Subacute sclerosing panencephalitis--the continuing threat.
Clinical, epidemiological and laboratory findings of four patients with subacute sclerosing panencephalitis (SSPE), diagnosed in Croatia in 2002, were examined. Patient age at disease onset ranged from 5-11 years. All patients were vaccinated regularly with MMR-vaccine. Two patients had a history of measles infection at the age of six and seven months, respectively. In the other two patients, the disease started immediately after the varicella infection. Complement fixing antibody titre to the measles virus (MV) ranged from 1:1024 to 1:65536 in serum, and from 1:16 to 1:128 in cerebrospinal fluid (CSF). In CSF, no antibodies to varicella-zoster virus were found. Brain tissue samples were obtained at autopsy from two patients. In one patient, electron microscopy demonstrated intranuclear viral inclusions (MV nucleocapsids). MV antigen was detected in brain imprints using IFA in both of them. Viral RNA was found in brain tissue samples only, while plasma, serum and CSF were negative. Nucleotide sequence analysis showed that the viruses detected in brain tissue belong to the wild-type MV D6 genotype.
Cavlek
Tatjana Vilibić
TV
Department of Virology, Croatian National Institute of Public Health, Zagreb, Croatia. tatjana.vilibic-cavlek@hzjz.hr
Sternak
Suncanica Ljubin
SL
Zarković
Kamelija
K
Marina
Branka Marusić Della
BM
Sojat
Ljerka Cvitanović
LC
Basnec
Anica
A
Kaić
Bernard
B
Turković
Branko
B
Galinović
Gordana Mlinarić
GM
D000914:Antibodies, Viral / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008457:Measles / Q000276:immunology / Q000517:prevention & control; D008459:Measles virus / Q000276:immunology; D013344:Subacute Sclerosing Panencephalitis / Q000175:diagnosis / Q000821:virology; D014611:Vaccination
D000914:Antibodies, Viral