title: Subacute sclerosing panencephalitis--the continuing threat.
abstract: 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.
authors.affiliation: Department of Virology, Croatian National Institute of Public Health, Zagreb, Croatia. tatjana.vilibic-cavlek@hzjz.hr
authors.forename: Tatjana Vilibić
authors.initials: TV
authors.lastname: Cavlek
authors.forename: Suncanica Ljubin
authors.initials: SL
authors.lastname: Sternak
authors.forename: Kamelija
authors.initials: K
authors.lastname: Zarković
authors.forename: Branka Marusić Della
authors.initials: BM
authors.lastname: Marina
authors.forename: Ljerka Cvitanović
authors.initials: LC
authors.lastname: Sojat
authors.forename: Anica
authors.initials: A
authors.lastname: Basnec
authors.forename: Bernard
authors.initials: B
authors.lastname: Kaić
authors.forename: Branko
authors.initials: B
authors.lastname: Turković
authors.forename: Gordana Mlinarić
authors.initials: GM
authors.lastname: Galinović
mesh_terms: 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
chemical_list: D000914:Antibodies, Viral