Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 2005 Jun 17;90(10):1077–1081. doi: 10.1136/adc.2005.074104

Intussusception and rotavirus associated hospitalisation in New Zealand

Y Chen 1, S Beasley 1, K Grimwood 1, t and 1
PMCID: PMC1720128  PMID: 15964860

Abstract

Aims: To describe the epidemiology of intussusception and its relation to rotavirus associated hospitalisation in New Zealand.

Methods: National hospital discharge data between January 1998 and June 2003 for all children younger than 3 years of age with intussusception were reviewed. Independently, children from the same age group, admitted to eight paediatric units with rotavirus gastroenteritis between May 1998 and May 2000, were identified prospectively. Epidemiological characteristics of cases with intussusception were compared with those of hospitalised rotavirus disease.

Results: During the 5.5 year study period, there were 277 cases of intussusception and no deaths. Most (72%) occurred in the first year of life (age adjusted incident rate 65 per 100 000 child-years, 95% CI 56 to 74). Risk of intussusception was less in females (risk ratio 0.58; 95% CI 0.43 to 0.78) and for Maori (risk ratio 0.52; 95% CI 0.35 to 0.77) when compared with European infants. In contrast to hospitalised rotavirus cases, intussusception peaked at a younger age and lacked seasonality.

Conclusions: This study provides national baseline data on intussusception for future rotavirus vaccine programmes in New Zealand. Wild-type rotaviruses do not appear to have a major role in triggering intussusception. Prospective surveillance systems, using standardised case definitions and nested case-control methodology, are needed to further our understanding of the aetiology and epidemiology of intussusception.

Full Text

The Full Text of this article is available as a PDF (76.6 KB).

Figure 1.

Figure 1

Open in a new tab

 Age distribution of hospitalised intussusception cases in New Zealand children less than 3 years of age, January 1988 to June 2003.

Figure 2.

Figure 2

Open in a new tab

 Age distribution for intussusception and rotavirus gastroenteritis hospitalisations in New Zealand children younger than 3 years of age.

Figure 3.

