LeBano

Reference

Wendorf K, Winter K, Harriman K, et al. Subacute Sclerosing Panencephalitis: the Devastating Measles Complication is More Common than We Think. Abstract 916. ID Week 2016; October 28, 2016. New Orleans, LA.