title: Subacute sclerosing panencephalitis: results of the Canadian Paediatric Surveillance Program and review of the literature.
abstract: BACKGROUND
  Subacute Sclerosing Panencephalitis (SSPE) is so rare in developed countries with measles immunization programs that national active surveillance is now needed to capture sufficient number of cases for meaningful analysis of data. Through the Canadian Paediatric Surveillance Program (CPSP), the SSPE study was able to document a national incidence and determine the epidemiology of affected Canadian children.
  
  
  METHODS
  Between 1997 and 2000, the CPSP surveyed monthly 1978 to 2294 Canadian pediatricians and sub-specialists for SSPE cases. The response rate varied from 82-86% over those years.
  
  
  RESULTS
  Altogether, four SSPE cases were reported to the CPSP: one case before, two during and one after the study period. The incidence of SSPE in Canadian children was 0.06/million children/year. Of the four cases, diagnosed between ages four and 17 years, three children had measles infection in infancy. All children showed a progressive course of dementia, loss of motor skills and epilepsy. Two children were treated with isoprinosine and intraventricular interferon but died in less than three years from disease onset. One child did not have any treatment and died after seven years of illness. One child received intraventricular ribavirin and remains alive, but markedly impaired, nine years following diagnosis.
  
  
  CONCLUSIONS
  The CPSP has demonstrated that Canadian paediatricians and paediatric neurologists may encounter cases of SSPE. This report highlights the clinical course of affected Canadian children and provides a review of the disease and its management.
authors.affiliation: Section of Pediatric Neurology, Department of Pediatrics, Children's Hospital of Western Ontario, University of Western Ontario, London, Canada. craig.campbell@lhsc.on.ca
authors.forename: Craig
authors.initials: C
authors.lastname: Campbell
authors.forename: Simon
authors.initials: S
authors.lastname: Levin
authors.forename: Peter
authors.initials: P
authors.lastname: Humphreys
authors.forename: Wikke
authors.initials: W
authors.lastname: Walop
authors.forename: Renee
authors.initials: R
authors.lastname: Brannan
mesh_terms: D000293:Adolescent; D002170:Canada / Q000453:epidemiology; D002648:Child; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008457:Measles / Q000150:complications; D011159:Population Surveillance; D013344:Subacute Sclerosing Panencephalitis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology