A recent surge of fulminant and early onset subacute sclerosing panencephalitis (SSPE) in the United Kingdom: An emergence in a time of measles

AbstractBackground Subacute Sclerosing Panencephalitis (SSPE) is a fatal progressive neurological disorder following measles infection. Methods Cases were collated from Paediatric Neurology centres in the UK over 24 months 2017 to 2019 and represent all cases referred National Viral Reference Department (VRD). Diagnosis was established with detection of raised index, demonstrating intrathecal antibody production. Findings Six children presented SSPE two years, median age five years (range 2–7 years) latency period three 2–6 years). The majority exposed during infancy. Atypical features common, including visual impairment, focal generalised tonic-clonic seizures, headache, vomiting movement disorders. EEG demonstrated typical cases, though not always at presentation. Initial MRI normal four showing widespread white matter changes. Antiviral immunomodulatory treatment led minimal or no improvement. All progressed cognitive regression, seizures decline within six months. Interpretation These demonstrate highest incidence since 2000, progressing acute fulminant disease, younger onset, short atypical presentations. Recent global surges raise importance clinician awareness as potential diagnosis regression. Herd immunity remains key protective mechanism for infants groups that cannot be vaccinated. Health care providers, educators governments must ensure resources continue target effective education access immunisation programmes, only means combat this devastating condition.