Intussusception is associated with the detection of adenovirus C, enterovirus B and rotavirus in a rotavirus vaccinated population

J Clin Virol. 2014 Dec;61(4):579-84. doi: 10.1016/j.jcv.2014.10.018. Epub 2014 Nov 4.

Abstract

Background: Intussusception, a condition where one segment of intestine invaginates into another, occurs predominantly in infants and young children. A number of potential causes have been identified including infectious agents and rotavirus vaccination. Following the introduction of rotavirus vaccination of infants in Western Australia, a laboratory surveillance programme testing notified intussusception cases for infectious agents was commenced. This led to a PCR-based study of the association between gastrointestinal viruses and intussusception.

Objectives: Conduct viral testing on stool samples from intussusception patients to determine viruses that may have an association with intussusception.

Study design: A retrospective case-control study was conducted using stool samples collected from children with intussusception (n=74) and matched controls (n=289) between 2008 and 2011. Samples were tested for rotavirus, norovirus, adenovirus, enterovirus, rhinovirus, astrovirus, parechovirus and bocavirus. Adenovirus, enterovirus and rhinovirus species were determined by DNA sequencing.

Results: Human adenovirus C was detected in significantly more cases than controls with 31/74 (41.9%) cases testing positive compared to 39/289 (13.49%) controls (OR=4.38, p<0.001). A significant difference was seen in Enterovirus B detections with 11/74 (14.9%) cases testing positive compared to 21/289 (7.3%) controls (OR=2.24, p=0.04). Rotavirus was detected in 7/74 (9.46%) cases and 11/289 (3.81%) controls, which was also a significant difference (OR=2.88, p=0.045).

Conclusions: Our results show that intussusception is associated with non-enteric adenovirus infections, and Enterovirus B infections. While a statistical association was seen with rotavirus and intussusception, we were not able to determine if this was related to vaccine strain or wild type rotavirus.

Keywords: Adenovirus; Enterovirus; Intussusception; Rotavirus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoviruses, Human / isolation & purification*
  • Case-Control Studies
  • Child, Preschool
  • Enterovirus B, Human / isolation & purification*
  • Feces / virology*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Intussusception / epidemiology*
  • Intussusception / virology*
  • Male
  • Polymerase Chain Reaction
  • Retrospective Studies
  • Rotavirus / isolation & purification*
  • Rotavirus Vaccines / administration & dosage
  • Rotavirus Vaccines / adverse effects*
  • Sequence Analysis, DNA
  • Western Australia

Substances

  • Rotavirus Vaccines