Abstract
Background
A licensed rotavirus vaccine was withdrawn from use because of an increased risk of
intussusception. The association of rotavirus vaccination with intussusception raised
concerns about a potential link between natural rotavirus disease and intussusception.
The objectives of the present study were to determine whether an epidemiological association
with natural rotavirus infection existed.
Methods
From 1984 to 2003, all children younger than 5 years with intussusception were retrospectively
identified by medical charts, and from 1995 to 2003, a prospective surveillance study
of rotavirus infection in children younger than 5 years was independently conducted.
Epidemiological characteristics of intussusception and rotavirus infection were then
compared.
Results
A total of 533 cases of intussusception and 146 cases of rotavirus infection were
identified. The incidence of intussusception for infants younger than 1 year was 62/100,000
child-years. The age distributions of intussusception and rotavirus gastroenteritis
overlapped, and a masculine predominance was noted in both cases. No significant association
was observed between the monthly distribution of intussusception and rotavirus infection.
Conclusion
The present study has not convincingly shown that rotavirus diarrhea plays a major
role in intussusception. However, data about age and sex distributions supported the
biologic plausibility of such an association.
Key words
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References
- The link between rotavirus vaccination and intussusception: implications for vaccine strategies.Gut. 2002; 50: 11-12
- Intussusception, infection, and immunization: summary of a workshop on rotavirus.Pediatrics. 2001; 108: 37
- Rotavirus vaccines and the risk of intussusception.Arch Pediatr. 2007; 14: 618-620
- Intussusception after administration of the rhesus tetravalent rotavirus vaccine (Rotashield): the search for a pathogenic mechanism.Pediatrics. 2006; 117: 827-832
- Intussusception among infants given an oral rotavirus vaccine.N Engl J Med. 2001; 344: 564-572
- Population-based study of rotavirus vaccination and intussusception.Pediatr Infect Dis J. 2001; 20: 410-416
- Intussusception and an oral rotavirus vaccine.N Engl J Med. 2001; 344 ([Letter]): 1866
- Intussusception and an oral rotavirus vaccine.N Engl J Med. 2001; 344 ([Letter]): 1866-1867
- Intussusception and an oral rotavirus vaccine.N Engl J Med. 2001; 344 ([Letter]): 1866
- Trends in intussusception-associated hospitalizations and deaths among US infants.Pediatrics. 2000; 106: 1413-1421
- Intussusception, rotavirus diarrhea, and rotavirus vaccine among children in New York State.Pediatrics. 2001; 108: 54-60
- Effect of rotavirus vaccination programme on trends in admission of infants to hospital for intussusception.Lancet. 2001; 358: 1224-1229
- Rotavirus vaccination and intussusception.Lancet. 1999; 354: 956
- Incidence of rotavirus diarrhea and intussusception in Hong Kong using standardized hospital discharge data.Pediatr Infect Dis J. 2002; 21: 701-703
- Intussusception: 354 cases in 10 years.J Pediatr Surg. 1971; 6: 16-27
- Paediatric intussusception.Br J Surg. 1992; 79: 867-876
- Intussusception.in: O'Neill J.A. Rowe M.I. Grosfeld J.L. Fonkalsrud E.W. Coran A.G. Pediatric surgery. 5th ed. Mosby-Year Book, St Louis1998: 1185-1198
- Intussusception : a 9-year survey (1986-1995).J Pediatr Gastroenterol Nutr. 1997; 24: 253-256
- Intussusception in Newcastle in a 25-year period.Aust N Z J Surg. 1991; 61: 608-613
- Atypical characteristics of a group of children with intussusception.Acta Paediatr Scand. 1990; 79: 675-679
- Acute intussusception in infants and children: incidence, clinical presentation and management: a global perspective. Department of Vaccines and Biologicals, World Health Organisation (WHO). Document WHO/V&B/02.19.WHO, Geneva2002
- More on rotashield and intussusception: the role of age at the time of vaccination.J Infect Dis. 2005; 192: S36-S43