Figure 3

Open in a new tab

 Seasonal distribution of hospitalisation for intussusception and rotavirus disease in New Zealand children aged less than 3 years.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ardern-Holmes S. L., Lennon D., Pinnock R., Nicholson R., Graham D., Teele D., Schousboe M., Gillies M., Hollis B., Clarkin A. M. Trends in hospitalization and mortality from rotavirus disease in New Zealand infants. Pediatr Infect Dis J. 1999 Jul;18(7):614–619. doi: 10.1097/00006454-199907000-00009. [DOI] [PubMed] [Google Scholar]
  2. Bines Julie E., Ivanoff Bernard, Justice Frances, Mulholland Kim. Clinical case definition for the diagnosis of acute intussusception. J Pediatr Gastroenterol Nutr. 2004 Nov;39(5):511–518. doi: 10.1097/00005176-200411000-00012. [DOI] [PubMed] [Google Scholar]
  3. Chang Emily J., Zangwill Kenneth M., Lee Hang, Ward Joel I. Lack of association between rotavirus infection and intussusception: implications for use of attenuated rotavirus vaccines. Pediatr Infect Dis J. 2002 Feb;21(2):97–102. doi: 10.1097/00006454-200202000-00003. [DOI] [PubMed] [Google Scholar]
  4. Chang H. G., Smith P. F., Ackelsberg J., Morse D. L., Glass R. I. Intussusception, rotavirus diarrhea, and rotavirus vaccine use among children in New York state. Pediatrics. 2001 Jul;108(1):54–60. doi: 10.1542/peds.108.1.54. [DOI] [PubMed] [Google Scholar]
  5. Dennison W. M., Shaker M. Intussusception in infancy and childhood. Br J Surg. 1970 Sep;57(9):679–684. doi: 10.1002/bjs.1800570912. [DOI] [PubMed] [Google Scholar]
  6. Eshel G., Barr J., Heyman E., Tauber T., Klin B., Vinograd I., Starinsky R., Lahat E. Intussusception: a 9-year survey (1986-1995). J Pediatr Gastroenterol Nutr. 1997 Mar;24(3):253–256. doi: 10.1097/00005176-199703000-00004. [DOI] [PubMed] [Google Scholar]
  7. Fischer Thea Kølsen, Bihrmann Kristine, Perch Michael, Koch Anders, Wohlfahrt Jan, Kåre Mølbak, Melbye Mads. Intussusception in early childhood: a cohort study of 1.7 million children. Pediatrics. 2004 Sep;114(3):782–785. doi: 10.1542/peds.2004-0390. [DOI] [PubMed] [Google Scholar]
  8. Gay N., Ramsay M., Waight P. Rotavirus vaccination and intussusception. Lancet. 1999 Sep 11;354(9182):956–956. doi: 10.1016/S0140-6736(05)75710-X. [DOI] [PubMed] [Google Scholar]
  9. Glass Roger I., Bresee Joseph S., Parashar Umesh D., Jiang Baoming, Gentsch Jon. The future of rotavirus vaccines: a major setback leads to new opportunities. Lancet. 2004 May 8;363(9420):1547–1550. doi: 10.1016/S0140-6736(04)16155-2. [DOI] [PubMed] [Google Scholar]
  10. Guarner Jeannette, de Leon-Bojorge Beatriz, Lopez-Corella Eduardo, Ferebee-Harris Tara, Gooding Linda, Garnett C. T., Shieh Wun-Ju, Dawson Jacqueline, Erdman Dean, Zaki Sherif R. Intestinal intussusception associated with adenovirus infection in Mexican children. Am J Clin Pathol. 2003 Dec;120(6):845–850. doi: 10.1309/LBRN-GF9M-JW2M-HT97. [DOI] [PubMed] [Google Scholar]
  11. Hsu H. Y., Kao C. L., Huang L. M., Ni Y. H., Lai H. S., Lin F. Y., Chang M. H. Viral etiology of intussusception in Taiwanese childhood. Pediatr Infect Dis J. 1998 Oct;17(10):893–898. doi: 10.1097/00006454-199810000-00009. [DOI] [PubMed] [Google Scholar]
  12. Konno T., Suzuki H., Kutsuzawa T., Imai A., Katsushima N., Sakamoto M., Kitaoka S., Tsuboi R., Adachi M. Human rotavirus infection in infants and young children with intussusception. J Med Virol. 1978;2(3):265–269. doi: 10.1002/jmv.1890020310. [DOI] [PubMed] [Google Scholar]
  13. Kramarz P., France E. K., Destefano F., Black S. B., Shinefield H., Ward J. I., Chang E. J., Chen R. T., Shatin D., Hill J. Population-based study of rotavirus vaccination and intussusception. Pediatr Infect Dis J. 2001 Apr;20(4):410–416. doi: 10.1097/00006454-200104000-00008. [DOI] [PubMed] [Google Scholar]
  14. Mulcahy D. L., Kamath K. R., de Silva L. M., Hodges S., Carter I. W., Cloonan M. J. A two-part study of the aetiological role of rotavirus in intussusception. J Med Virol. 1982;9(1):51–55. doi: 10.1002/jmv.1890090108. [DOI] [PubMed] [Google Scholar]
