Epidemiology of subacute sclerosing panencephalitis (SSPE) in Germany from 2003 to 2009: a risk estimation

PLoS One. 2013 Jul 9;8(7):e68909. doi: 10.1371/journal.pone.0068909. Print 2013.


Subacute sclerosing panencephalitis (SSPE) is a fatal long-term complication of measles infection. We performed an estimation of the total number of SSPE cases in Germany for the period 2003 to 2009 and calculated the risk of SSPE after an acute measles infection. SSPE cases were collected from the Surveillance Unit for Rare Paediatric Diseases in Germany and the Institute of Virology and Immunobiology at the University of Würzburg. The total number of SSPE cases was estimated by capture-recapture analysis. For the period 2003 to 2009, 31 children with SSPE who were treated at German hospitals were identified. The capture-recapture estimate was 39 cases (95% confidence interval: 29.2-48.0). The risk of developing SSPE for children contracting measles infection below 5 years of age was calculated as 1∶1700 to 1∶3300. This risk is in the same order of magnitude as the risk of a fatal acute measles infection.

Publication types

  • Historical Article
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Coinfection
  • Female
  • Germany / epidemiology
  • History, 21st Century
  • Humans
  • Male
  • Measles / epidemiology
  • Risk
  • Subacute Sclerosing Panencephalitis / epidemiology*
  • Subacute Sclerosing Panencephalitis / history

Grant support

The study was supported by the Bavarian State Ministry of the Environment and Public Health for the ESPED data collection and by the Robert-Koch-Institute from funds of the Federal Ministry of Health (FKZ 1369-400). Employees of the Robert-Koch-Institute provided data on measles infections in Germany, which were reported to the Robert-Koch-Institute based on the German Infection Protection Act. These data were used for further analysis by the authors. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.