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Infectious Etiologies of Intussusception Among Children <2 Years Old in 4 Asian Countries

Eleanor Burnett1, Furqan Kabir2, Nguyen Van Trang3

  • 1Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

The Journal of Infectious Diseases
|November 23, 2019
PubMed

Insights

Adenovirus and human herpes virus 6 (HHV-6) are linked to intussusception in infants. This study found no association between wild-type rotavirus and intussusception, suggesting other viral infections may be key etiologies.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Epidemiology

Background:

  • Intussusception is a leading cause of bowel obstruction in infants, with unknown etiology in most cases.
  • Adenovirus has been previously associated with intussusception.
  • A slight increase in intussusception risk has been observed following rotavirus vaccination.

Purpose of the Study:

  • To evaluate infectious etiologies of intussusception in young children.
  • To investigate the association between specific pathogens and intussusception before rotavirus vaccine introduction.
  • To identify potential triggers for intussusception in a multi-country setting.

Main Methods:

  • A case-control study was conducted with 249 matched pairs of intussusception cases and hospital controls in Bangladesh, Nepal, Pakistan, and Vietnam.
  • Stool specimens were analyzed for 37 infectious agents using TaqMan Array technology.
  • Conditional logistic regression was employed to determine the odds ratios (OR) and 95% confidence intervals (CI) for pathogen-associated intussusception.

Main Results:

  • Adenovirus (OR, 2.67; 95% CI, 1.75-4.36) and human herpes virus 6 (HHV-6) (OR, 3.50; 95% CI, 1.15-10.63) were significantly more frequent in intussusception cases.
  • Detection of Adenovirus C with low quantification cycles (<20) showed a strong association with intussusception (OR, 18.59; 95% CI, 2.45-140.89).
  • Wild-type rotavirus did not demonstrate a significant association with intussusception (OR, 1.07; 95% CI, 0.52-2.22).

Conclusions:

  • Adenovirus and HHV-6 are identified as significant infectious agents associated with infant intussusception.
  • The findings suggest that viral infections, beyond rotavirus, play a crucial role in the etiology of intussusception.
  • Further research is warranted to elucidate the mechanisms underlying intussusception, especially in the context of rotavirus vaccination programs.
Abstract

Keywords:
adenovirusintestinal obstructionintussusceptionrotavirusviral pathogens

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