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SSPE is a rare but always fatal disease that destroys a child's brain.
Child with measles. Credit: Getty | _jure
A child in Los Angeles has died of a measles-related brain disorder stemming from an infection in infancy, the Los Angeles County health department reported Thursday.
Specifically, the child died of subacute sclerosing panencephalitis (SSPE), a rare, but always fatal complication that strikes years after an initial measles infection. The health department's announcement offered few details about the child, including the child's age, but said that the child had contracted the virus before they were old enough to be vaccinated against measles. The first of two recommended doses of measles, mumps, and rubella (MMR) vaccine is given between 12 and 15 months.
"This case is a painful reminder of how dangerous measles can be, especially for our most vulnerable community members," Muntu Davis, a Los Angeles County health officer, said in a statement. "Infants too young to be vaccinated rely on all of us to help protect them through community immunity. Vaccination is not just about protecting yourself—it's about protecting your family, your neighbors, and especially children who are too young to be vaccinated."
SSPE is caused by a persistent measles infection in the central nervous system. Children infected with the virus may go through the standard disease progression—flu-like symptoms, high fever, the telltale rash—and then appear to fully recover. But, for a small few, the virus remains and SSPE emerges years later, often seven to 10 years after the initial infection.
The Los Angeles health department noted that SSPE generally affects about 1 in 10,000 people with measles, but the risk may be much higher—about 1 in 600—for those who get measles as infants, such as the child who recently died.
With widespread vaccination, which led to measles being declared eliminated from the US in 2000, SSPE has virtually disappeared in the US. However, with vaccination rates slipping and anti-vaccine misinformation and views gripping the country, health experts fear seeing more of these devastating cases. Already, the US measles case count for the year is at a 33-year high, and two other children, as well as an adult, died from the acute infection this year.
Devastating disease
Symptoms of SSPE emerge in horrifying stages, starting with mood and personality changes, including depression. Then, uncontrolled, jerky movements develop as well as vision loss, dementia, and seizures. In the third stage, jerky movements become writhing and rigidity. In the last stage, the parts of the brain that regulate breathing, heart rate, and blood pressure are damaged, leading to coma and death. The timeline for the stages varies widely, as does the exact presentation.
But a heart-wrenching 2016 case report of a boy in Oregon detailed the horrors of what the disease can look like. The boy, who was 14 when he died, had contracted measles in the Philippines as a 1-year-old. His SSPE symptoms began at age 11, when he was a straight-A fifth grader who played soccer and basketball. He began to struggle with homework, drop utensils, and fall asleep during meals and even while walking. Over the next month, he became less alert and seemed confused. He started having jerky movements. He lost his appetite and his weight dropped 12 pounds. He could no longer go to school and had a home tutor.
Next, he developed repetitive behaviors, couldn't sit still, frequently fell, and asked seemingly meaningless questions. He became aggressive and could no longer be tutored. He started shuffling and walking on his toes before refusing to walk altogether. He cried continuously, became increasingly aggressive, and began sleeping for long periods. His speech declined as did his mental status. He became incontinent and was unable to eat or drink. In the final stage, about four and half months after the symptoms began, he could no longer follow objects with his eyes, didn't seem to recognize his family members’ faces or voices, and was unresponsive to questions.
With no treatment for SSPE, he was discharged from the hospital to home hospice care and died 43 months later in 2015.
"This case underscores the importance of maintaining high population immunity, through routine administration of 2 doses of measles-containing vaccine to all eligible children," the authors of the boy's case report concluded.
Child with measles. Credit: Getty | _jure
A child in Los Angeles has died of a measles-related brain disorder stemming from an infection in infancy, the Los Angeles County health department reported Thursday.
Specifically, the child died of subacute sclerosing panencephalitis (SSPE), a rare, but always fatal complication that strikes years after an initial measles infection. The health department's announcement offered few details about the child, including the child's age, but said that the child had contracted the virus before they were old enough to be vaccinated against measles. The first of two recommended doses of measles, mumps, and rubella (MMR) vaccine is given between 12 and 15 months.
"This case is a painful reminder of how dangerous measles can be, especially for our most vulnerable community members," Muntu Davis, a Los Angeles County health officer, said in a statement. "Infants too young to be vaccinated rely on all of us to help protect them through community immunity. Vaccination is not just about protecting yourself—it's about protecting your family, your neighbors, and especially children who are too young to be vaccinated."
SSPE is caused by a persistent measles infection in the central nervous system. Children infected with the virus may go through the standard disease progression—flu-like symptoms, high fever, the telltale rash—and then appear to fully recover. But, for a small few, the virus remains and SSPE emerges years later, often seven to 10 years after the initial infection.
The Los Angeles health department noted that SSPE generally affects about 1 in 10,000 people with measles, but the risk may be much higher—about 1 in 600—for those who get measles as infants, such as the child who recently died.
With widespread vaccination, which led to measles being declared eliminated from the US in 2000, SSPE has virtually disappeared in the US. However, with vaccination rates slipping and anti-vaccine misinformation and views gripping the country, health experts fear seeing more of these devastating cases. Already, the US measles case count for the year is at a 33-year high, and two other children, as well as an adult, died from the acute infection this year.
Devastating disease
Symptoms of SSPE emerge in horrifying stages, starting with mood and personality changes, including depression. Then, uncontrolled, jerky movements develop as well as vision loss, dementia, and seizures. In the third stage, jerky movements become writhing and rigidity. In the last stage, the parts of the brain that regulate breathing, heart rate, and blood pressure are damaged, leading to coma and death. The timeline for the stages varies widely, as does the exact presentation.
But a heart-wrenching 2016 case report of a boy in Oregon detailed the horrors of what the disease can look like. The boy, who was 14 when he died, had contracted measles in the Philippines as a 1-year-old. His SSPE symptoms began at age 11, when he was a straight-A fifth grader who played soccer and basketball. He began to struggle with homework, drop utensils, and fall asleep during meals and even while walking. Over the next month, he became less alert and seemed confused. He started having jerky movements. He lost his appetite and his weight dropped 12 pounds. He could no longer go to school and had a home tutor.
Next, he developed repetitive behaviors, couldn't sit still, frequently fell, and asked seemingly meaningless questions. He became aggressive and could no longer be tutored. He started shuffling and walking on his toes before refusing to walk altogether. He cried continuously, became increasingly aggressive, and began sleeping for long periods. His speech declined as did his mental status. He became incontinent and was unable to eat or drink. In the final stage, about four and half months after the symptoms began, he could no longer follow objects with his eyes, didn't seem to recognize his family members’ faces or voices, and was unresponsive to questions.
With no treatment for SSPE, he was discharged from the hospital to home hospice care and died 43 months later in 2015.
"This case underscores the importance of maintaining high population immunity, through routine administration of 2 doses of measles-containing vaccine to all eligible children," the authors of the boy's case report concluded.
