[Measles in France]. / La rougeole en France.

From January 2008 to May 2012, over 22,000 cases of measles were reported in France. The highest incidence rate was observed in children below one year of age. Over 50% of cases were reported in young adults. Almost 5,000 patients were hospitalised including 1,023 with severe pneumonia, 27 with encephalitis and/or myelitis : 10 died. This situation is linked to insufficient and heterogeneous vaccination coverage with pockets of susceptible people allowing virus circulation. Although the vaccine coverage in children has now improved for both doses, the issue of convincing young susceptible adults to catch up for measles vaccination remains critical, if the elimination target is to be met, and in order to protect the most vulnerable population unable to benefit from this vaccination (children below 1 year, immunodeficient people, pregnant women).

Panencefalitis esclerosante subaguda: reporte de un caso en Chile / Subacute sclerosing panencephalitis: a case report in Chile

La panencefalitis esclerosante subaguda postsarampión (PEES) es en la actualidad una entidad infrecuente en aquellos países donde existen programas regulares de vacunación contra el sarampión. Presentamos un caso, con evolución rápida a la muerte, en el cual fueron observados hallazgos característicos. Entre los más relevantes: títulos elevados de anticuerpos antisarampión en el líquido cefalorraquídeo (LCR), patrón periódico en el EEG, fenómenos de desmielinización progresiva en el scanner y resonancia nuclear magnética cerebral, asociados a la presencia constante de crisis mioclónicas. A pesar de una terapia continua con alfa-interferón intratecal, cimetidina en dosis inmunorreguladoras y con antiviral, se observó un deterioro progresivo del paciente. El estudio neuropatológico reveló compromiso a nivel de los centros semiovales de los hemisferios frontales, de predominio izquierdo

Panencefalitis esclerosante subaguda de inicio en edad adulta: presentación atípica en 2 pacientes / Adult onset subacute sclerosing panencephalitis: atypical presentation in 2 cases

Subacute sclerosing panencephalitis is an infrequent central nervous system viral disease and is a late manifestation of persistent infection by a mutant form of measles virus. Since it affects mainly children and teenagers, the diagnosis in older ages is difficult. Its main clinical symptoms are cognitive impairment, behavioral disturbances and myoclonia. We report two males, aged 21 and 22 years old, presenting with the disease with atypical manifestations. One had a catatonic syndrome and the other, amaurosis. The recognition of the different presentation forms of the disease, endemic in developing countries, allows an earlier diagnosis and a more efficient treatment, when available

Neuroimagem em panencefalite esclerosante subaguda - relato de um caso e diagnóstico diferencial / Subacute sclerosing panencephaling - a case report and differential diagnosis

Os autores apresentam um caso de panencefalite esclerosante subaguda, enfocando os aspectos da neuroimagem e o diagnóstico diferencial com outras doenças do sistema nervoso central que têm quadro clínico semelhante.

Pan-encefalite esclerosante subaguda: uma demência mioclônica e a sua questäo causal - relato de série de casos / Subacute sclerosing panencephalitis: a myoclonic dementia and its causal question - a report of serial of cases

Este artigo descreve aspectos clínicos e epidemiológicos de 21 pacientes que preencheram os critérios diagnósticos de pan-encefalite esclerosante subaguda (PEES).Foram analisadas variáveis demográficas,clínicas e laboratoriais(eletroencefalográficas e do líquido cefalorraquiano).A partir deste relato de série de casos e revisäo de literatura, considerou-se a relaçäo de causa-efeito entre o vírus selvagem do sarampo e a PEES e os fatores de risco predisponentes à infecçäo subclínica, e, também, os fatores subjacentes aos eventos tardios(6/8 anos após a infecçäo aguda), tais como os clínicos (principalmente demência e mioclonias) e patológicos (baseados na reaçäo inflamatoria hiperimune e corpúsculos de inclusäo feitos de nucleocapsídeos do vírus do sarampo). Conclui-se que o vírus selvagem do sarampo é uma causa necessária mas näo suficiente para o desenvolvimento da PEES, e, também, que a vacinaçäo precoce, sistemática e homogênea da populaçäo contra o sarampo é a principal meta para a reduçäo ou eventualmente erradiaçäo da PEES

