Subacute sclerosing panencephalitis in papua new guinean children: the cost of continuing inadequate measles vaccine coverage.
<h4>Introduction</h4>subacute sclerosing panencephalitis (SSPE) is a late, rare and usually fatal complication of measles infection. Although a very high incidence of SSPE in Papua New Guinea (PNG) was first recognized 20 years ago, estimated measles vaccine coverage has remained at ≤ 70...
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2011
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oai:doaj.org-article:a1195e7c98c8429a9ca66e6531e440da2021-11-18T09:13:37ZSubacute sclerosing panencephalitis in papua new guinean children: the cost of continuing inadequate measles vaccine coverage.1935-27271935-273510.1371/journal.pntd.0000932https://doaj.org/article/a1195e7c98c8429a9ca66e6531e440da2011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21245918/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Introduction</h4>subacute sclerosing panencephalitis (SSPE) is a late, rare and usually fatal complication of measles infection. Although a very high incidence of SSPE in Papua New Guinea (PNG) was first recognized 20 years ago, estimated measles vaccine coverage has remained at ≤ 70% since and a large measles epidemic occurred in 2002. We report a series of 22 SSPE cases presenting between November 2007 and July 2009 in Madang Province, PNG, including localized clusters with the highest ever reported annual incidence.<h4>Methodology/principal findings</h4>as part of a prospective observational study of severe childhood illness at Modilon Hospital, the provincial referral center, children presenting with evidence of meningo-encephalitis were assessed in detail including lumbar puncture in most cases. A diagnosis of SSPE was based on clinical features and presence of measles-specific IgG in cerebrospinal fluid and/or plasma. The estimated annual SSPE incidence in Madang province was 54/million population aged <20 years, but four sub-districts had an incidence >100/million/year. The distribution of year of birth of the 22 children with SSPE closely matched the reported annual measles incidence in PNG, including a peak in 2002.<h4>Conclusions/significance</h4>SSPE follows measles infections in very young PNG children. Because PNG children have known low seroconversion rates to the first measles vaccine given at 6 months of age, efforts such as supplementary measles immunisation programs should continue in order to reduce the pool of non-immune people surrounding the youngest and most vulnerable members of PNG communities.Laurens ManningMoses LamanHenry EdoniIvo MuellerHarin A KarunajeewaDavid SmithIlomo HwaiwhanjePeter M SibaTimothy M E DavisPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 5, Iss 1, p e932 (2011) |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Laurens Manning Moses Laman Henry Edoni Ivo Mueller Harin A Karunajeewa David Smith Ilomo Hwaiwhanje Peter M Siba Timothy M E Davis Subacute sclerosing panencephalitis in papua new guinean children: the cost of continuing inadequate measles vaccine coverage. |
| description |
<h4>Introduction</h4>subacute sclerosing panencephalitis (SSPE) is a late, rare and usually fatal complication of measles infection. Although a very high incidence of SSPE in Papua New Guinea (PNG) was first recognized 20 years ago, estimated measles vaccine coverage has remained at ≤ 70% since and a large measles epidemic occurred in 2002. We report a series of 22 SSPE cases presenting between November 2007 and July 2009 in Madang Province, PNG, including localized clusters with the highest ever reported annual incidence.<h4>Methodology/principal findings</h4>as part of a prospective observational study of severe childhood illness at Modilon Hospital, the provincial referral center, children presenting with evidence of meningo-encephalitis were assessed in detail including lumbar puncture in most cases. A diagnosis of SSPE was based on clinical features and presence of measles-specific IgG in cerebrospinal fluid and/or plasma. The estimated annual SSPE incidence in Madang province was 54/million population aged <20 years, but four sub-districts had an incidence >100/million/year. The distribution of year of birth of the 22 children with SSPE closely matched the reported annual measles incidence in PNG, including a peak in 2002.<h4>Conclusions/significance</h4>SSPE follows measles infections in very young PNG children. Because PNG children have known low seroconversion rates to the first measles vaccine given at 6 months of age, efforts such as supplementary measles immunisation programs should continue in order to reduce the pool of non-immune people surrounding the youngest and most vulnerable members of PNG communities. |
| format |
article |
| author |
Laurens Manning Moses Laman Henry Edoni Ivo Mueller Harin A Karunajeewa David Smith Ilomo Hwaiwhanje Peter M Siba Timothy M E Davis |
| author_facet |
Laurens Manning Moses Laman Henry Edoni Ivo Mueller Harin A Karunajeewa David Smith Ilomo Hwaiwhanje Peter M Siba Timothy M E Davis |
| author_sort |
Laurens Manning |
| title |
Subacute sclerosing panencephalitis in papua new guinean children: the cost of continuing inadequate measles vaccine coverage. |
| title_short |
Subacute sclerosing panencephalitis in papua new guinean children: the cost of continuing inadequate measles vaccine coverage. |
| title_full |
Subacute sclerosing panencephalitis in papua new guinean children: the cost of continuing inadequate measles vaccine coverage. |
| title_fullStr |
Subacute sclerosing panencephalitis in papua new guinean children: the cost of continuing inadequate measles vaccine coverage. |
| title_full_unstemmed |
Subacute sclerosing panencephalitis in papua new guinean children: the cost of continuing inadequate measles vaccine coverage. |
| title_sort |
subacute sclerosing panencephalitis in papua new guinean children: the cost of continuing inadequate measles vaccine coverage. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2011 |
| url |
https://doaj.org/article/a1195e7c98c8429a9ca66e6531e440da |
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