measles encephalitis

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There are different forms of measles encephalitis which occur at different times in relation to the onset of rash:

  • post-infectious encephalomyelitis occurs at around one week after onset of the rash
    • infectious virus is rarely found in the brain
    • condition is associated with demyelination and is thought to have an auto-immune basis
  • acute measles encephalitis of the delayed type occurs in immunocompromised patients
    • may occur without a preceding measles-like illness although there may be a history of exposure to measles several weeks or months previously
    • characterised by acute neurological compromise and deterioration of consciousness, seizures and progressive neurological damage
  • subacute sclerosing pancencephalitis
    • a rare, fatal, late complication of measles infection. One case of SSPE occurs for every 25,000 measles infections
    • in children infected under the age of two, the rate is one in 8000 infections
    • developing measles under one year of age carries a risk of SSPE 16 times greater than in those infected over five years of age
    • median interval from measles infection to onset of symptoms is around seven years but may be as long as two to three decades
    • SSPE may follow an unrecognised measles infection. Wild measles virus has been found in the brain of SSPE cases including those with no history of measles disease

Reference:

  1. Immunisation Against Infectious Disease - "The Green Book".Chapter 21 Measles (August 2006)

Last reviewed 01/2018

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