Child dies from complications of measles years after infection

A school-age child has died from a devastating brain complication of measles in Los Angeles, highlighting the deadly consequences of declining vaccination rates.

The child, who was too young to receive the measles vaccine, developed subacute sclerosing panencephalitis (SSPE) – a progressive and almost always fatal brain condition that strikes years after initial measles infection.

SSPE affects around one in 10,000 people who contract measles, but the risk soars to one in 600 for infants infected before their first birthday. The condition causes progressive brain scarring and inflammation, typically emerging six to eight years after the original measles infection.

Early symptoms can be mistaken for learning difficulties or concentration problems. But over months, patients develop rapidly worsening dementia, uncontrollable jerking movements and seizures. Despite treatment attempts with antiviral and anti-inflammatory drugs, nearly all patients die within five years.

The tragedy underscores growing concerns about measles outbreaks in countries with previously high vaccination coverage. The US Centers for Disease Control and Prevention has reported nearly 1,500 measles cases so far this year alone.

The anti-vaccine legacy

Declining vaccination rates stem partly from fraudulent research attempting to link the MMR vaccine to autism – claims by a now-discredited doctor that have been thoroughly debunked. Social media misinformation has amplified these fears, potentially worsened by COVID pandemic scepticism around vaccines.

Before measles vaccination began in the 1960s, the UK saw between 100,000 and 800,000 cases annually. Globally, the disease killed around 2-3 million people each year. Measles remains one of the most contagious viruses known, infecting nine out of ten unvaccinated people exposed to it.

The measles vaccine is 97% effective and prevented more than 60 million deaths worldwide between 2000 and 2023. Crucially, high vaccination rates create “herd immunity” that protects infants too young for vaccination – like the child who died in Los Angeles.

Medical experts can diagnose SSPE through brain scans, electrical activity tests and spinal fluid analysis to detect antibodies against the replicating measles virus. However, treatment options remain extremely limited due to the condition’s rarity, which prevents large-scale clinical trials.

It comes about because the measles virus can lie dormant in the body after infection, later mutating and attacking the brain. This causes irreversible widespread brain cell death and inflammation – the “panencephalitis” that gives SSPE its name.

While SSPE was once common in developing countries, it has become rare in nations with robust childhood vaccination programmes. However, falling vaccination rates now threaten to bring back this and other preventable diseases.

Given the years-long delay between measles infection and SSPE development, health officials warn that more tragic cases may follow current outbreaks. By the time SSPE cases become common, it will be too late to prevent a great many more through vaccination.

The death in LA serves as an important reminder that measles is not a benign childhood illness. It can cause serious complications, including pneumonia and, as this case shows, delayed but deadly brain damage years later.

This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Benedict Michael, University of Liverpool

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Benedict Michael is affiliated with Encephalitis International.