» 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
after a measles infection. It is followed by a generalised
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)
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,
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
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