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.

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Background: A licensed rotavirus vaccine was withdrawn from use because of an increased risk of intussusception.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.

Publication types

  • Comparative Study

MeSH terms

  • Age Distribution
  • Child
  • Child, Preschool
  • Comorbidity
  • Diarrhea, Infantile / complications*
  • Diarrhea, Infantile / epidemiology
  • Diarrhea, Infantile / prevention & control
  • Gastroenteritis / epidemiology
  • Gastroenteritis / prevention & control
  • Humans
  • Incidence
  • Infant
  • Intussusception / epidemiology
  • Intussusception / etiology*
  • Population Surveillance
  • Retrospective Studies
  • Risk Factors
  • Rotavirus Infections / epidemiology
  • Rotavirus Infections / prevention & control*
  • Rotavirus Vaccines / adverse effects*
  • Rotavirus Vaccines / therapeutic use
  • Safety-Based Drug Withdrawals / statistics & numerical data
  • Seasons
  • Sex Distribution
  • Tunisia / epidemiology
  • United States / epidemiology
  • Vaccines, Attenuated / adverse effects
  • Vaccines, Attenuated / therapeutic use

Substances

  • Rotavirus Vaccines
  • Vaccines, Attenuated