La Panencefalite subacuta sclerosante (in inglese subacute sclerosing panencephalitis (SSPE) è una grave complicanza tardiva del morbillo. Purtroppo non si conoscono cure ed è sempre mortale. L'unico mezzo per prevenirla è la vaccinazione.
Il rischio di questa complicanza è più alto se il bambino è molto piccolo quando avviene l'infezione. I sintomi compaino in media 7 anni dopo.
Here you can see two videos of German children who have SSPE. For both the virus was transmitted in the pediatrician's waiting room in which there was a child suffering from measles (at that time not yet diagnosed), which had not been vaccinated because their parents were opposed to vaccination.
http://www.kinderaerzte-im-netz.de/video/krankheiten/masern/Natalie-SSPE.wmv
Some say that the vaccine can cause this terrible disease. As an example, I examine what the pediatrician Stephen writes in his pocket Mammeonline forums:
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Before you continue reading the article, I inform you that from 10.1. 11, the Veneto Region has developed an online questionnaire for parents about vaccinations.
Please participate and run the link as much as possible.
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Screenshot # 1
pocket writes:
subacute sclerosing panencephalitis
This is one of the most feared complications of measles but it can also be caused by other viruses (including that of the mumps and rubella). E 'due to the persistence of the viral genome, hypermutation and adapted to the human environment, within the genome of nerve cells. After several years of contact with the measles vaccine virus with the genome is reactivated and causes a neurodegeneration, lethal in 100% cases. Contrary to what you disclose, subacute sclerosing panencephalitis (SSPE) can also be caused by the vaccine and it is not automatically prevented.
Contrary to what Dr. Pocket divulges, both the epidemiological data, virological tests confirm that the subacute sclerosing panencephalitis is caused only by the wild virus, not by the attenuated virus vaccine. (Later follows the bibliography.). Rubella does not cause subacute sclerosing panencephalitis subacute but progressive, which has similtuditi with SSPE. I never heard that mumps virus can cause SSPE and I did not find anything on Pubmed or Google.
Riporto alcuni recenti studi al riguardo.
In uno studio Indiano del 1997 si dice che l'incidenza di PESS è diminuita per merito del vaccino. L'incidenza della PESS da vaccino (cioè indotta dalla vaccinazione), invece, è stimata intorno allo 0,7 per milione di dosi. In questo studio (case report) si parla di una quindicenne indiana che ha sviluppato la PESS come risultato di un effetto ritardato del vaccino MMR. La ragazza aveva effettuato il vaccino di routine a 9 mesi d'età. Non aveva una storia di morbillo conclamato. Il suo titolo anticorpale antimorbillo era alto sia nel siero che nel liquido cefalorachidiano.
Source: Measles, mumps, rubella vaccine-induced subacute sclerosing panencephalitis
J Ind Med Assoc 1997 November, 95 (11): 594 India Belgamwar RB et al
can not be distinguished only by antibodies in the case of wild virus or vaccine strains. So far, when they were made autopsies on people who died of SSPE, has always found the genome of the wild virus, has never been found the virus in the vaccine. Most likely the girl had been infected so unreal before receiving the vaccine. If so, at the time of vaccination wild virus was already present in your body and not the vaccine could do anything else. Of course you can not feel when the girl has been infected, but Dr. Pocket can not say that it was a delayed effect of the MMR vaccine. "
In a December 2004 study of English is said that an annual fall incidence of SSPE has been calculated on the basis of 14%, keeping pace with the decline in notified cases of measles. Between 1990 and 2002 there were 47 cases observed, however. In 35 there was a history of measles has been confirmed. The interval between onset of measles and SSPE was 2.7 Minimum and maximum of 23.4 years. Four children with a history of vaccination had no history of morbillo conclamato. In due di questi casi una biopsia cerebrale ha mostrato un'infezione morbillosa inapparente (presenza di genoma). La biopsia cerebrale di altri 3 casi con storia di morbillo, di cui due vaccinati, hanno evidenziato genoma del tipo selvaggio.
