EARLY ONSET SUBACUTE SCLEROSING PANENCEPHALITIS IN INDIAN CHILDREN: A CASE SERIES HIGHLIGHTING AN ALARMING TREND AND THE NEED TO RE-ASSESS THE CURRENT VACCINATION STRATEGIES

Abstract

Subacute Sclerosing Panencephalitis (SSPE) is a very rare and deadly complication of measles infection, with its incidence being signicantly higher in developing countries. Our retrospective analysis of four patients highlights another ominous trend of this deadly disease, i.e, early age at onset leading to a rapid progress of symptoms. Four patients, presenting to the pediatrics department of a tertiary care hospital of eastern India, from February 2020 To December 2020, diagnosed as SSPE, by the modied Dyken's criterion, were analyzed. Paired CSF and serum samples were taken from all the patients and were analyzed for measles-specic IgG in serum (dilution 1:404) & CSF (dilution 1:2) using measles specic IgG ELISA (Enzyme-linked immunosorbent assay) kit. All the patients were under 6 years of age with a mean latency period of 2.5 years. All had contracted measles infection before receiving the scheduled rst dose of vaccine at 9 months of age. Treatment was initiated according to the institutional protocol, keeping in mind the affordability. However, follow-up of the patients reected the rapid progression of the disease. High morbidity and mortality is associated with SSPE in developing countries like India, where treatment availability and affordability becomes a major issue. In order to prevent this disease, it is necessary to prevent measles infection. Recent studies have recorded early disappearance of maternal measles-specic antibodies thus pointing towards the need to vaccinate early. Our case series emphasizes the need to revamp the current vaccination strategies in India with particular focus on re-scheduling the rst dose to 6 months of age.