Pan-encefalite esclerosante subaguda (PEES): consideraçöes epidemiológicas e etiopatogênicas / Subacute sclerosing panencephalitis (SSPE): epidemiological and etiopathogenics considerations

Foram estudados dados de mortalidade sobre a pan-encefalite esclerosante subaguda (PEES) e de casos notificados de sarampo, em todo o Brasil. Os dados de mortalidade por PEES apresentaram distribuiçäo similar aos de morbidade descritos na literatura revisada e em nossa casuística hospitalar, tanto quanto ao sexo (dois masculinos x um feminino), quanto às faixas etárias (70 por cento de seis a 20 anos). A concentraçäo dos diagnósticos é dominante nas regiöes sul e sudeste. Embora haja nas regiöes norte e nordeste o predomínio relativo da mortalidade por sarampo e a populaçäo de zero a 19 anos corresponder a 37 por cento da do Brasil, apenas 5 por cento dos casos de PEELS (quatro dos 74) foram ai registrados pelo Sistema de Informaçäo sobre Mortalidade do Ministério da Saúde (SIM), nos anos de 1979 a 1986. Também neste trabalho säo feitas consideraçöes etiopatogênicas e epidemiológicas sobre a PEES, a partir dos dados sobre esta doença e o sarampo no Brasil

[Nursing care and the neurological sequelae of measles]. / Assistência de enfermagem e as seqüelas neurológicas do sarampo.

The neurological sequelae after measles can be encephalitis or subacute sclerosing pan-encephalitis (SSPE). The encephalitis is lethal in 15-18% of the patients, that can rest handicapped at 25%. The SSPE is always lethal. The social and economical consequences of these problems are emphasised. It is suggested nursing care by Leavell & Clark levels of prevention.

Subacute sclerosing panencephalitis in Jamaica

The clinical features, outcome, electroencephalographic (EEG) and laboratory findings in 12 children with subacute sclerosing panencephalitis are described. The diagnosis was made on the clinical features, the characteristic EEG pattern and the detection of measles complement-fization antibodies in the spinal fluid and serum. The autopsy findings in 2 of 6 patients who died were typical of subacute sclerosing panenecephalitis. This report suggests that the incidence of the condition is high in Jamaica. It is recommended that strenuous efforts be made to improve the measles immunisation status of children and that a registry for the disease be established in the island (AU)

Panencefalitis esclerosante subaguda / Subacute sclerosing panencephalitis

Se presenta el primer caso diagnosticado y comprobado en Manizales, de P.E.E.S.A. Se describe el cuadro clinico caracteristico de la enfermedad; se hacen unas consideraciones especiales sobre la relacion vacuna antisarampionosa y P.E.E.S.A., finalmente se hace enfasis en la importancia de la biopsia cerebral, ya que estando en un medio universitario es mandatorio llegar al verdadero diagnostico etiologico de la enfermedad

Immunological response of subacute sclerosing panencephalitis patients to measles virus.

The immunological responses of patients with clinical signs of SSPE were examined by the direct migration inhibition, complement-mediated antibody cytoxicity and the lymphocyte-mediated cytotoxicity assay techniques. Peripheral lymphocytes migrated similarly to controls when exposed to measles antigen. Lymphocytes from SSPE patients responded to a SSPE strain of measles infected cells in a manner similar to lymphocytes from controls. A factor which interfered with the expected activity of sensitized lymphocytes to measles virus was detected in some cerebral spinal fluid obtained from SSPE patients. The blocking activity varied from 100% in 4 of 20 patients with SSPE to no blocking in 2 of the SSPE patients. The occurrence of blocking factor in SSPE patients could not be related to sex or age of the patient, serum of CSF antibody levels, and duration of disease or outcome.