Rotavirus Infection and Intussusception: A View from Retrospect

Nakagomi, Toyoko

doi:10.1111/j.1348-0421.2000.tb02542.x

Cited by 43 publications

(21 citation statements)

References 49 publications

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“…12 Dr Nakagomi postulated that some strains, such as a G3 serotype, could induce intussusception whereas others may not. This finding might explain the yearly variation in the incidence of intussusception.…”

Section: Intussusception Pathogenesismentioning

confidence: 99%

Intussusception, Rotavirus, and Oral Vaccines: Summary of a Workshop

Peter

Myers²

2002

Pediatrics

140

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ABSTRACT. Rotavirus gastroenteritis continues to cause substantial morbidity and mortality worldwide, despite widespread breastfeeding and use of oral rehydration therapy. This burden of disease indicates that an effective, safe rotavirus vaccine is needed, and in 1998 the first rhesus-human reassortant rotavirus tetravalent vaccine, Rotashield, was licensed in the United States. However, the recommendations for its use were withdrawn in 1999 because of the recognition of an uncommon but serious adverse event, intussusception. A workshop in September 2001 was held to review the subsequent developments and research regarding this association, the proceedings of which are summarized here. Although the pathogenesis of this association remains unknown, epidemiologic evidence supports a causal relationship, with a population attributable risk of ϳ1 per 10 000 (range of 1 in 5000 to 1 in 12 000) vaccine recipients. Whether this association will exist with other candidate rotavirus vaccine strains and whether the attributable risk for intussusception would be similar in other populations administered this vaccine are unclear. Because perceptions of vaccine safety derive from the relative disease burdens of the illness prevented and adverse events induced, the acceptance of rare adverse events may vary substantially in different settings. Nevertheless, a continuing consensus on the need for a safe and effective vaccine to prevent rotavirus gastroenteritis, especially for use in developing countries, exists. Pediatrics 2002;110(6). URL: http://www. pediatrics.org/cgi/content/full/110/6/e67; intussusception, oral vaccines, rotavirus, rotavirus infection, rotavirus vaccines.

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Section: Intussusception Pathogenesismentioning

confidence: 99%

Intussusception, Rotavirus, and Oral Vaccines: Summary of a Workshop

Peter

Myers²

2002

Pediatrics

140

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Section: Introductionmentioning

confidence: 99%

“…It is a pediatric emergency in infants and shows a peak in occurrence in infants aged at 6-8 months with no apparent seasonality (1,2). This condition received much attention when a tetravalent rotavirus vaccine, RotaShield (Wyeth-Lederle Vaccines and Pediatrics) (3), was suspected to cause intussusception in approximately 1 in 10,000 vaccine recipients, resulting in the withdrawal of this vaccine from the market in the United States (2,(4)(5)(6). Consequently, large, phase III clinical trials, each recruiting more than 60,000 infants were conducted, and their results showed that two succeeding rotavirus vaccines, Rotarix (GlaxoSmithKline Biologicals, Rixensart, Belgium) and RotaTeq (Merck & Co., Whitehouse Station, N.J., USA), were safe with respect to intussusception (7,8).…”

Section: Introductionmentioning

confidence: 99%

Incidence of Intussusception as Studied from a Hospital-Based Retrospective Survey over a 10-Year Period (2001^|^ndash;2010) in Akita Prefecture, Japan

et al. 2012

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SUMMARY:One concern about rotavirus vaccines is its possible association with intussusception. Thus, it is necessary to determine the baseline incidence for intussusception in the first year of life in places where rotavirus vaccines are introduced. However, few safety data exist for the period at which the first dose of Rotarix and RotaTeq are allowed to administer in Japan. The first dose of Rotarix is scheduled to administer at 6-20 weeks of age and that of RotaTeq is scheduled to administer at 6-24 weeks of age; the upper limits for these vaccines is later than the upper limit recommended by the World Health Organization by 5 and 9 weeks, respectively. We performed a retrospective cross-sectional study by reviewing medical charts of all hospitals that provided pediatric beds in Akita Prefecture, Japan, and identifying the cases of intussusception that met the Brighton criteria level 1 in these hospitals between January 2001 and December 2010. During this 10-year period, 122 children younger than 1 year of age were diagnosed with intussusception. The incidence of intussusception was estimated at 158 per 100,000 person-years among children younger than 1 year (95z confidence interval, 131-188), 10 per 100,000 person-years for children aged 0-2 months, 165 for children aged 3-5 months, and 300 for children aged 6-8 months. This rapid and substantial increase in the incidence of intussusception during the first year of life should be considered when formulating the immunization schedule for administering rotavirus vaccines in Japan.

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“…Reviewing the electropherotype of intussusception causing rotaviruses, a hypothesis has been postulated that wild type G3 human rotaviruses may selectively cause intussusception in infants (19). Therefore, one might consider that intussusception is the particular complication of RRV or serotype G3 rotavirus.…”

Section: Discussionmentioning

confidence: 99%