A-Z Index × Submit A-Z Index × Submit A-Z Index Search Dropdown × Submit Facebook Twitter LinkedIn Syndicate Emerging Infectious Disease journal ISSN: 1080-6059 Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.
Subacute sclerosing panencephalitis (SSPE) is a delayed, almost uniformly fatal complication of measles. The Philippines had measles outbreaks in 2010–2011, 2013, and 2018–2019; the last was the largest in the World Health Organization Western Pacific Region. Published SSPE data from the Philippines end in 2015. We reviewed all 20 children admitted with SSPE to a tertiary pediatric hospital in Quezon City during 2007–2022 and estimated year of measles infection. Median patient age was 6.2 years at hospital admission and 0.7 years at reported measles illness. Five (25.0%) of 20 admissions occurred in 2022, and estimated infection dates placed 4 patients within the 2018–2019 outbreak; all were admitted during 2020–2022. Given the multiyear latency of SSPE, additional cases might emerge over coming years. Reported measles history could not be established in one quarter of patients. Strengthened measles surveillance and sustained 2-dose vaccination coverage are needed.
Subacute sclerosing panencephalitis (SSPE) is a progressive neurodegenerative disorder caused by persistent central nervous system infection with a defective, hypermutant measles virus. It typically follows measles acquired in early childhood after a latency of years and is almost always fatal ( 1 , 2 ). Because SSPE follows measles by years rather than weeks, the neurologic consequences of an outbreak do not become visible until long after the outbreak has ended.
Measles vaccination was introduced in the Philippines in 1983; the first routine dose is scheduled at 9 months of age ( 3 ). Nationwide immunization campaigns in 1998 and 2004 were followed by historically low measles incidence in 2006 ( 3 ). First-dose measles-containing vaccine coverage later declined from 92% in 2004–2007 to 80% in 2015–2016 and 64% in 2021 ( 4 ). Reported measles cases rose sharply during a 2018–2019 outbreak, from 2,428 in 2017 to 48,525 in 2019, the largest outbreak in the World Health Organization Western Pacific Region during that period ( 5 ).
Published data on SSPE in the Philippines are limited; the largest local series described children seen at a single tertiary hospital during 2005–2015 ( 6 ). No published series from the Philippines spans the period during which children infected in the 2018–2019 outbreak would be expected to demonstrate symptoms of SSPE. We describe children admitted with SSPE to a tertiary government pediatric hospital over 16 years and examine the distribution of their estimated years of measles infection against the national outbreak record.
We retrospectively reviewed the records of all children admitted to National Children’s Hospital, a tertiary government pediatric hospital in Quezon City, the Philippines, with a final diagnosis of SSPE during January 1, 2007–December 31, 2022. All such patients were enumerated. The 2007 start date reflects the period from which complete institutional records and corresponding registry data were available.
We modified the case definition from Dyken’s criteria ( 1 ). We defined a case as a clinical diagnosis of SSPE by the attending pediatric neurologist on the basis of progressive neurologic…