Retrospective identification of three undiagnosed cases of measles encephalitis

It has long been recognised that neuroinvasion may occur as a rare complication of measles. According to cases reported in the medical literature [1], measles virus (MV) can persist in the central nervous system producing chronic neurological disease without systemic viremia [2, 3]. In most industrialised countries, the introduction of live attenuated measles vaccines has resulted in the virtual disappearance of measles as a common childhood disease and strongly reduced the numbers of patients with MV-related neurological disease. However, measles did not completely disappear: occasional clinical cases are still observed due to importation of MV from endemic areas [4], and larger outbreaks continue to occur amongst clusters of unvaccinated individuals [5]. It is difficult to assess how many people are exposed to wild-type MV as a result of these cases, but the virus is only rarely considered as a possible cause of neurological symptoms.

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