The epidemiology of subacute sclerosing panencephalitis in England and Wales 1970-1989.
Two hundred and ninety cases of subacute sclerosing panencephalitis (SSPE) registered in England and Wales from 1970 to 1989 were followed at 6-monthly intervals. Male to female ratio was 2.8:1. Age at onset increased significantly over the period. Measles was recorded for 81% of cases; in nearly half this had occurred under 2 years. Measles vaccine was documented in 20 cases; in 10 measles was also documented and it could not be positively excluded in the remainder. The calculated risk of SSPE following measles was 4.0/100,000 cases compared with the risk after vaccine of 0.14/100,000 doses. Measles under 1 year carried a risk 16 times greater than measles over 5 years. There was an excess of cases in third and subsequent children. The incidence was higher in the northwest than in the southeast of the country. Survival time varied from 4 weeks to 16 years and was shorter when measles had occurred over the mean age of 2.5 years. Of the cases 9% had a history of mental retardation before the onset of SSPE. The incidence of SSPE has fallen following the reduction in measles resulting from vaccination. However, because of the median 8-year interval between measles and onset of SSPE, further cases arising from measles during the study period must still be expected, particularly in adolescents.
Miller
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C
PHLS Communicable Disease Surveillance Centre, London, UK.
Farrington
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CP
Harbert
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K
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008457:Measles / Q000453:epidemiology; D012307:Risk Factors; D013344:Subacute Sclerosing Panencephalitis / Q000453:epidemiology*; D014852:Wales / Q000453:epidemiology