Lack of association between rotavirus infection and intussusception: implications for use of attenuated rotavirus vaccines
- PMID: 11840074
- DOI: 10.1097/00006454-200202000-00003
Lack of association between rotavirus infection and intussusception: implications for use of attenuated rotavirus vaccines
Abstract
Background: Withdrawal of the tetravalent rhesus-human rotavirus vaccine Rotashield because of its association with intussusception raised concerns about a potential link between natural rotavirus disease and intussusception. Our objective was to determine whether such an association exists.
Methods: In the Southern California Kaiser Permanente Health Care Plan, a large health maintenance organization, from October, 1992, to July, 1999, we retrospectively identified by computerized data and medical charts all children <3 years old with intussusception, and from 1997 to 1999 we independently identified by prospective clinical and laboratory evaluation children <3 years old with rotavirus diarrhea. We compared the epidemiologic characteristics of intussusception and rotavirus infection in our study population and evaluated for the presence of both diseases in individual patients.
Results: Using computerized data we identified 124 cases of intussusception, 101 (81%) of which were confirmed by medical chart and radiologic reviews. The incidences for infants <1 year old and for children <3 years old were 41 (95% confidence interval, 32 to 55) and 17 (95% confidence interval, 13 to 20) per 100,000 child years, respectively. Between November 1997 and July 1999, we identified 470 cases of rotavirus diarrhea and none had intussusception. Although rotavirus diarrhea had a distinct peak incidence between December and February, intussusception had no apparent seasonality. The age distributions overlapped, but intussusception occurred at an earlier age than rotavirus disease.
Conclusions: We found no epidemiologic evidence for an association between intussusception and natural rotavirus infection, but our study was limited by an insufficient number of cases to definitively exclude a causal link. The dramatic winter peak of rotavirus disease had no discernable parallel in the incidence of intussusception. Our data suggest that the association between tetravalent rhesus-human rotavirus vaccine and intussusception may possibly result from the nonhuman rotavirus components of that vaccine.
Similar articles
-
Rotavirus infection and intussusception in Tunisian children: implications for use of attenuated rotavirus vaccines.J Pediatr Surg. 2009 Nov;44(11):2133-8. doi: 10.1016/j.jpedsurg.2009.05.003. J Pediatr Surg. 2009. PMID: 19944222
-
[Distribution signature analysis between intussusception and rotavirus diarrhea in young children].Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2008 Jun;22(3):216-8. Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi. 2008. PMID: 19031708 Chinese.
-
Analysis of hospitalizations due to intussusception in Sicily in the pre-rotavirus vaccination era (2003-2012).Ital J Pediatr. 2015 Aug 1;41:52. doi: 10.1186/s13052-015-0160-4. Ital J Pediatr. 2015. PMID: 26232152 Free PMC article.
-
Rotavirus vaccines and intussusception risk.Curr Opin Gastroenterol. 2005 Jan;21(1):20-5. Curr Opin Gastroenterol. 2005. PMID: 15687880 Review.
-
Rotavirus vaccine and intussusception. Where do we go from here?Infect Dis Clin North Am. 2001 Mar;15(1):189-207, x-xi. doi: 10.1016/s0891-5520(05)70275-0. Infect Dis Clin North Am. 2001. PMID: 11301815 Review.
Cited by 10 articles
-
Incidence of intussusception before and after the introduction of rotavirus vaccine in Korea.PLoS One. 2020 Aug 28;15(8):e0238185. doi: 10.1371/journal.pone.0238185. eCollection 2020. PLoS One. 2020. PMID: 32857776 Free PMC article.
-
Retrospective multicenter matched case-control study on the risk factors for intussusception in infants less than 1 year of age with a special focus on rotavirus vaccines - the German Intussusception Study.Hum Vaccin Immunother. 2020 Oct 2;16(10):2481-2494. doi: 10.1080/21645515.2020.1726679. Epub 2020 Apr 9. Hum Vaccin Immunother. 2020. PMID: 32271647 Free PMC article.
-
Incidence and risk factors for intussusception among children in northern Israel from 1992 to 2009: a retrospective study.BMC Pediatr. 2014 Aug 31;14:218. doi: 10.1186/1471-2431-14-218. BMC Pediatr. 2014. PMID: 25174640 Free PMC article.
-
Incidence of intussusception in Singaporean children aged less than 2 years: a hospital-based prospective study.BMC Pediatr. 2013 Oct 8;13:161. doi: 10.1186/1471-2431-13-161. BMC Pediatr. 2013. PMID: 24103115 Free PMC article.
-
Intussusception-associated hospitalisations in southern Germany.Eur J Pediatr. 2010 Dec;169(12):1487-93. doi: 10.1007/s00431-010-1248-x. Epub 2010 Jul 17. Eur J Pediatr. 2010. PMID: 20640443
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical