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Subacute sclerosing panencephalitis: clinical phenotype, epidemiology, and preventive interventions

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TLDR
This report documents current data relating to the clinical phenotype, epidemiology, and understanding of SSPE, inclusive of preventive interventions, and indicates children residing in areas with poor vaccination coverage and high prevalence of human immunodeficiency virus are at increased risk of developing S SPE.
Abstract
Subacute sclerosing panencephalitis (SSPE) is a preventable condition reported in 6.5 to 11 per 100 000 cases of measles, and highest in children who contracted measles infection when they were less than 5 years of age. Children residing in areas with poor vaccination coverage and high prevalence of human immunodeficiency virus are at increased risk of developing SSPE. SSPE is life-threatening in most affected children. This report documents current data relating to the clinical phenotype, epidemiology, and understanding of SSPE, inclusive of preventive interventions. While improvements in disease progression with immunomodulation may occur, overall there is no cure. Most therapies focus on supportive needs. Seizures and abnormal movements may respond to carbamazepine. Many countries advocate policies to enhance vaccination coverage. Effective preventive health care programmes, assurance of parental perceptions, and crisis support for unprecedented events obstructing effective primary health care are needed. Until measles is eradicated worldwide, children in all regions remain at risk. WHAT THIS PAPER ADDS: Measles contracted under 5 years of age has highest risk of developing subacute sclerosing panencephalitis (SSPE). Children with, or exposed to, human immunodeficiency virus infection, who contract measles may be at increased risk of SSPE.

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References
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Journal ArticleDOI

The dynamics of measles in sub-Saharan Africa

TL;DR: It is shown that measles epidemics in Niger are highly episodic, particularly in the capital Niamey, and how increased vaccine coverage, but still below the local elimination threshold, could lead to increasingly variable major outbreaks in highly seasonally forced contexts.
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Effectiveness of antiretroviral therapy among HIV-infected children in sub-Saharan Africa

TL;DR: The findings emphasise the need for low-cost diagnostic tests that allow for earlier identification of HIV infection in infants living in sub-Saharan Africa, improved access to antiretroviral treatment programmes, including expansion of care into rural areas, and the integration of antireTroviral Treatment programmes with other health-care services, such as nutritional support.
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Subacute Sclerosing Panencephalitis: More Cases of This Fatal Disease Are Prevented by Measles Immunization than Was Previously Recognized

TL;DR: It was determined that the development of SSPE was associated with the measles resurgence that occurred in the United States during 1989-1991, and the estimated risk of developing S SPE was 10-fold higher than the previous estimate reported for the United United States in 1982.
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Reduced vaccination and the risk of measles and other childhood infections post-Ebola

TL;DR: There is a clear path to avoiding outbreaks of childhood vaccine-preventable diseases once the threat of Ebola begins to recede: an aggressive regional vaccination campaign aimed at age groups left unprotected because of health care disruptions.