What is the risk?

"When the Department of Health ran its last major vaccine drive in 1989, Dr Norman Begg, consultant epidemiologist of the Public Health Laboratory Service, cited the then official statistics that one in 5,000 children contracting wild measles will develop acute encephalitis, an inflammation of the brain: and one in 5,000 of those will develop SSPE (sub-acute sclerosing panencephalitis), an almost inevitably fatal progressive disease which causes hardening of the brain.
        Five years later when one columnist encouraged parents to have their children re-vaccinated in the countrywide measles campaign, the percentage of measles victims who might go on to develop encephalitis had shrunk to one in every 500. One in 10 of these will die and one in four will suffer permanent brain damage, the columnist maintained. As the campaign intensified, other newspapers had magnified the danger even further. By November it seemed that one out of every 17 cases of measles would turn into a case of encephalitis.
        But the report of the journal geared specifically for the study of the fatal illness being worried ovet the SSPE Registry concluded that the measles-induced form of this disease is "very rare", occurring in one per million cases (J of the Amer Med Assoc, 1972: 220:. 959-62). Furthermore, a study of 52 people with SSPE concluded that environmental factors other than measles, such as head injuries or close exposure to certain animals, played an important part in the onset of the disease (Amer J of Epid, 1980: iii: 415-24). "There were no differences with regard to the average age at vaccination, having received more than one measles vaccination, or having received measles vaccine after natural measles," concluded the authors."---Lynne McTaggart, WDDTY.  www.wddty.co.uk

Jabbour JT, et al.
Epidemiology of subacute sclerosing panencephalitis (SSPE). A report of the SSPE registry.
JAMA. 1972 May 15;220(7):959-62. No abstract available.
PMID: 4554467; UI: 72182576.

"Measles (rubeola) is often a severe disease, frequently complicated by middle ear infection or bronchopneumonia. Encephalitis
occurs in approximately 1 of every 2,000 reported cases; survivors often have permanent brain damage and mental retardation.
Death, predominantly from respiratory and neurologic causes, occurs in 1 of every 3,000 reported measles cases. The risk of death is known to be greater for infants and adults than for children and adolescents. "---CDC/ACIP 1982 http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00001090.htm

A crude estimate can be made of the risk of SSPE following natural measles infection by determining the year in which a given person who developed SSPE contracted measles and the number of measles cases that occurred in that year.** Similarly, the risk, if any, associated with measles vaccine can be estimated by determining the year of vaccination of patients with SSPE and the net number of doses of live-virus measles vaccine distributed during that year. The estimated risk of SSPE following natural measles infection averaged 8.5 cases per million measles cases occurring in 1960-1974.*** The estimated rate of SSPE following measles vaccination averaged 0.7 reported SSPE cases per million doses of live-virus measles vaccine distributed from 1963 (the year of vaccine licensure) through 1974. **Assuming a 10% reporting efficiency, estimated case numbers were determined by multiplying reported cases for those years by 10. ***The average interval between onset of measles and onset of SSPE is approximately 7 years. Thus, SSPE risk estimates for persons who developed measles beyond 1974 are less likely to be accurate. Reported by P Dyken, MD, R DuRant, P Shmunes, Medical College of Georgia, Augusta, GA; Surveillance, Investigations, and Research Br, Immunization Div, Center for Prevention Svcs, CDC.  http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00001185.htm


SSPE from vaccines

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