Donald L. Eddins

Epidemiology of subacute sclerosing panencephalitis

The Subacute Sclerosing Panencephalitis Registry has compiled data from 453 instances of SSPE occurring in the United States from 1960 through 1976. The mean annual incidence during this period was 3.5 per 10 million persons under 20 years of age, 2.3 times higher for males than females, and 4.0 times higher for whites than blacks. Although the long-term pattern of incidence is unknown, the incidence of reported SSPE declined dramatically from 1970 to 1976. There are marked geographic variations of SSPE activity within the United States and also a higher incidence for children from farms (9.4 per 10 million persons under 20) compared with children from other rural domiciles (3.7 per 10 million), suburban children (2.9 per 10 million), and inner-city children (1.6 per 10 million). Available epidemiologic evidence suggests that some extrinsic factor, unrelated to measles or measles vaccine, is important in the pathogenesis of the disease.

Risk of congenital abnormality after inadvertent rubella vaccination of pregnant women.

The risk to a fetus after rubella vaccination of its mother is unknown. The Center for Disease Control has compiled information from the pregnancies of 343 women inadvertently given rubella vaccine shortly before or after conception. The pregnancies of 145 women were terminated by therapeutic abortion, and rubella vaccine virus was recovered from the products of conception of nine women, including six of the 28 known to be seronegative to rubella at the time of vaccination. None of the 172 infants carried to term had either clinical or serologic evidence of rubella infection, including 38 infants of women known to be susceptible and 12 additional women estimated to be susceptible at the time of rubella vaccination. On the basis of the binomial distribution, the maximum risk of fetal infection after maternal rubella vaccination is between 5 and 10 per cent. The actual risk is probably less.

Measles mortality in the United States 1971-1975.

During 1971-75, an average of 35.4 measles-related deaths were recorded each year; one death for every 1,000 measles cases reported. Measles mortality rate was highest in children under 1 year of age, as was the death-to-case ratio. Mortality rates were higher in non-metropolitan than in metropolitan counties. Measles mortality rates were inversely related to median family income.