A case of subacute sclerosing panencephalitis in a 23‐year‐old recent immigrant to Australia

Fulminant subacute sclerosing panencephalitis: Not only a disease of the past

“…For example, there were only four confirmed Australian cases between 1995 and 1998, and we have found no other cases of SSPE in the Sydney Children's Hospital records back to 1990. Falling immunisation rates with resultant measles outbreaks have been associated with later increased incidence of SSPE, as have rising immigration rates from measles endemic countries, as recently reported in a Filipino immigrant to Australia . This case alerts us to another subgroup at risk – children adopted from measles‐endemic regions.…”

“…This deterioration prompted reconsideration of uncommon infections, including fulminant subacute sclerosis panencephalitis (SSPE). Ophthalmological review revealed peripheral retinal scarring, suggestive of past chorioretinitis and suggestive of SSPE . Repeat MRIs showed progressive diffusion changes involving bilateral thalami, bi‐frontal and right parieto‐occipital lobes and, eventually, the brain‐stem (Fig.…”

The ASID test

“…In this issue of the MJA , we read about re‐emergence of Ebola virus, 1 preparedness for Zika virus 2 and local transmission for hepatitis E 3 as salient examples. Williams and colleagues also describe the diagnosis of subacute sclerosing panencephalitis in a 23‐year‐old man, 4 a timely reminder that high levels of herd immunity are required to prevent measles outbreaks, which still occur in parts of Australia with suboptimal immunisation rates 5 . But emerging infections are not only viral.…”