» Measles, SSPE

Measles is seen as a harmless child disease. However, the illness is not as harmless as it seems. Usually, the measles virus leads to a temporary weakening of the immune system. During this period (6 to 8 weeks) bacterial infections of the middle ear, the lung and the upper respirational area can occur. In some cases an infection of the brain can appear, without the virus itself multiplying inside the brain (so called post infectious encephalitis).

Additional information on measles and possible protections against an infection can be found here.

SSPE (subacute sclerosing panencephalitis) is the worst complication after a measles infection. It is followed by a generalised inflammation of the brain with nerve demyelisation (de-marrowing) and severe damage to the brain, resulting in death. With SSPE, there are virus mutants to be found which contain an altered M-antigene (M-protein or matrix protein), against which the patient cannot produce enough antibodies.  

For reasons yet unknown, the disease breaks out months and up to ten years after having been infected with measles, after seven years on average. Usually it breaks out between the ages of four and fourteen.

It begins insidiously and continues slowly progredient during one to three years – SSPE is one of the  so-called slow virus infections - in 10 % of all cases an acute fast course (3 to 6 months), in a further 10 % of all cases a slower process (longer than three years) will occur.

There are three stages of  SSPE. In the beginning there are psychic changes: lack of interest, apathy, nightly fear, tantrums, hallucinations and deterioration in school achievements.  
During the second stage, after several months, abrupt and unmotivated movements (so-called myoclonies) which appear periodically and epileptic seizures in combination with muscle hypertony of the limbs, as well as an increase of mental deterioration. At the EEG, typical changes significant for SSPE (Radermecker complex) can be detected.
The third stage is the decerebraliation syndrome.

In the past, the number of SSPE cases has been quoted as being 5 to 10 per 1 million measles infections. Modern literature, however, states a figure of approx. 1:10,000 infected patients.

In most cases, SSPE breaks out as a late complication in children that had suffered from measles at ages younger than one year. Since these highly vulnerable children cannot be immunized at that age (vaccination does not start before 11 months of age), they can only be protected if they cannot get infected by their vaccinated environment.