http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=11840074&form=6&db=m&dopt=r
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Pediatr Infect Dis J 2002 Feb;21(2):97-102 |
Books
Lack of association between rotavirus
infection and intussusception: implications for use of attenuated rotavirus
vaccines.
Chang EJ, Zangwill KM, Lee H, Ward JI.
UCLA Center for Vaccine Research, Torrance (EJC, KMZ, HL, JIW) and Southern
California Kaiser Permanente Health Care Plan, Pasadena (EJC), CA.
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.
PMID: 11840074 [PubMed - as supplied by publisher]
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