- A hexavalent human rotavirus-bovine rotavirus (UK) reassortant vaccine designed for use in developing countries and delivered in a schedule with the potential to eliminate the risk of intussusception.J Infect Dis. 2005; 192: S22-S29
- Two year review of intestinal intussusception in six large public hospitals of Santiago, Chile.Pediatr Infect Dis J. 2003; 22: 717-721
- Intussusception associated hospitalization among Venezuelan infants during 1998 through 2001: anticipating rotavirus vaccines.Pediatr Infect Dis J. 2003; 22: 234-239
- The changing pattern of intussusception in Northern Nigeria: an analysis of 85 consecutive cases.East Afr Med J. 1992; 69: 640-642
- Rotavirus infection in children seen at a greater Buenos Aires hospital.Rev Argent Microbiol. 1999; 31: 87-89
- The epidemiology of rotavirus diarrhea in the United States: surveillance and estimates of disease burden.J Infect Dis. 1996; 174: S5-S11
- Hospitalizations associated with rotavirus diarrhea in the United states, 1993 through 1995: surveillance based on the new ICD-9-CM rotavirus diagnostic code.J Infect Dis. 1998; 177: 13-17
- Lack of an apparent association between intussusception and wild or vaccine rotavirus infection.Pediatr Infect Dis J. 1998; 17: 924-925
- Lack of association between rotavirus infection and intussusception: implications for use of attenuated rotavirus vaccines.Pediatr Infect Dis J. 2002; 21: 97-102
- A two-part study of the aetiological role of rotavirus in intussusception.J Med Virol. 1982; 9: 51-55
- Viral etiology of intussusception in Taiwanese childhood.Pediatr Infect Dis J. 1998; 17: 893-898
- Intussusception in infancy and childhood: a review of 400 cases.Br J Surg. 1959; 46: 484-495
- Human herpes virus 6 and intussusception.Pediatr Infect Dis J. 1993; 12: 788-789
- Intussusception due to lymphoid hyperplasia of the intestine.Am J Proctol. 1976; 27: 27-29
- Papillary lymphoid hyperplasia at the ileocecal valve as a cause of acute intussusception in infancy.Arch Dis child. 1963; 38: 89-91
- A one-year virological survey of acute intussusception in childhood.J Med Virol. 1982; 9: 267-271
- Adenovirus and intranuclear inclusions in the appendix of children with acute intussusception.Ann Pathol. 1997; 17: 89-93
- Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia.Bull World Health Organ. 2006; 84: 569-575
- Human rotavirus infection in infants and young children with intussusception.J Med Virol. 1978; 2: 265-269
- Rotavirus infection and intussusception: a view from retrospect.Microbiol Immunol. 2000; 44: 619-628
- Role of the enteric nervous system in the fluid and electrolyte secretion of rotavirus diarrhea.Science. 2000; 287: 491-495
- Distribution of rotavirus VP7 serotypes and VP4 genotypes circulating in Sousse, Tunisia, from 1995 to 1999: emergence of natural human reassortants.J Clin Microbiol. 2000; 38: 3415-3419
- Evaluation of anatomic changes in young children with natural rotavirus infection: is intussusception biologically plausible.J Infect Dis. 2004; 189: 1382-1387
- Rotavirus infection enhances lipopolysaccharide-induced intussusception in a mouse model.J Virol. 2006; 80: 12377-12386
- Rotavirus vaccines.in: Plotkin S.A. Orenstein W.A. Vaccines. 3rd ed. Saunders, Philadelphia1999: 987-1005
- Hypertrophy, hyperplasia, and infectious virus in gut-associated lymphoid tissue of mice after oral inoculation with simian-human or bovine-human reassortant rotaviruses.J Infect Dis. 2001; 183: 1108-1111
- Evaluation of RIX4414, a live, attenuated rotavirus vaccine, in a randomized, double-blind, placebo controlled; phase 2 trial involving 2464 Singaporean infants.J Infect Dis. 2005; 192: S6-S16
- Update on rotavirus vaccines.Pediatr Infect Dis. 2005; 24: 947-952
Article info
Publication history
Accepted:
May 6,
2009
Received in revised form:
April 17,
2009
Received:
March 17,
2009
Identification
Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
