Epidemiology and Infection

Research Article

High incidence of subacute sclerosing panencephalitis in South India

V. Sahaa1, T. Jacob Johna1 c1, P. Mukundana1, C. Gnanamuthua2, S. Prabhakara2, G. Arjundasa3, Z. A. Sayeeda3, G. Kumaresana3 and K. Srinivasa4a5

a1 Departments of Virology, Christian Medical College and Hospital, Vellore

a2 Departments of Neurology, Christian Medical College and Hospital, Vellore

a3 Institute of Neurology, Madras Medical College, Madras

a4 K. Gopalakrishna Department of Neurology, V.H.8. Medical Centre, Madras

a5 T. S. Srinivasan Department of Neurology and Research, Public Health Centre, Madras

Abstract

During 19837 a clinical diagnosis of subacute sclerosing panencephalitis (SSPE) was confirmed by the detection of measles virus haemagglutination inhibiting antibody in the cerebrospinal fluid (CSF) in 81 subjects resident in Tamilnadu. The antibody titre (reciprocol of the endpoint dilution) in the CSF ranged from 2 to 32 and in the sera from 8 to 2048. The CSF: serum ratios of titres were 1:41:64 in 80 cases and 1:128 in one case. The median age at onset of SSPE was 10 years and 97% of cases were diagnosed at stage 2 and beyond. Based on the geographic distribution of 72 cases in an estimated population of 84 million, the annual incidence of SSPE was calculated to be 214 per million population, or 43 cases per million children below 20 years. Assuming that only 10% of all cases would have reached the level of laboratory diagnosis, the incidence may be as high as 21 cases per million population.

(Accepted October 03 1989)

Correspondence:

c1 Professor T.Jacob John, Head, Department of Virology, Christian Medical College and Hospital. Vellore, India 632004.

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