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. 2020 Jun;26(6):737-742.
doi: 10.1016/j.cmi.2019.10.035. Epub 2019 Nov 11.

High risk of subacute sclerosing panencephalitis following measles outbreaks in Georgia

N Khetsuriani  1 , K Sanadze  2 , M Abuladze  3 , N Tatishvili  3
Affiliations

High risk of subacute sclerosing panencephalitis following measles outbreaks in Georgia

N Khetsuriani et al. Clin Microbiol Infect. 2020 Jun.

Abstract

Objective: To describe cases and estimate subacute sclerosing panencephalitis (SSPE) risk following large-sale measles outbreaks in Georgia. A rare, fatal late complication of measles, SSPE is often overlooked in assessments focused on the acute illness. Georgia had 8377 and 11,495 reported measles cases during the 2004-2005 and 2013-2015 outbreaks, respectively, but SSPE burden has not been assessed.

Methods: SSPE cases diagnosed during 2008-2017 were identified from hospitalization registries in major neurological departments likely to admit SSPE patients. Information on reported measles cases and deaths was obtained from the national measles surveillance system and published reports. The risk of SSPE (number of measles cases per one SSPE case) was calculated for cases associated with the 2004-2005 outbreak. Crude estimates were adjusted to account for potential under-reporting of measles, using 50%, 25% and 10% estimates of completeness of reporting.

Results: Sixteen SSPE cases diagnosed during 2008-2017 were identified. Eleven (92%) of 12 SSPE cases with a known history of measles had infection at ≤2 years and one (8%) at 3 years of age. Crude estimate of SSPE risk for the 2004-2005 outbreak was 1:1396. Adjusted estimates were 1:2792, 1:1:5584 and 1:13 960, assuming 50%, 25% and 10% completeness of reporting measles cases, respectively.

Conclusions: The review demonstrated substantial risk of SSPE in Georgia, supporting recent data suggesting that risk of SSPE following measles infection is higher than previously thought. To prevent SSPE in Georgia, very high timely immunization coverage for measles should be achieved among children, and immunity gap among adults should be closed.

Keywords: Burden of measles; Georgia; Measles; Measles complications; Subacute sclerosing panencephalitis.

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Figures

Figure 1.
Figure 1.
Subacute sclerosing panencephalitis (SSPE) cases identified during 2008–2017 and measles cases reported during 1995–2017, Georgia
Figure 2.
Figure 2.
Subacute sclerosing panencephalitis (SSPE) cases with known history of measles by measles onset year, Georgia
See this image and copyright information in PMC

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