Year: 2016
Type: article
Study design: Case Report
Abstract: In 2015, the Oregon Health Authority was notified of the death of a boy with subacute sclerosing panencephalitis (SSPE), a rare and fatal complication of measles.The patient, aged 14 years, had reportedly been vaccinated against measles in the Philippines at age 8 months.However, the patient contracted measles at age 1 year while still in the Philippines.He had been well until 2012, when his neurodegenerative symptoms began.After the diagnosis of SSPE was made, the patient remained in home hospice care until his death.Investigators from the Oregon Health Authority and the Oregon Health and Science University reviewed the patient's medical records and interviewed the parents.Vaccination against measles can prevent not only acute measles and its complications, but also SSPE.Investigators learned that, in 2012, at age 11 years, the boy, who was previously healthy and developmentally normal, had been admitted to a tertiary care children's hospital in Oregon with severe, progressive encephalopathy.Before the onset of his neurologic illness, the patient had been a straight-A, fifthgrade student who played soccer and basketball.The symptoms began approximately 4 months before the hospital admission, when the patient began to struggle with homework, drop utensils, and doze off during meals, eventually progressing to falling asleep while walking.During the subsequent month, his mother reported that he was less alert and sometimes seemed confused.He experienced myoclonic jerks and involuntary hand and arm movements, which became increasingly frequent, and his coordination deteriorated.He missed 3 weeks of school and required a home tutor.His appetite decreased, and he lost 12 pounds but remained playful and interactive.A pediatric neurologist was consulted.No family history of neurologic disease was reported.The initial evaluation included a lumbar puncture and magnetic resonance imaging of the brain, both of which were unremarkable.An electroencephalogram (EEG) was abnormal, with frequent, highamplitude bifrontal slowing, a nonspecific finding.Despite extensive evaluation, the cause of the neurologic degeneration was not identified.During the following month, the patient's cognitive and motor skills declined further and included the onset of repetitive behaviors, as well as inability to sit still, frequent falling, and asking seemingly meaningless questions.He became aggressive and could no longer be tutored.During the month * http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/table-of-contents.pdf.† http://indianpediatrics.net/apr1998/337.pdf.§ Measles, mumps, and rubella (MMR) and measles, mumps, rubella, and varicella (MMRV) vaccines are the only measles-containing vaccines available in the United States.
Institution: Oregon Health Authority
Language: English
Topic: Virology and Viral Diseases
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2268223255