Lack of an Apparent Association Between Intussusception and Wild or Vaccine Rotavirus Infection

Rennels, Margaret B.; Parashar, Umesh D.; Holman, Robert C.; Lē, Chinh T.; Chang, Hwa-Gan; Glass, Roger I.

doi:10.1097/00006454-199810000-00018

Cited by 134 publications

(84 citation statements)

References 3 publications

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“…Male predominance, which is observed globally and in previous studies conducted in Asia (1), is reaffirmed in this study. No clear seasonality trend was observed in our study, which is consistent with reports from other studies (14,15). In this study, the classic triad of abdominal pain, vomiting, and rectal bleeding was not the typical clinical manifestations in the intussusception cases.…”

Section: Discussionsupporting

confidence: 92%

Retrospective Surveillance for Intussusception in Children Aged Less than Five Years in a South Indian Tertiary-care Hospital

Bhowmick

Kang

Bose

et al. 2009

J Health Popul Nutr

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To facilitate the assessment of the safety profile of rotavirus vaccines effectively, baseline data on intussusception are important for comparison with intussusception rates following the introduction of vaccine. The aim of the study was to describe epidemiological and clinical features of intussusception in children aged less than five years in an Indian medical facility. Hospital data on intussusception for children discharged during 1 January 2001-30 June 2004 from the Christian Medical College Hospital, Vellore, India, were reviewed. Relevant information was extracted from medical records to classify cases according to the criteria of the Brighton Collaboration Intussusception Working Group. Complete review of medical records for clinical and demographic information was only performed for those cases fulfilling level 1 diagnostic certainty (definite intussusception) (Study ID 101245). During the surveillance period, 31 infants and children with definite intussusception were identified. The majority (61.2%) of the cases occurred in the first year of life. The male : female ratio was 3.4 : 1. Intussusception cases occurred round the year with no distinct seasonality. No intussusception-associated death was recorded. This study provides baseline data on intussusception in South India. Cases identified in the study were similar in presentation and demographics as those observed in other Asian settings. Prospective surveillance systems, using standardized case definitions will further increase the understanding of the aetiology and epidemiology of intussusception, especially as new rotavirus vaccines are made available.

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Section: Discussionsupporting

confidence: 92%

Retrospective Surveillance for Intussusception in Children Aged Less than Five Years in a South Indian Tertiary-care Hospital

Bhowmick

Kang

Bose

et al. 2009

J Health Popul Nutr

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“…This may also explain why intussusception was seen shortly after vaccination with RRV-TV but is not believed to be associated with wild rotavirus. 7,11,34 …”

Section: Discussionmentioning

confidence: 99%

“…6 Over the entire vaccine-development program, 5 cases of intussusceptions were observed among 10 054 vaccinees, compared with 1 case among 4633 controls. 7 Although this difference was not statistically significant, it did result in specific admonition to continue postlicensure surveillance for intussusception and inclusion in the product label as a possible adverse event.…”

mentioning

confidence: 98%

An Analysis of Rotavirus Vaccine Reports to the Vaccine Adverse Event Reporting System: More Than Intussusception Alone?

et al. 2004

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ABSTRACT. Background. The rhesus-human rotavirus reassortant-tetravalent vaccine (RRV-TV) was licensed on August, 31, 1998, and subsequently recommended for routine infant immunizations in the United States. After ϳ1 million doses had been administered, an increase in acute risk of intussusception in vaccinees led to the suspension of the use of RRV-TV and its withdrawal from the market. These postmarketing safety studies focused on a single adverse event (intussusception) and, to minimize the risk of a false-positive finding, accepted only cases that met a strict case definition. Safer rotavirus vaccines are needed to prevent the substantial global morbidity and mortality caused by rotavirus infections; their development and future use may benefit from a better understanding of the postmarketing safety profile of RRV-TV beyond intussusception.Objective. To characterize more completely the postmarketing surveillance safety profile of RRV-TV more completely by review and analysis of Vaccine Adverse Event Reporting System (VAERS) case reports to better understand 1) whether severe adverse events other than intussusception may have occurred after RRV-TV and 2) the likely scope of gastrointestinal illnesses, of which the previously identified, highly specific intussusception cases may account for just a fraction.Setting and Participants. Infants vaccinated with RRV-TV and other vaccines in the United States and for whom a report was submitted to VAERS during September 1, 1998, to December 31, 1999.Methodology. To detect adverse events of interest other than intussusception, we used proportional morbidity analysis to compare the adverse event profile of VAERS reports among infants who received routine vaccines including RRV-TV (after excluding confirmed and suspected intussusception reports) with infants who received identical vaccine combinations but without RRV-TV. Next, to better capture all described diagnoses, signs, and symptoms associated with the suspected adverse events, a set of new codes was developed and assigned to each VAERS report. All 448 nonfatal RRV-TV-associated reports (including intussusception) were recoded manually from the clinical description on the VAERS report and categorized into clinical groups to better describe a spectrum of reported illnesses after the vaccine. Each report was assigned to one of the following hierarchical and mutually exclusive clinical groups: 1) diagnosed intussusception; 2) suspected intussusception; 3) illness consistent with either gastroenteritis or intussusception; 4) gastroenteritis; 5) other gastrointestinal diagnoses (ie, not consistent with intussusception or rotavirus-like gastroenteritis); and 6) nongastrointestinal diagnoses.Results. Even after excluding intussusception cases, a higher proportion of RRV-TV reports than non-RRV-TV reports included fever and various gastrointestinal symptoms, most notably bloody stool but also vomiting, diarrhea, abdominal pain, gastroenteritis, abnormal stool, and dehydration. R otavirus infection is the leading cause of ...

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“…A comprehensive review in 1998 concluded that those studies constituted insufficient evidence to conclude that rotavirus infection caused intussusception (9). Other studies were also unable to find an association between intussusception and natural rotavirus infection (4,(10)(11)(12).…”

Section: Rotavirus-associated Intussusception Followed By Spontaneousmentioning

confidence: 99%

“…Serotype was established by sequence identity search with BLAST. The VP4 gene was amplified with consensus primers con-2 and con-3 (15), and the P type was identified with genotype-specific primers for P [8], P [4], P [6] and P [9], as described previously with a few modifications as follows (16). For VP7 and VP4 gene amplification, reverse transcription polymerase chain reaction (RT-PCR) was done with AccessQuick RT-PCR (Promega Corporation; Madison, WI, USA).…”

Section: Case Reportmentioning

confidence: 99%

Rotavirus-associated intussusception followed by spontaneous resolution

Dallar

Bostancı²,

Bozdayı³

et al. 2009

Turk J Gastroenterol

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Lack of an Apparent Association Between Intussusception and Wild or Vaccine Rotavirus Infection

Cited by 134 publications

References 3 publications

Retrospective Surveillance for Intussusception in Children Aged Less than Five Years in a South Indian Tertiary-care Hospital

Retrospective Surveillance for Intussusception in Children Aged Less than Five Years in a South Indian Tertiary-care Hospital

An Analysis of Rotavirus Vaccine Reports to the Vaccine Adverse Event Reporting System: More Than Intussusception Alone?

Rotavirus-associated intussusception followed by spontaneous resolution

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