| CLINICAL SIGNS |
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| Year : 2002 | Volume
: 20
| Issue : 4 | Page : 226 |
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SSPE and measles vaccine
Y Paul
A-D-7, Devi Marg, Bani Park, Jaipur-302 016, Rajasthan, India
Correspondence Address:
A-D-7, Devi Marg, Bani Park, Jaipur-302 016, Rajasthan, India
How to cite this article:
Paul Y. SSPE and measles vaccine. Indian J Med Microbiol 2002;20:226 |
Dear Editor,
This refers to a thought provoking study by Manayani et al entitled 'SSPE - The continuing challenge: A study based on serological evidence from a tertiary care centre in India.'[1] Three observations made by the authors are important and need clarification. Firstly, the authors have stated “Incidence of SSPE continues to be high, like a previous study published from Christian Medical College Hospital, Vellore.”[2] The study referred to had been done at the same centre from 1983-1987 i.e., before introduction of measles vaccine in India. The present study had been conducted from June 1996 to December 1998 i.e., about 10 years after introduction of measles vaccination in India. During the study period Pulse Polio Immunization Campaigns were going on, which had some adverse effect on measles vaccine coverage. Perhaps for all practical purposes, the study populations in both studies were similar or near similar regarding measles vaccination, therefore, much difference in epidemiology of the disease was not expected.
Secondly, there were ten cases (24%) of SSPE who had a history of measles vaccination. The authors have not mentioned the age of the cases at the time of measles vaccination. It would be important to know how many of these cases had received the vaccine below 12 months of age and how many had received vaccine after 12 months of age.
Lastly, the authors have stated “the cases of SSPE in vaccinated individuals could have occurred due to poor seroconversion or vaccine failure, as there are no reported cases of vaccine associated SSPE. This could be either due to poor quality of vaccine (improper cold chain) or administration of measles vaccine at an earlier than the recommended age of 12-15 months or may be due to variants of measles virus.”[3] This has very important implication, because in our country the measles vaccine is recommended at 9 months of age, or earlier, if there is increased incidence of measles infection at that point of time. In developed countries, the age for measles infection has shifted upwards, so they can wait till the age of 12 months or later, while in our country measles infection cases are reported from 6 months of age onwards. If we start administration of measles vaccine at 12-15 months of age, then majority of infants would have contacted measles infection before the new recommended age of vaccination and may later succumb to SSPE.
| ~ References | |  |
| 1. | Manayani DJ, Abraham M, Gnanmuthu C, Solomon T, Alexander M, Sridharan G. SSPE - The continuing challenge : A study based on serological evidence from a tertiary care centre in India. Indian J Med Microbiol 2002;20:16-18.  |
| 2. | Saha V, John TJ, Mukundan P, Gnanamuthu C, Prabhakar S, Arjundas G, et al. High incidence of subacute sclerosing panencephalitis in South India. Epidemiol Infect 1990;104:151-156. |
| 3. | Katayam Y, Shibara K, Koham T, Homma M, Hotta H. Molecular epidemiology and changing distribution of genotypes of measles virus field strain in Japan. J Clin Microbiol 1997;35:2651-2653. |
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