Fonte: The epidemiology of subacute sclerosing panencephalitis in England and Wales 1990-2002 Arch Dis Child 2004 Dec;89(12):1145-8, Miller C et al England
Ecco, anche questo studio conferma che finora è sempre stato trovato il virus selvaggio come causa della PESS. In questi casi i bambini sono stati vaccinati dopo l'infezione con il morbillo e poco cambia se era inapparente. Nel primo anno di vita i bambini sono protetti dalla herd immunity, cioè dall'alta copertura vaccinale della comunità in cui vive. Se quasi tutti i bambini sono vaccinati contro il morbillo, il virus non può circolare e non può raggiungere i bambini suscettibili. Un'infezione (anche inapparente) nei primi due anni di vita è correlata con un rischio aumentato di sviluppare la PESS.
Ovviamente gli autori dello studio citato dal dott. Tasca sono arrivati ad una conclusione molto diversa dalla sua. Nell'abstract alla voce "conclusions" scrivono: La prevenzione della diffusione endemica del virus del morbillo in Inghilterra e Galles, grazie all'elevata copertura della vaccination against measles, mumps and rubella vaccination campaign with the measles / rubella started in 1994, have contributed to the virtual elimination of SSPE.
Another study English (in September 2005) points out that in the event of a vaccine-preventable diseases, the high rate of mutation of RNA viruses can lead to the emergence of abnormal forms that escape all ' immunity. The WHO has allocated measles elimination in many regions of the world where the genetic variability of the virus responsible was monitored to assess the possibility that mutant forms can emerge. The phylogenetic analysis of parts of genes N and H 230 strains circulating measles was conducted in the UK over a period of 10 years. Accrued substitution (mutant) in three different outbreaks were detected experimentally and found an order of magnitude higher than what was expected and what has been reported previously. Plus it was evaluated the genetic variability of forms of persistent measles virus isolated from cases of SSPE that has proven more stable than that of the circulating virus. It is concluded that the rate of substitution (mutation) in the circulating virus may be higher than the hypermutation shapes and persistent (SSPE) and the high rate of mutability of the MV can lead to forms resistant to the vaccine. We would like greater control of this evidence with a view to prevention.
Source: Genetic variability of Measles Virus Infections in acute and persistent Infect Genet Evol 2005 Sep 16 Kuhne M et al England
It 's true that the measles virus is type RNA, but is antigenically very stable. This explains the fact that once you contract measles is immune for life. If the measles virus had a high rate of mutations of the antigenic characteristics, as the dr. Tasca, many adults who had already contracted the disease from sick children with measles should also more than once. E 'prudent to monitor the measles all over the world and is also important to continue the program for elimination of the virus. A virus can not mutate eradicated ...
Dr. Pocket continues to bring evidence that run counter to his thesis. In these two cases of SSPE viruses responsible were wild type. These two patients had obviously been infected prior to vaccination in cases of SSPE virus mutation takes place in the body of the patient, making virus "defective." Mutations that are not circulating in the community. The cause is a defect in the replication cycle of the virus that occurs in the central nervous system and prevents the production of membrane virus, especially protein M.