  15. Murphy T. V., Gargiullo P. M., Massoudi M. S., Nelson D. B., Jumaan A. O., Okoro C. A., Zanardi L. R., Setia S., Fair E., LeBaron C. W. Intussusception among infants given an oral rotavirus vaccine. N Engl J Med. 2001 Feb 22;344(8):564–572. doi: 10.1056/NEJM200102223440804. [DOI] [PubMed] [Google Scholar]
  16. Nelson E. A. S., Tam John S., Glass Roger I., Parashar Umesh D., Fok Tai Fai. Incidence of rotavirus diarrhea and intussusception in Hong Kong using standardized hospital discharge data. Pediatr Infect Dis J. 2002 Jul;21(7):701–703. doi: 10.1097/00006454-200207000-00019. [DOI] [PubMed] [Google Scholar]
  17. Nicolas J. C., Ingrand D., Fortier B., Bricout F. A one-year virological survey of acute intussusception in childhood. J Med Virol. 1982;9(4):267–271. doi: 10.1002/jmv.1890090404. [DOI] [PubMed] [Google Scholar]
  18. O'Ryan Miguel, Lucero Yalda, Peña Alfredo, Valenzuela María Teresa. Two year review of intestinal intussusception in six large public hospitals of Santiago, Chile. Pediatr Infect Dis J. 2003 Aug;22(8):717–721. doi: 10.1097/01.inf.0000078374.82903.e8. [DOI] [PubMed] [Google Scholar]
  19. Parashar U. D., Holman R. C., Cummings K. C., Staggs N. W., Curns A. T., Zimmerman C. M., Kaufman S. F., Lewis J. E., Vugia D. J., Powell K. E. Trends in intussusception-associated hospitalizations and deaths among US infants. Pediatrics. 2000 Dec;106(6):1413–1421. doi: 10.1542/peds.106.6.1413. [DOI] [PubMed] [Google Scholar]
  20. Pérez-Schael Irene, Escalona Marisol, Salinas Belén, Materán Mercedes, Pérez María Egleé, González Germán. Intussusception-associated hospitalization among Venezuelan infants during 1998 through 2001: anticipating rotavirus vaccines. Pediatr Infect Dis J. 2003 Mar;22(3):234–239. doi: 10.1097/01.inf.0000055064.76457.f3. [DOI] [PubMed] [Google Scholar]
  21. Raudkivi P. J., Smith L. H. Intussusception: analysis of 98 cases. Br J Surg. 1981 Sep;68(9):645–648. doi: 10.1002/bjs.1800680912. [DOI] [PubMed] [Google Scholar]
  22. Reid R., Kulkarni M., Beasley S. The potential for improvement in outcome of children with intussusception in the South Island. N Z Med J. 2001 Oct 12;114(1141):441–443. [PubMed] [Google Scholar]
  23. Rennels M. B., Parashar U. D., Holman R. C., Le C. T., Chang H. G., Glass R. I. Lack of an apparent association between intussusception and wild or vaccine rotavirus infection. Pediatr Infect Dis J. 1998 Oct;17(10):924–925. doi: 10.1097/00006454-199810000-00018. [DOI] [PubMed] [Google Scholar]
  24. Roberts Leslie. Vaccines. Rotavirus vaccines' second chance. Science. 2004 Sep 24;305(5692):1890–1893. doi: 10.1126/science.305.5692.1890. [DOI] [PubMed] [Google Scholar]
  25. Robinson Christine G., Hernanz-Schulman Marta, Zhu Yuwei, Griffin Marie R., Gruber William, Edwards Kathryn M. Evaluation of anatomic changes in young children with natural rotavirus infection: is intussusception biologically plausible? J Infect Dis. 2004 Apr 2;189(8):1382–1387. doi: 10.1086/382655. [DOI] [PubMed] [Google Scholar]
  26. STRANG R. Intussusception in infancy and childhood; a review of 400 cases. Br J Surg. 1959 Mar;46(199):484–495. doi: 10.1002/bjs.18004619917. [DOI] [PubMed] [Google Scholar]
  27. Stringer M. D., Pablot S. M., Brereton R. J. Paediatric intussusception. Br J Surg. 1992 Sep;79(9):867–876. doi: 10.1002/bjs.1800790906. [DOI] [PubMed] [Google Scholar]
  28. Sáez-Llorens Xavier, Guevara Javier Nieto. Intussusception and rotavirus vaccines: what is the background risk? Pediatr Infect Dis J. 2004 Apr;23(4):363–365. doi: 10.1097/00006454-200404000-00020. [DOI] [PubMed] [Google Scholar]
  29. Velázquez F. Raúl, Luna Guillermina, Cedillo Roberto, Torres Javier, Muñoz Onofre. Natural rotavirus infection is not associated to intussusception in Mexican children. Pediatr Infect Dis J. 2004 Oct;23(10 Suppl):S173–S178. doi: 10.1097/01.inf.0000142467.50724.de. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES