A Vaccine‐Preventable Infectious Disease Kills Half a Million Children Annually

Abstract

The study by Bellini et al. [1] in this issue of the Journal of Infectious Diseases pro vides a reassuring affirmation that what previously had been only a clinical/epi demiologic observation is indeed factual: measles vaccine viruses do not cause sub acute sclerosing panencephalitis (SSPE). Bellini and colleagues have also revealed that the incidence of SSPE is much higher after natural measles than previously had been appreciated. Using sophisticated lab oratory technology that was not available when SSPE was previously reported in the United States, these investigators exam ined brain tissue specimens obtained dur ing the resurgence of measles in the United States during 1989-1991, confirmed the diagnosis of SSPE, and, by use of genotype analysis, established wild-type measles vi ruses as the responsible etiologic agents. The authors demonstrated, by use of data gathered during the measles outbreak of 1989-1991, as well as by use of data col lected during earlier outbreaks, that the true incidence of SSPE was ~7-ll cases of SSPE/100,000 cases of measles, rather than the previously cited estimate of 1 case of SSPE/100,000 cases of measles. When a live attenuated measles virus vaccine was first licensed in the United States in 1963 [2], the etiology of SSPE was unknown. It was not until 1967-1969 that measles viruses were demonstrated to