{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T08:08:47Z","timestamp":1783930127968,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":193,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Subacute sclerosing panencephalitis (SSPE) is a rare, fatal, late complication of measles that develops years after infection, particularly following measles in early childhood. In Japan, measles incidence has declined markedly after improved vaccination coverage and verification elimination; however, recent SSPE epidemiology remains poorly characterized.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n SSPE cases were identified from the Intractable Disease Treatment Research Project, the Research Project on the Treatment of Children with Specified Chronic Diseases, and Okinawa\u2010specific publications. Measles\u2010related outpatient visits (1986\u20132007) were estimated by public health center jurisdiction using annual pediatric sentinel surveillance reports and outpatient visit volumes from the Static Survey of Medical Institutions. Ratio estimation with finite population correction was applied.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Seventeen SSPE cases were identified, 71% in males. SSPE onset occurred during 1994\u20132009, at a mean age of 8.1\u2009years. The year of measles infection was known for 14 cases, most frequently 1990. For risk estimation, 16 infections occurring during 1986\u20132007 were included. SSPE risk was estimated as one per 3944 estimated measles\u2010related outpatient visits (95% CI: 1054\u20136995). In 1990, SSPE risk was one per 1828 outpatient visits (95% CI: 836\u20132820). Among infants aged <\u20091\u2009year, SSPE risk was one per 910 outpatient visits (95% CI: 416\u20131403).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Estimating denominators for medically attended measles cases from sentinel surveillance enabled quantification of SSPE risk during historical outbreaks in Okinawa. The higher risk during infancy emphasizes the long\u2010term consequences of measles transmission and the need to maintain high measles vaccination coverage.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ped.70483","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T07:30:27Z","timestamp":1783927827000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimating the Risk of Subacute Sclerosing Panencephalitis After Measles in Okinawa, Japan, 1986\u20132007"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4541-8318","authenticated-orcid":false,"given":"Yusuke","family":"Kobayashi","sequence":"first","affiliation":[{"name":"Department of Infectious Disease Surveillance National Institute of Infectious Diseases, Japan Institute for Health Security Tokyo Japan"},{"name":"Center for Public Health Action in Applied Epidemiology National Institute of Infectious Diseases, Japan Institute for Health Security Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuri","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Surveillance National Institute of Infectious Diseases, Japan Institute for Health Security Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyomi","family":"Hirayasu","sequence":"additional","affiliation":[{"name":"Nago Ryoiku Medical Center Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomimasa","family":"Sunagawa","sequence":"additional","affiliation":[{"name":"Center for Public Health Action in Applied Epidemiology National Institute of Infectious Diseases, Japan Institute for Health Security Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"577","volume-title":"Handbook of Clinical Neurology","author":"Griffin D. E.","year":"2014"},{"key":"e_1_2_10_3_1","first-page":"13","article-title":"Global Advisory Committee on Vaccine Safety, 1\u20132 December 2005","volume":"81","author":"World Health Organization","year":"2006","journal-title":"Weekly Epidemiological Record"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1093\/ije\/21.5.998","article-title":"The Epidemiology of Subacute Sclerosing Panencephalitis in England and Wales 1970\u20131989","volume":"21","author":"Miller C.","year":"1992","journal-title":"International Journal of Epidemiology"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"1686","DOI":"10.1086\/497169","article-title":"Subacute Sclerosing Panencephalitis: More Cases of This Fatal Disease Are Prevented by Measles Immunization Than Was Previously Recognized","volume":"192","author":"Bellini W. J.","year":"2005","journal-title":"Journal of Infectious Diseases"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1093\/ije\/18.3.684","article-title":"Incidence of Subacute Sclerosing Panencephalitis Following Measles and Measles Vaccination in Japan","volume":"18","author":"Okuno Y.","year":"1989","journal-title":"International Journal of Epidemiology"},{"key":"e_1_2_10_7_1","first-page":"427","article-title":"Epidemiology of Subacute Sclerosing Panencephalitis in Okinawa, Japan (1977\u20132005)","volume":"42","author":"Hirayasu K.","year":"2010","journal-title":"No to Hattatsu"},{"key":"e_1_2_10_8_1","unstructured":"Okinawa Prefectural Government Department of the Environment and Health \u201cNational Epidemiological Surveillance of Infectious Diseases Program Report Okinawa Prefecture 1986\u20131997\u201d."},{"key":"e_1_2_10_9_1","unstructured":"Okinawa Prefectural Government Department of Welfare and Health \u201cNational Epidemiological Surveillance of Infectious Diseases Program Report Okinawa Prefecture\u201d1998\u20132008."},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.2174\/1874279301810010029","article-title":"Improvement of Influenza Incidence Estimation Using Auxiliary Information in Sentinel Surveillance in Japan","volume":"10","author":"Kawado M.","year":"2018","journal-title":"Open Infectious Diseases Journal"},{"key":"e_1_2_10_11_1","first-page":"585","article-title":"Subacute Sclerosing Panencephalitis Surveillance\u2014United States","volume":"31","author":"Centers for Disease Control (CDC)","year":"1982","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1097\/INF.0000000000004234","article-title":"Patients With Subacute Sclerosing Panencephalitis in Japan: A 2022 Nationwide Survey","volume":"43","author":"Okabe H.","year":"2024","journal-title":"Pediatric Infectious Disease Journal"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1093\/cid\/cix302","article-title":"Subacute Sclerosing Panencephalitis: The Devastating Measles Complication That Might Be More Common Than Previously Estimated","volume":"65","author":"Wendorf K. A.","year":"2017","journal-title":"Clinical Infectious Diseases"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.cmi.2019.10.035","article-title":"High Risk of Subacute Sclerosing Panencephalitis Following Measles Outbreaks in Georgia","volume":"26","author":"Khetsuriani N.","year":"2020","journal-title":"Clinical Microbiology and Infection"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0068909","article-title":"Epidemiology of Subacute Sclerosing Panencephalitis (SSPE) in Germany From 2003 to 2009: A Risk Estimation","volume":"8","author":"Sch\u00f6nberger K.","year":"2013","journal-title":"PLoS One"},{"key":"e_1_2_10_16_1","unstructured":"Okinawa Prefectural Government Department of Welfare and Health \u201cReport on the Administrative Response to the Measles Outbreak in Okinawa Prefecture \u201d(2018)."},{"key":"e_1_2_10_17_1","unstructured":"Ministry of Health Labour and Welfare \u201cMeasles\u2010Rubella Vaccination Status \u201d(2026)."}],"container-title":["Pediatrics International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70483","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ped.70483","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.70483","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T07:30:30Z","timestamp":1783927830000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ped.70483"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/ped.70483"],"URL":"https:\/\/doi.org\/10.1111\/ped.70483","archive":["Portico"],"relation":{},"ISSN":["1328-8067","1442-200X"],"issn-type":[{"value":"1328-8067","type":"print"},{"value":"1442-200X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-03-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70483"}}