Despite the beliefs of many people that measles is a harmless and benign disease, it actually has deadly complications, including SSPE, that can be easily prevented with the very safe and very effective MMR vaccine.

Because large measles epidemics and their complications were last seen 50 or more years ago, almost all parents of children today have no idea about measles. And the reason we have forgotten about what measles can do to children is that we nearly eradicated it with the measles vaccine.

Before 1963, approximately 500,000 cases and 500 measles deaths were reported annually, with epidemic cycles every 2 to 3 years. However, the actual number of cases was estimated at 3-4 million annually. Annual cases decreased by nearly 95% following the licensure of the measles vaccine.

Measles complications — SSPE

There are several serious and deadly complications of measles, including sudden death in about 2-3 out of 1000 measles cases. For those who claim that measles is “nothing more than a rash,” nothing could be further from the truth.

A 2017 study of California children who developed subacute sclerosing panencephalitis (SSPE) after a measles outbreak there years ago determined that 1 case is diagnosed for about every 1,400 known cases of measles in children under age 5, and 1 for every 600 infected babies.

SSPE is a rare chronic, progressive encephalitis that primarily affects children and young adults. SSPE results from a persistent measles virus infection, which usually occurs before the age of 2. It is followed by approximately 6-15 asymptomatic years before the first symptoms of SSPE appear.

Some researchers think the asymptomatic period is around 5-8 years after the initial disease. Gradually, the disease progresses with psychological and neurological deterioration, which can include personality changes, seizures, and coma. It is ultimately fatal in nearly 100% of cases.

We do not know how measles causes SSPE. It is hypothesized that the measles virus slowly infects neurons in the brain until it reaches a point when SSPE symptoms are recognizeable.

I recently wrote about a school-age California child who died from SSPE years after contracting measles in their infancy.

Here’s what is scary about SSPE — the child or adult seemingly recovers from measles and goes about life as if nothing happened. Then, a few years later, SSPE begins showing its initial symptoms, and that person will eventually die from the complication.

To me, SSPE is one of the more insidious complications of measles.

Other deadly complications of measles

Measles causes complications — ranging from diarrhea to death — in 3 in 10 infected people, according to the Infectious Diseases Society of America. Some appear immediately, while others, like SSPE, take years to appear.

As I wrote above, around 2-3 out of 1,000 individuals will die from measles itself (not including those who will die of SSPE). But there are other dangerous complications from measles.

About 1 child in every 1,000 who gets measles will develop encephalitis, an inflammation of the brain that can lead to convulsions, deafness, and other long-term neurological deficits. A 7-year-old in South Carolina will have to relearn how to walk after enduring one of the more immediate complications, brain swelling.

Summary

As the vaccination rate for measles drops, it will return as we lose the herd immunity that once limited the breadth of a measles outbreak. The disease can infect unvaccinated children and adults, along with babies who are too young for the vaccine, and immunocompromised children and adults who are susceptible to measles.

And as we see more measles cases, we are going to see more complications like SSPE and death.

I know I sound like I am yelling, “the sky is falling,” but it is. Measles is dangerous and deadly.

And I will continue to write about how deadly measles is, so that maybe I’ll change the mind of one parent to vaccinate their children.

Citations

• Buchanan R, Bonthius DJ. Measles virus and associated central nervous system sequelae. Semin Pediatr Neurol. 2012 Sep;19(3):107-14. doi: 10.1016/j.spen.2012.02.003. PMID: 22889539.
• Wendorf KA, Winter K, Zipprich J, Schechter R, Hacker JK, Preas C, Cherry JD, Glaser C, Harriman K. Subacute Sclerosing Panencephalitis: The Devastating Measles Complication That Might Be More Common Than Previously Estimated. Clin Infect Dis. 2017 Jul 15;65(2):226-232. doi: 10.1093/cid/cix302. PMID: 28387784.

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