Finally, in a study in December 2004, Croatian analyze two cases of SSPE occurred in 2002. Both were immunized . It has not been identified but the genome of a vaccine virus genotype D6 mutated in several loci of gene sequences and N H. By comparing this genome with the Edmonston (strain measles reference) was observed hypermutation. Source: Detection and Characterization of measles strais virus in subacute sclerosing panencephalitis in the case of Croatia Virus Res 2004 Jan; 99 (1) :51-6
Forcic D et al Croatia
The data show that the virus has actually or virtually eliminated in countries where the SSPE was achieved high vaccination coverage. If the thesis of dr. Pocket were true, you should see an I increase of cases of SSPE, but it is not. If this is compounded by the fact that so far the virus has been isolated from patients was always the wild type, the conclusion is that MMR vaccination is extremely important to eradicate the disease (in most countries this goal has already been achieved, such as in America (North and South), Finland, Australia etc. )
About SSPE, in conclusion, I would not escape a detail that, for a reading too fast and not very thoughtful, it can easily go unnoticed. The incidence of SSPE from measles is estimated at one in 100,000 people who contract measles. Even in a significant outbreak (infrequent and sporadic), with 40 or 50 000 patients, it may not happen at all or occur within a long period of time (years and years between a case and the other by the sum of those with any epidemic ). The incidence of SSPE is caused by the vaccine instead estimated at 0.7 cases per million doses of vaccine. The number is much lower than that of SSPE measles natural but when they make a decision in this case it turns out that they might experience more cases of SSPE due to the vaccine, since every year are carried out well over a million doses and even in completely healthy subjects. Meditating on this element can be useful.
meditate on scientific evidence would be helpful for Dr. Tasca.
now carry some of my sources, as promised:
The Global Advisory Committee on Vaccine Safety (GACVS) which advises the WHO on vaccines, wrote the following report:
subacute sclerosing panencephalitis and measles vaccine
The Committee reviewed the epidemiology of subacute sclerosing panencephalitis (SSPE) and the relationship between the mmunizzazione against measles and the onset of SSPE. Of great help in this work was to review a report commissioned and presented by experts from the Health Protection Agency (HPA) of the United Kingdom. The meeting was joined by experts from the Division of Viral and rickettsial diseases, CDC National Center for Infectious Diseases (NCIDE), which agreed with the general conclusions and recommendations of the HPA experts. Evidence was provided that the true incidence of SSPE is approximately 4-11 cases per 100 000 cases of measles, although with measles infection acquired early in life, the risk may be higher (18 per 100 000 cases ). It 'also cited a risk highest (27.9 cases per 100 000 cases of measles). In many countries with good measles control, an increase in age of onset of SSPE has been observed attributable to measles cases where the infection occurred at a time when the disease was more widespread.
epidemiological data are consistent with a direct protective effect of vaccine against SSPE mediated by prevention of measles. In countries that have achieved good measles control, one could observe a decline in new cases of SSPE few years after the decline in the incidence of measles. However, given the latency of SSPE after measles infection, it takes at least 5 years before we see an impact on the incidence, e più di 10 anni prima di vedere una forte diminuzione. Anche con l'eliminazione del morbillo, i casi di PESS possono ancora verificarsi 20 o 30 anni dopo gli ultimi casi di morbillo a causa del disallineamento della distribuzione di latenza. Una ricomparsa di casi di PESS è stato visto, a causa di focolai di morbillo che si sono verificati dopo un periodo di buon controllo del morbillo. I dati epidemiologici disponibili, in linea con i dati di genotipizzazione del virus, non suggeriscono che il virus vaccino contro il morbillo possa causare la PESS. Inoltre, i dati epidemiologici non suggeriscono che la somministrazione del vaccino contro il morbillo possa accelerare il corso dell'insorgenza della PESS o svegliare il virus nei casi in cui un'infezione latente è present.
For situations in which the SSPE occurred in vaccinated individuals who have no previous history of natural measles infection, the available data indicate that the cause is natural measles infection, not the vaccine.
Source: http://www.who.int/vaccine_safety/topics/measles_sspe/Dec_2005/en/index.html
Other sources:
Complications of Measles (CDC, Atlanta)
Int J Epidemiol. 2007 Dec; 36 (6) :1334-48. Epub 2007 Nov. 23. Review of the effect of measles vaccination on the epidemiology of SSPE , H Campbell, N Andrews , Brown KE , Miller E . Immunisation Department, Health Protection Agency Centre for Infections, 61 Colindale Avenue, London NW9 5EQ, UK.
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