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A continuing high incidence of subacute sclerosing panencephalitis (SSPE) in the Eastern Highlands of Papua New Guinea

Published online by Cambridge University Press:  07 October 2003

T. TAKASU
Affiliation:
Department of Neurology, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610 Japan University Research Center, Nihon University, Tokyo
J. M. MGONE
Affiliation:
Goroka Base General Hospital, Eastern Highlands Province, Papua New Guinea
C. S. MGONE
Affiliation:
Papua New Guinea Institute of Medical Research
K. MIKI
Affiliation:
Department of Neurology, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610 Japan
K. KOMASE
Affiliation:
Department of Research and Development, Research Center of Biologicals, The Kitasato Institute, Tokyo
H. NAMAE
Affiliation:
Department of Infection and Immunology, SRL, Tokyo
Y. SAITO
Affiliation:
Department of Infection and Immunology, SRL, Tokyo
Y. KOKUBUN
Affiliation:
Department of Neurology, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610 Japan
T. NISHIMURA
Affiliation:
Department of Neurology, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610 Japan
R. KAWANISHI
Affiliation:
Department of Neurology, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610 Japan
T. MIZUTANI
Affiliation:
Department of Neurology, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610 Japan
T. J. MARKUS
Affiliation:
Goroka Base General Hospital, Eastern Highlands Province, Papua New Guinea
J. KONO
Affiliation:
Papua New Guinea Institute of Medical Research
P. G. ASUO
Affiliation:
Goroka Base General Hospital, Eastern Highlands Province, Papua New Guinea
M. P. ALPERS
Affiliation:
Papua New Guinea Institute of Medical Research
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Abstract

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The aims of this descriptive study were to confirm the high incidence of subacute sclerosing panencephalitis (SSPE) previously reported from Papua New Guinea (PNG) and to relate SSPE to previous measles vaccination and measles illness. From February 1997 to April 1999 we diagnosed a total of 55 patients with SSPE at Goroka Base General Hospital in Eastern Highlands Province (EHP) of PNG. The diagnosis was based on high cerebrospinal fluid and serum measles virus antibody titres with progressive neurological disorder and myoclonic jerks. Of these 55 patients 42 were from EHP, including 32 whose onset was in the 2-year period 1997–1998. The annual incidence of SSPE in EHP in these 2 years was 98 per million population under 20 years of age, the highest ever reported. This incidence was more than ten times higher than the highest incidence in the prevaccine era reported from elsewhere. The mean age of onset of SSPE was 7·7 years (range 2·8–14·8 years) and the interval between measles and the onset of SSPE, where known, had a mean of 5·9 years and a range of 2·5–11·1 years. Among the SSPE patients 19 had a documented history of measles vaccination. Eight of these 19 also had documentation of previous measles illness; of these, seven were vaccinated after the development of measles and one was vaccinated 20 days before measles illness. Two non-SSPE children received vaccination twice which was documented and subsequently developed measles which was also substantiated by documentation. Two patients with SSPE yielded amplified nucleotide sequences of measles virus that were different from any of the vaccine strains. We found no evidence to implicate measles vaccination in the development of SSPE.

Type
Research Article
Copyright
2003 Cambridge University Press