ABSTRACT
Although the incidence of measles has declined substantially since the introduction of live attenuated vaccines, it is still a disease of worldwide importance. With about 100,000 deaths per year, measles remains among the three most common causes of childhood mortality and is a major cause of neurological deficits. Measles can be accompanied by the acute postinfectious measles encephalomyelitis (APME), and the late complications measles inclusion body encephalitis (MIBE) affecting immunocompromised patients and subacute sclerosing panencephalitis (SSPE), which presents months to years after the initial measles infection. Recent findings indicated that the risk for children contracting measles below 5 years of age to develop SSPE is higher than supposed earlier, namely in the range of 1:1700 to 1:3300, and in the same order of magnitude as the risk of a fatal acute measles infection. The recommended vaccination effectively protects against measles and its complications. In cases of children who developed SSPE after having been vaccinated against measles, wild-type measles infection usually occurred before the vaccination, and wild-type, not vaccine virus, is the cause of SSPE. This chapter describes in detail virological aspects, clinical manifestations, pathophysiology, diagnostic strategies, and treatment options of these complications.
