Global burden of measles: A registry of neurological complications
Ibrahim Oncel, Ruzica Kravljanac, Altynshash Jaxybayeva, Sophia Bakhtadze, Jo Wilmshurst, Elaine Wirrell, Banu Anlar
Background Neurological complications of measles include acute encephalitis of viral or postinfectious etiology. The most chronic and severe complication, subacute sclerosing panencephalitis (SSPE), is often underdiagnosis and underreported. ICNA initiated a registry in 2020 to increase awareness about neurological complications of measles, understand epidemiological trends, form a network of clinicians, promote knowledge and collaboration for future research.
Methods A REDCap-based registry was developed to collect data from pediatric neurologists on neurological complications of measles from February 2019 to February 2022 disseminated via ICNApedia and letters to pediatric neurologists in countries with measles in endemic or epidemic state. Anonymized data was collected through a standard questionnaire.
Results Nine SSPE patients (F/M=3/6) from 4 different countries were recorded. Seven patients had a history of primary measles infection at mean age 0.8 years. Six/9 patients were unvaccinated against measles. Symptoms of SSPE started at mean 6.2 years with behavioral changes(8/9), myoclonus(8/9), seizures(7/9). Treatment was with IVIg in 8/9 patients followed by inosiplex(6/8) and interferon(3/7). Six/9 patients required hospitalization for mean 45 days, 2 of them in intensive care. All patients had severe cognitive impairment and 7/8 were non-ambulant at last follow up. Quality of life was described as “very poor” in all patients and caregivers.
Discussion Routine pediatric vaccination coverage decreased worldwide during the COVID-19 pandemic meanwhile knowledge on the pathogenesis of viral infections, antiviral immunity, and antiviral drugs expanded. The overall result of these developments on the global burden of measles on public health can only be assessed throguh up-to-date clinical data.
Keywords: Measles, Neurological Complications, Global Burden
Ibrahim Oncel
Hacettepe University Faculty of Medicine
Turkey
Ruzica Kravljanac
Faculty of Medicine University of Belgrade
Serbia
Altynshash Jaxybayeva
Astana Medical University
Kazakhstan
Sophia Bakhtadze
Tbilisi State Medical University
Georgia
Jo Wilmshurst
University of Cape Town, Red Cross War Memorial Children’s Hospital, Neuroscience Institute
South Africa
Elaine Wirrell
Mayo Clinic
United States
Banu Anlar
Hacettepe University Faculty of Medicine
Turkey
Background Neurological complications of measles include acute encephalitis of viral or postinfectious etiology. The most chronic and severe complication, subacute sclerosing panencephalitis (SSPE), is often underdiagnosis and underreported. ICNA initiated a registry in 2020 to increase awareness about neurological complications of measles, understand epidemiological trends, form a network of clinicians, promote knowledge and collaboration for future research.
Methods A REDCap-based registry was developed to collect data from pediatric neurologists on neurological complications of measles from February 2019 to February 2022 disseminated via ICNApedia and letters to pediatric neurologists in countries with measles in endemic or epidemic state. Anonymized data was collected through a standard questionnaire.
Results Nine SSPE patients (F/M=3/6) from 4 different countries were recorded. Seven patients had a history of primary measles infection at mean age 0.8 years. Six/9 patients were unvaccinated against measles. Symptoms of SSPE started at mean 6.2 years with behavioral changes(8/9), myoclonus(8/9), seizures(7/9). Treatment was with IVIg in 8/9 patients followed by inosiplex(6/8) and interferon(3/7). Six/9 patients required hospitalization for mean 45 days, 2 of them in intensive care. All patients had severe cognitive impairment and 7/8 were non-ambulant at last follow up. Quality of life was described as “very poor” in all patients and caregivers.
Discussion Routine pediatric vaccination coverage decreased worldwide during the COVID-19 pandemic meanwhile knowledge on the pathogenesis of viral infections, antiviral immunity, and antiviral drugs expanded. The overall result of these developments on the global burden of measles on public health can only be assessed throguh up-to-date clinical data.
Keywords: Measles, Neurological Complications, Global Burden
Ibrahim Oncel
Hacettepe University Faculty of Medicine
Turkey
Ruzica Kravljanac
Faculty of Medicine University of Belgrade
Serbia
Altynshash Jaxybayeva
Astana Medical University
Kazakhstan
Sophia Bakhtadze
Tbilisi State Medical University
Georgia
Jo Wilmshurst
University of Cape Town, Red Cross War Memorial Children’s Hospital, Neuroscience Institute
South Africa
Elaine Wirrell
Mayo Clinic
United States
Banu Anlar
Hacettepe University Faculty of Medicine
Turkey
Ibrahim Oncel
Hacettepe University Faculty of Medicine Turkey
Hacettepe University Faculty of Medicine Turkey