Subacute sclerosing panencephalitis is a complication associated with which virus?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2018

Microbiology

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2018

Explanation

Subacute Sclerosing Panencephalitis (SSPE) is a rare but fatal, progressive neurodegenerative disease.
It is a delayed complication of infection with the measles virus (Rubeola).
The condition is caused by a persistent, defective measles virus that remains in the central nervous system for years after the initial infection.
Symptoms typically emerge 7-10 years after the primary measles infection, often when the initial infection occurred in early childhood (under 2 years of age).
The disease progresses from subtle behavioral changes to myoclonus, dementia, and eventually a vegetative state.

Option B: Rubella (German measles) is not the cause of SSPE. Its primary neurological complication is Congenital Rubella Syndrome when a pregnant woman is infected.
Option C: The Japanese Encephalitis (JE) virus causes acute encephalitis, which is a rapid-onset inflammation of the brain.
Option D: BCG (Bacillus Calmette-Guérin) is a vaccine, not a virus. It provides protection against tuberculosis, which is caused by a bacterium (Mycobacterium tuberculosis), not a virus.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Neurological complications of viral infections as background academic context rather than a clinical decision trigger.
The primary clinical relevance is the critical importance of the Measles, Mumps, and Rubella (MMR) vaccine. Widespread vaccination has made SSPE an extremely rare disease in countries with high immunization rates.
Nurses play a vital role in educating parents about the necessity of the MMR vaccine and dispelling misinformation. This education directly prevents devastating, albeit rare, complications like SSPE.
What if? If a child presents with new-onset seizures and a decline in school performance, and their history reveals they had measles at age 1 and were unvaccinated, a nurse should recognize the possibility of SSPE and ensure this history is communicated to the physician for a thorough neurological workup.

How to Approach the Question

First, identify the key term in the question: 'Subacute sclerosing panencephalitis' (SSPE). Recognize this as a specific neurological disease.
The question asks for the associated 'virus'. This directs you to recall or look up the etiology of SSPE.
Evaluate the options provided:
Measles: Recall that this is the well-established cause of SSPE.
Rubella: Differentiate it from measles. While it can cause neurological issues (Congenital Rubella Syndrome), it is not the cause of SSPE.
JE: Recognize this as a cause of acute encephalitis, which has a different presentation and timeline than the subacute/chronic SSPE.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1966-1968

E6 Medicine Harrison 22e Part 1 p. 1159-1161

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 357-359